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Paul Kato of Ntake Bakery and Company Limited, a wheat flour plant, adds fortificants to a dossier.
Photo Credit: SPRING

Large-scale food fortification (the addition of vitamins and minerals to foods and condiments), when appropriately designed and implemented, can be a high coverage, cost-effective, and efficient intervention strategy. For over 20 years, the Government of Malawi has implemented several nutrition programs, including fortification, to increase micronutrient intake. The Micronutrient Action Policy Support (MAPS) project, funded by the Bill & Melinda Gates Foundation, is working with partners in Malawi to use data in innovative ways to inform policies and programs that can address the underlying risk factors of micronutrient inadequacies—one of the causes of micronutrient deficiencies. Results suggest that strategies to reduce vitamin A and iodine inadequacies may be effective, but insufficient dietary supply of iron, zinc, riboflavin, and vitamin B12 still remain high, especially for the rural poor, despite the fortification of a number of foods. To tackle this issue, complementary interventions should be implemented and current MAPS studies are in the process of modeling the potential contributions and cost-effectiveness of these additional micronutrient interventions.

The Malawi Integrated Household Survey (IHS), routinely administered every 5 years, is one source of data integral to this modelling work. The data from this survey help fill an important information gap by providing proxy measures for food consumption and nutrient intakes. During this webinar, panelists shared the results of an analysis of the Fourth Malawi IHS, or IHS4, conducted by USAID Advancing Nutrition and MAPS. They also reflected on the findings as they relate to the MAPS project overall, USAID’s efforts to support context-specific approaches to improving nutrient intake, and efforts in Malawi to bolster support for national and local-level decision-making aimed at decreasing nutrient deficiencies.

Speakers also described novel and simple methodologies for the secondary analysis of IHS data and similar Household Consumption and Expenditure Surveys (HCES), as those provide opportunities to make deductions at the national level and at different population strata (geographic, economic-wealth, and others), in a short period of time and at a very low cost.

 

Jennifer Yourkavitch (moderator) is the Director of Monitoring, Evaluation, and Learning at USAID Advancing Nutrition. She leads and provides strategic direction to a broad range of activities in the USAID Advancing Nutrition portfolio that focus on or involve key aspects of monitoring, evaluation, and learning. Jennifer is a perinatal and pediatric epidemiologist and lactation consultant who has authored articles and technical publications on global health issues, including health and nutrition equity in low- and middle-income countries, and led several quantitative and qualitative studies on maternal and child health and nutrition. She is also a Research Scientist at the University of North Carolina, Greensboro, holds an adjunct position at the University of North Carolina, Chapel Hill, and serves as an Academic Editor for child health at PLoS One.

Kevin Tang is a PhD candidate in Epidemiology and Population Health at the London School of Hygiene and Tropical Medicine, where he contributes to computational research that combines epidemiological, econometric, and geostatistical methods to understand food system drivers of undernutrition. Kevin's areas of expertise include micronutrient undernutrition, nutrition equity, mathematical modeling, dietary assessment, large-scale household surveys, and food fortification. He has worked as an epidemiologist with Doctors Without Borders in the Democratic Republic of the Congo and Niger, and served as a Peace Corps Volunteer in Cameroon.

Louise Ander leads the MAPS project and is based at the School of Biosciences, University of Nottingham, UK. She has a background in managing and combining environmental spatial datasets to understand links between the environment and nutrition, with a specialization in geochemical data. Her research includes long-standing partnerships with colleagues in Malawi, including Alexander Kalimbira, investigating mineral micronutrient deficiencies. She has a split institutional role, and is also a geochemist in the Centre for Environmental Geochemistry at the British Geological Survey, UK.

Omar Dary >serves as a Nutrition Science Specialist in the Bureau for Global Health at the U.S. Agency for International Development (USAID). He has worked in public health nutrition from basic research to strategic planning at national and global levels. His major areas of expertise are micronutrient assessment and food fortification, and he has been involved in food analysis, nutrition surveillance, food and nutrient intakes and biomarker interpretation for the design, implementation, monitoring and evaluation of specific nutritional interventions. He has been an advisor to many international organizations such as WHO, UNICEF, WFP, and FAO, and has provided technical assistance to more than 45 countries. He is a current or past member of several international consultative groups for micronutrient nutrition.

Alexander Kalimbira is an Associate Professor and Head of the Department of Human Nutrition and Health at Lilongwe University of Agriculture and Natural Resources (LUANAR). His research mainly focuses on child growth, adolescent nutrition, micronutrient nutrition, and diet-related non-communicable diseases, with particular emphasis on determinants and behaviour change issues in the Malawian context. He is the LUANAR lead for the MAPS project in Malawi.

Gareth Osman is a Human Nutritionist and Family Scientist with a special interest in improving child and maternal nutrition. As a specialist in human nutrition, he has extensive experience in program implementation, monitoring and evaluation, as well as competencies in dietary assessments, nutrition status assessments, nutrition education and food analysis. He is also proficient in multiple analytical packages (predominantly R software for statistical computing). Gareth is currently a nutritionist at Lilongwe University of Agriculture and Natural Resources Department of Human Nutrition and Health, where he is working on the MAPS Project. He is integrating and analyzing HCES data, landscaping biomarker data, and co-designing the MAPS tool.