SPRINKLES!

Part of phase 3 for the Sprinkles Project finally happened this week after many weeks of delays. It is so exciting to see everything taking place after anticipating it for many weeks. Before I let you know what I’m doing, let me tell you a bit about the project.

What is Sprinkles?

Sprinkles is an “in-home fortification” micronutrient powder (MNP) which is an alternative method used to fight micronutrient deficiencies in many part of the world including Nepal, Kenya, Ghana, Haiti, Bangladesh, Philippines and Mongolia. Sprinkles is known as an effective treatment in preventing anaemia in young children between 6 and 24 months. It is not a “stand-alone intervention” but it is part of the infant and young child feeding practices which is recommended by the WHO in regions where the prevalence of anaemia is high and iron-fortified foods are not affordable or available.

Sprinkles does not just contain iron, but it also contains 15 other vitamins and minerals including Vitamin C, folic acid, Vitamin A, Vitamin D Zinc and others. It is stored in a small sachet (similar to sugar) and mothers are supposed to sprinkle it to the semi-solid foods of the babies. The packaging and the name of sprinkles is catered to each country. In Rwanda, it is called Ongera Intungamubiri and we haven’t seen the packaging yet!

Why Sprinkles in Rwanda?

Rwanda is very committed to reducing malnutrition and there are national efforts to “eliminate” malnutrition (Vision 2020 and NSEM). The nutritional status still remains poor especially among infants. The sprinkles project is aimed at contributing to government initiatives, targeting children between 6 months and 11 months, in order to reduce malnutrition with a focus on nutritional anaemia. The funding organizations for this project are UNICEF, CONCERN & WORLD VISION. 

~The Missing Ingredient~

Phase 1 involved formative work and identified the current knowledge, attitudes, beliefs and practices around infant and young child feeding practices in two different districts. They explored these topics in order to find out if Sprinkles would be a feasible option and to find out what kind of naming and packaging would be the most suitable for the Rwandan context.

Phase 2 was a pre-test to evaluate the acceptability of In-Home Fortification with MNP in 60 households in two districts and use the results of the trial to finalize the procedures for phase 3. 

Phase 3, or the current phase, involves the distribution of the MNPs and to test the effectiveness in the 4 districts (Nyaruguru, Nyamagabe, Musanze and Burera). The children in Nyaruguru and Musanze will be receiving the Sprinkles while the participants in Nyamagabe and Burera are comparison districts (or not getting Sprinkles. There is a baseline questionnaire and then another questionnaire again in 6 months to test the effectiveness of Sprinkles. In addition to the questionnaires (regarding hygiene and sanitation, infant and young child feeding (IYCF) practices, mother's knowledge and attitude and household food security), anthropometric measurements (mid-upper-arm circumference, weight, length) and biochemical assessments (haemoglobin level) are also being taken. 

For measuring haemoglobin level 

Measuring the length of the baby...the toughest job when they're kicking and screaming. Sometimes you need 4 people to measure one baby!

MUAC measurement tapes

I just wanted to update you all. My internet usage has been fluctuating quite a bit because of field work and the internet is either too slow or non-existent. I'll have another blog post up soon about the work we're doing in the field.