MI Bangladesh is having great success saving and improving lives, working with the Government and other partners through targeted action in micronutrient programming.
MI Bangladesh helps sustain high vitamin A supplementation coverage and advocates to lower the age for the first dose of vitamin A from 9 to 6 months. Our other priorities include:
- advocate to include hard-to-reach and newborn vitamin A supplementation within the national program
- with partners, scales up zinc supplementation, combined with oral rehydration salts, to treat diarrhoea in children
- increase the amount and quality of iodized salt being produced and to increase the percentage of iodized salt being consumed at the household level
- increase the number of women receiving iron and folic acid supplements
- increase access to double fortified salt
- 99% coverage of children 9-59 months with two doses of vitamin A through the National Vitamin A Plus Campaigns in 2010.
- Hard-to-reach approach for 11 districts now included in the national vitamin A program and 0.42 million hard-to-reach children reached with vitamin A supplementation in 2010.
- Increased salt iodization capacity by an additional 277,000 MT in 2014, with goal to supply an additional 69 million people with iodized salt.
MI, in collaboration with UNICEF, continues to support twice-yearly vitamin A supplementation. Through the National Vitamin A Plus Campaigns, children 12-59 months receive a twice-yearly dose, while the first dose for infants 9-11 months is given along with measles vaccinations during National Immunisation Days. In 2010, MI successfully advocated for including a hard-to-reach approach within the national vitamin A supplementation program and decreasing the age of dosing to 6 months. MI provided targeted support to 36 Hard-to-Reach sub-districts (upazillas) in nine districts of Nepal.
Since 2004, the Government of Bangladesh has secured funds and procured its own supply of vitamin A capsules. This is an important part of in-country ownership and sustainability of this child survival program.
Newborn Vitamin A Supplementation
Clinical research has suggested that giving newborns a single lower dose of vitamin A (50,000 IU) within the first two days of life may reduce infant mortality by 20%. MI, in partnership with the Government of Bangladesh, A2Z, AED, USAID and UNICEF, supported operational research in Bangladesh examining the feasibility of newborn vitamin A supplementation. This pilot project tested different newborn vitamin A delivery mechanisms.
MI is leading a zinc supplementation demonstration project to support the government´s efforts to scale up the use of zinc through the Primary Health System. This three-year project aims to see an increase in the coverage of the zinc and oral rehydration salts for the treatment of diarrhoea in two districts and compliance to at least 50%.
MI is supporting the Ministry of Industries’ Control of Iodine Deficiency Disorders project, under the Bangladesh Small and Cottage Industries Corporation (BSCIC), to increase household coverage of adequately iodized salt. MI refurbished 200 salt iodization plants, upgraded eight government salt testing laboratories and supported private salt millers in setting up salt testing laboratories.
MI is also working with UNICEF, GAIN and BSCIC on an operational strategy to make the purchase and management of potassium iodate financially sustainable.
New Technologies to Increase Salt Iodization
As Bangladesh has a number of small-scale salt producer across the country, MI developed the geographic information system-based Salt Industries Information System software. Known simply as GSIIS, the software contains data on salt production, a brief about the salt factories and their owners, and data on the quality of iodized salt, average sales and distribution by wholesalers. The GSIIS is used to plan interventions with individual salt processors.
MI also developed the user-friendly Bangladesh Salt Iodization Information System – BSIIS – software to analyze salt iodization-related data.
Double Fortified Salt
MI signed a Memorandum of Understanding with Confidence Salt Ltd. to introduce salt fortified with iodine and iron to deficient populations through commercial channels in the Bangladesh market. MI is providing Confidence Salt with technical support and assisting them with double fortified salt information sharing, quality control and procurement procedures and training. Confidence Salt launched double fortified salt in November 2011.
Iron and Folic Acid Supplementation
MI initiated a situational analysis of Bangladesh’s iron and folic acid (IFA) supplementation program in consultation with the government and stakeholders.
MI will help demonstrate an effective three-year program model for increased iron and folic acid supplementation coverage and compliance. The project was initially implemented through the existing health infrastructure, among pregnant women in two districts over two years.
Since 2011, MI has supported sub-national IFA programs in Bangladesh, now in four districts – Narsingdhi, Satkhira, Narail and Narayanganj. The objective is to increase the number of pregnant women who receive IFA and take it daily.
This demonstration project involves planning meetings with upazillas (villages), improving the supply chain for IFA, developing behaviour change interventions to improve awareness and uptake, and strengthening the program monitoring systems. Already, progress is clear – coverage of the IFA program has gone from 51% in 2011 to 83% in 2013.