Micronutrients are substances only needed in miniscule amounts but that are essential for our bodies to produce enzymes, hormones, and other substances fundamental to growth and development.[i] The recently published 2016 Global Nutrition Report calls for an end of all forms of malnutrition by 2030, which includes micronutrient deficiencies, namely in vitamin A, zinc, iron, iodine, and folic acid. These deficiencies affect approximately 2 billion people annually, with children being a particularly vulnerable group.[ii] At least half of children worldwide ages 6 months to 5 years have diets deficient in one or more micronutrients.[iii] The CHMI database catalogues 36 programs working to address micronutrient deficiencies through innovative fortification and distribution approaches.
Globally, 1 in 6 pregnant women and 1 in 3 preschool-aged children suffer from inadequate vitamin A intake. Deficiencies in Vitamin A have particularly negative consequences on children, who can face an increased risk of blindness and death from measles and diarrhea, when lacking this micronutrient.[iv]
In Madagascar, Elimentaire Sarl works to prevent vitamin A deficiency by selling a powder food additive from local Moringa trees at markets. The powder contains essential nutrients including vitamins A and C, calcium, potassium, and proteins and is sold to the bottom of the pyramid. The program is working to expand their distribution efforts to food companies, local NGOs, and the government to be included in school meals and baby food.
Zinc supplements have been shown to reduce incidences of premature birth, childhood diarrhea and respiratory infections, and all-cause mortality while increasing growth and weight gain among infants and young children.[v]
ColaLife is combatting zinc deficiency through their innovations in distribution and delivery. After noticing the barrier to delivering essential medicines to remote locations in Zambia, ColaLife partnered with Coca-Cola to make use of their distribution chain. Popularized by fitting their AidPod container in the unused space of drink crates, ColaLife has delivered micronutrient supplements, water purification tablets, and anti-diarrhea kits to inaccessible areas in their Kit Yamoyo. After seeing the kit was still “expensive” or “too expensive” for 42% of mothers in 2013, ColaLife redesigned their container to reduce manufacturing costs and increase affordability for their target populations. Now, Kit Yamoyo is distributed to smaller retailers, Shoprite stores, and Pharmanova pharmacies.
Iron deficiency leads to anemia, which affects 43% of children under 5 years of age and 38% of pregnant women. Anemia during pregnancy increases the risk of maternal and neonatal deaths, which together cause an estimated 2.5 to 3.4 million deaths worldwide.[vi]
The Management of Malnutrition Program of the Biocon Foundation distributes iron and other nutrient supplements to malnourished children under 5 during monthly check-ups at 389 anganwadis (child health centers) in Bagalkot, India. Additionally, the program offers discussion groups and workshops for caregivers on malnutrition prevention and nutrition education. Management of Malnutrition focuses on severe acute malnourished (SAM) children by conducting regular follow-up appointments, providing supplements for 6 months, and educating parents to prevent these children from returning to SAM from moderately malnourished.
The Nyando Integrated Child Health and Education (NICHE) Project relies on community-based distribution of health products through community vendors to reduce high rates of childhood diseases in western Kenya. NICHE distributes Sprinkles™, single-serve packets of dry powder containing iron and other micronutrients intended for home fortification for children no longer exclusively breastfeeding. NICHE uses inexpensive, locally-available interventions to reduce costs and increase the sustainability of the program.
Iodine is particularly important for fetal brain and cognitive development. In fact, average IQ is shown to be 13 points higher on average in communities where iodine intake is sufficient compared to iodine-deficient communities.[vii]
Annapurna Iodized Salt is the result of a partnership between Unilever, Ghana Ministry of Health, and UNICEF to reduce iodine deficiency and improve MNCH. Unilever works with local companies to streamline production and distribution, minimize costs, ensure affordability, and create local manufacturer and distribution jobs through the production of iodized salt. Delivery mechanisms are tailored to each locale, but a microcredit program with a local bank allows local Ghanaian women to sell the salt at markets. In addition to these production and retail components, Annapurna also has an education component that works to change mindsets and eating habits through awareness campaigns and programs in rural schools.
Although micronutrients do not comprise a large component of a healthy diet, they are an essential component to reducing disease burden and mortality. CHMI will continue to profile programs working to end all forms of malnutrition including micronutrient-related malnutrition.
Photo © Melanie Suter, Community Eye Health