Country: Kyrgyzstan

Project Name: Infant Young Child Nutrition (IYCN) / Micronutrient Powder (MNP)

Objective/Purposes:

• Design and implement a monitoring and evaluation (M & E) system for the IYCN/MNP program in Kyrgyzstan
• Design and implement an M & E system for the scaled-up nationwide IYCN/MNP program.

Background:

In Kyrgyzstan, anemia in preschool children has long been an important public health problem. The 1997 Demographic and Health Survey estimated a prevalence of anemia of 45% in children 6–36 months of age. Non-nationally representative studies undertaken since 1997 suggest that the prevalence of anemia has not declined, despite various campaigns that have included the distribution of iron syrups. In June 2009, the Kyrgyzstan Ministry of Health (MoH) launched a pilot Infant and Young Child Nutrition/ Micronutrient Powder (IYCN/MNP) program in the Talas Oblast to combat iron deficiency. The pilot program had two objectives: (1) improve breast feeding and complementary feeding practices through a network of Village Health Committees (VHCs) and, (2) to improve the micronutrient status of children 6 to 24 months of age through home fortification of complementary foods. Based on the success of the pilot program, in 2011the program was scaled up nationwide and the CDC is now assisting Kyrgyzstan with establishing a long term M & E plan.

Recent Achievements and/or key findings:

• 2008/2009 – Baseline survey and MNP (Gulazyk) distribution program began in Talas Oblast
• In 2010 a follow up survey was conducted, and in 2011 the Gulazyk program was scaled up nationally
• Statistically significant declines were observed from baseline to follow-up for prevalence of iron deficiency (62.0% to 53.2% as measured by ferritin, 71.0% to 46.8% as measured by sTFR) and iron deficiency anemia (45.5% to 33.4%)
• Kyrgyzstan is the 3rd country in the world with a nationwide MNP distribution program
• Two national surveys using Lot Quality Assurance Sampling (LQAS) methods were conducted to monitor the home fortification program in 2011 and 2012
• A national follow-up survey, including biomarkers and assessment of use of Gulazyk, was conducted in August 2013

Potential Impact:

The evaluation of the Talas pilot program shows that an integrated IYCN/MNP program can reduce anemia and iron deficiency in a large scale setting. Kyrgyzstan is being used globally as an example of a successful MNP program, as well as being documented as a successful bi-lateral collaboration between UNICEF and CDC.

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