This is a summary of lessons learned from the Zinc and Low-osmolarity Oral Rehydration Salts and Iron and Folic Acid Supplementation program (ZIFAS). ZIFAS aimed to scale up the provision and use of zinc and low-osmolarity Oral Rehydration Salts for the treatment of diarrhea in children under 5 and the uptake of Iron and Folic Acid Supplementation 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.
Key Results – zinc for children under 5:
- Over 390,000 more children under age 5 received diarrhea treatment
- 89% increase in the number of frontline health workers who are aware of the need to use zinc lo-ORS in diarrhea treatment
- 11.8% increase in the number of caregivers who can identify benefits of treating childhood diarrhea with zinc/lo-ORS in ZIFAS intervention states
Key Results – iron and folic acid supplementation for pregnant women:
- Reduction in anemia prevalence among targeted women
- Over a million more pregnant women received iron and folic acid supplementation
- Over 187,542 pregnant women received and reported to consume 90+ days of iron and folic acid supplementation
- 52% increase in the number of frontline health workers trained in the targeted states who can now correctly administer iron and folic acid supplementation
- 98% increase in the number of pregnant women counselled in targeted sates on the recommended iron and folic acid supplementation
Lessons learned from ZIFAS are:
- Building an existing systems and structures enables accelerated scale up and impact
- Harnessing and building political commitment and government leadership of program interventions requires sustained and long term commitment
- Enhancing coordination amongst partners is an effective way of sharing lessons and maximising impact and value for money of their activities
- Advocating for improved evidence generation is a critical factor for success and must be supported by adequate financial resources and time
- Working with religious leader is an effective dissemination mechanism for behaviour change communication and health messaging
The program 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.
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 was lead agency in the consortium managing the programme in partnership with NPHD, a Nigerian consultancy organisation.