This final report from the Zinc and Low-osmolarity Oral Rehydration Salts and Iron and Folic Acid Supplementation programme (ZIFAS) provides an overview of the programme and final results. ZIFAS aimed to scale up the provision and use of zinc and low-osmolarity Oral Rehydration Salts (lo-ORS) for the treatment of diarrhea in children under 5 and the uptake of Iron and Folic Acid Supplementation (IFAS) for pregnant women in four states in northern Nigeria. ZIFAS built on the Partnership for Reviving Routine Immunisation/Maternal Newborn and Child Health’s (PRRINN/MNCH) program implementation structure and systems, working in the same four states, to develop and implement integrated strategies to achieve the program’s objectives. This facilitated significant scale up of nutrition interventions especially the utilization of zinc/lo-ORS and IFAS in four program states.
Lessons learned from ZIFAS are:
1. Building an existing systems and structures enables accelerated scale up and impact
2. Harnessing and building political commitment and government leadership of program interventions requires sustained and long term commitment
3. Enhancing coordination amongst partners is an effective way of sharing lessons and maximising impact and value for money of their activities
4. Advocating for improved evidence generation is a critical factor for success and must be supported by adequate financial resources and time
5. Working with religious leader is an effective dissemination mechanism for behaviour change communication and health messaging
The programme combined efforts in health systems strengthening, including commodity procurement and supply chain management, women’s empowerment and governance to provide a platform for improvements in nutrition. Achievements included:
• Increased coverage and utilisation of antenatal iron and IFAS
• Improved health workers’ awareness of zinc/lo-ORS in diarrhea management
• Zero stock-outs in IFAS commodities at health facilities
• Development of costed integrated annual health plans and medium term procurement plans that included ZIFAS commodities and health service interventions.
ZIFAS was a collaborative project between the Micronutrient Initiative, funded by the Government of Canada, through Global Affairs Canada, and PRRINN/MNCH, funded by UK aid from the UK government and the State Department of the Norwegian Government. HPI inwas lead agency in the consortium managing the programme in partnership with NPHD, a Nigerian consultancy organisation which undertook technical work for the contract.