Nutrition

Lyndon Paul of Vissot Co Ltd in Cambodia will reduce production costs for their nutritional wafer biscuits, which are made from a micronutrient-fortified fish powder, to help treat severe acute malnutrition in children and prevent malnutrition in young children and pregnant women in Cambodia. Acute and chronic malnutrition are a major public health concern in Cambodia. They previously developed a fortified fish powder and showed that it could replace milk in food for infants and was effective at reducing malnutrition.

The project will scale-up distribution of the Lucky Iron Fish: an innovative, affordable, and clinically-proven solution to iron deficiency. The fish have a compliance rate of 90% and reduce the prevalence of iron deficiency by ~50%. We will integrate business, health care and university-based expertise to create a different service delivery and carry out research into the impact of the fish on iron status in women with HIV. We will promote an integrated approach that will change service delivery to some of the poorest people in urban areas including HIV positive women.

Salt is universally consumed at a constant, predictable level independently of social status. Our approach is to develop innovative technology for incorporating these micronutrients into salt at levels that can have a significant beneficial health effect. Our objective is to develop a stable premix in the laboratory, test its long-term stability in salt, and scale up the process for premix production in pilot scale tests in India.

This project will prevent neural tube defects in Nicaragua through fortification of rice - a staple food - with folic acid. We will support twelve early adopter rice mills that collectively produce 60% of rice in Nicaragua with training and equipment to enable local production of fortified rice, as well as a comprehensive branding campaign to promote the purchase and consumption of fortified rice. By establishing high consumer demand, high acceptability, and relatively low costs, the program will harvest market forces to drive sustainable production and consumption of fortified rice.

Lactoferrin, a safe, naturally occurring iron-binding protein found in high concentration in breast milk, offers an exciting new approach to correct iron deficiency early in pregnancy, prevent low birth weight, preterm delivery and reduce neonatal deaths. It has few side effects, facilitates absorption of iron, and reduces maternal inflammation to enhance the utilization of iron giving it the potential to rapidly restore iron status in pregnant women, even in populations with high burdens of infectious diseases.

We propose to develop a novel once-daily microencapsulated micronutrient powder containing iron, folic acid, and calcium (Prenatal Sprinkles) to overcome barriers to the integration of calcium into prenatal care in developing countries. If successful, our innovation - "differential time-release microencapsulation" - will mask the taste of iron and the gritty tongue-feel of calcium, and facilitate differential iron and calcium absorption.

Iron deficiency is a major contributor to maternal death. Improving the health of women through iron fortification of a universally consumed food vehicle will result in significant saving of lives at birth. Tea is universally consumed in South Asia; however, iron forms complexes in tea, reducing bioavailability, and thus thwarting earlier fortification attempts. Our approach will make tea viable as an iron fortification vehicle.

Günther Fink of Harvard School of Public Health in the U.S. will help parents to assess their child's development, thereby making them more likely to seek necessary treatment. They will test two strategies in a randomized controlled trial involving 600 children from Eastern Zambia. For one group, they will install life-size growth chart posters in selected households along with instructions for use and where to seek help if the child's height is below a critical level. For the other, they will arrange regular community meetings to measure children's heights and offer further advice.

Tanvir Huda of ICDDRB in Bangladesh will improve care and nutrition for pregnant women and young children by setting up a system whereby mobile phones are used to receive nutritional information and financial incentives for positive health-related behavior, such as attending clinics. They will perform a pilot study in Bangladesh by recruiting 350 pregnant women, providing them with mobile handsets, and establishing trained health workers who will send weekly nutritional advice and supply nutritional supplements.