Sprinkles to address childhood anemia and stunting

Headline Health

To address childhood anemia and stunting, the Ministry of Health, with support of UNICEF launched ‘Sprinkles’ – a micronutrient powder, which can be easily mixed at home to make food more nutritious for children. The powder will address childhood Iron Deficiency Anemia (IDA) and stunting.  

Sprinkles, a blend of 15 vitamins and minerals packed in one gram of sachet is essential for child health, growth, and development especially during the first 1,000 days – from conception until the child turns two years. Children in this age have increased nutritional needs and are at a higher risk of developing deficiencies. The nutrition which comes in a sachet is to be sprinkled with the meal and fed thrice a week for children up to 11 months and, twice a week for the children above one year up to 23 months.   

The National Nutrition Survey, 2015 found that two in five children were anemic, while one in five were stunted in Bhutan, a serious public health issue according to the World Health Organization.

Among the many causes, the main cause of child malnutrition in Bhutan is poor child feeding practices. The national survey found that almost nine in 10 children do not get the recommended diverse diet. When children’s diet lack sufficient quantities and variety of foods they are at risk of being anemic and stunted.

The increased burden of anemia and stunting, particularly among infants and children, calls for action, especially in view of the devastating impact on cognitive and motor development of an entire generation of children and the vast economic losses at present as well as in the future.

The objectives of the Sprinkles program are to help improve nutritional status of under-five children, particularly of those with childhood Iron Deficiency Anemia (IDA) and stunted, to increase knowledge and awareness among parents and health service providers about the importance of micronutrient containing food and adequate dietary intake, and to promote exclusive breastfeeding and proper complementary feeding of nutritious foods.

The Sprinkles program is a part of the “accelerating maternal and child health policy”, which is working on accelerating the health outcomes of all mothers and children in Bhutan.
Health Minister Dechen Wangmo said the ministry is confident that after successfully scaling up this program, the government would be able to make meaningful difference in the lives of children and families in Bhutan.

“We are on a task to finally break the intergenerational cycle of malnutrition,” the minister said. “By stopping child malnutrition in this generation, we will essentially be securing a healthy and productive future for our next generation,” she said.

The sprinkles program is an evidence-based and cost-effective intervention that will improve the quality of complementary food for children aged six months to two years. Health centers will distribute sprinkles when mothers and caregivers bring their child for routine growth monitoring. Micronutrient powders (MNP) are a mixture of vitamins and minerals, enclosed in single‐dose sachets, which are stirred into a child’s portion of food immediately before consumption. It has proven that the use of MNPs has significantly reduced the prevalence of anemia by 34% and IDA by 57%

UNICEF Representative, Dr Will Parks’ said UNICEF is happy to be part of this important effort that secures the wellbeing of children at a critical age.

“The introduction of sprinkles will bring immediate impact on child growth and development by improving the quality of complementary foods,” he said.

The sprinkles program was piloted in nine health centers in three dzongkhags of Samtse, Dagana and Mongar. An assessment of the program in these three dzongkhags found high user acceptability and compliance to the MNP. 

The interventions were successful in improving the infant and young child feeding practices and nutrition status of children aged six to 23 months.

Now all the health facilities in Samtse have sprinkles. Sprinkles will be available across the dzongkhags by June 2020.

Krishna Ghalley from Phuentsholing

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