This HF-TAG programmatic guidance brief is intended to provide countries with further information in order to permit the appropriate contextualization of the WHO Guideline: Use of multiple micronutrient powders for home fortification of foods consumed by infants and children 6–23 months of age.  The need for this brief was highlighted in discussions at home fortification workshops organized by UNICEF, CDC and other partners in Bangkok, Mexico City, Dakar and Lusaka around programmatic issues and concerns shared by participants.  For example, one of the perceived gaps was how MNPs fit within larger programs aimed at improving nutrition in young children, for example, improving breastfeeding practices and nutrient density / micronutrient content of complementary foods.  



The HF-TAG programmatic guidance brief addresses the possible benefit of additional micronutrients and the provision of MNPs for longer periods, recognizing that such suggestions are based on the principles of good nutrition and not specifically on scientific evidence of impact on specific outcomes.  In this way the HF-TAG programmatic guidance brief is intended to build on the WHO guidance and provide countries with the tools that would permit the development of policies and programs that fit the local context.  HF-TAG believes that this brief augments the value of the WHO guidance by providing less restricted advice, more tailored to the programmatic circumstances of countries. 


In this way, the HF-TAG programmatic guidance brief builds on the 2011 WHO Guideline.  Scientific evidence of the impact of MNPs on nutritional outcomes beyond anemia and the cost-effectiveness of different supplementation schemes (e.g. dose, frequency, composition of the powder) is gradually accumulating.  The HF-TAG programmatic guidance brief is built on good nutrition principles and aims to support countries in the interpretation of the WHO guideline and its relevance for specific country settings.  This brief provides a number of suggestions for program design based on best available evidence and experience.


HF-TAG 2011