Improving Complementary Feeding: Assessing Public and Private Sector Business Models

A GAIN report on improving complementary feeding: assessing public and private sector business models with a compilation of evidence.

Context

This paper condenses evidence and learning from a portfolio of innovative private and public models that have sought to improve the consumption of nutrient dense and vitamin-rich and mineral-rich complementary foods in children 6 to 24 months of age alongside breastfeeding. The portfolio consists of a diverse set of 23 projects in 17 countries in Africa, Asia, and Latin America carried out over a 6 year period between 2008 and 2014. With an initial target reach of 20 million, by December 2014 a total of 19 million beneficiaries have been reached, and cumulative coverage is expected to be almost 25 million by the end of 2015.

Poor complementary feeding is a significant driver of malnutrition and infant and child mortality globally, with 3.1m annual child deaths due to malnutrition (45% of all deaths in children). Despite the considerable progress made over the past decades, millions of children are still affected by acute and chronic malnutrition and many more are suffering from some degree of sub-optimal health and/or development due to micronutrient deficiencies. A number of efficacious and proven interventions to improve dietary intake and reduce the risk of infection exist (Bhutta et al, 2013). Infant feeding, specifically exclusive breastfeeding through 6 months of age and continued breastfeeding through 2 years of age, with nutritionally adequate complementary foods introduced from 6 months of age (WHO, 2003), remains at the core of these interventions.

For a host of economic and social reasons, accessing locally available and culturally acceptable foods makes sense as the basis of the complementary diet for older infants and young children. Evidence suggests, however, that substantial constraints to ensuring a nutrient adequate diet exist due to ingredient availability and cost constraints. Even where economic barriers can be overcome, the adequacy of some nutrients may be difficult to achieve using only local ingredients (Osendarp et al, 2015). High-quality commercially produced fortified complementary foods or multi-nutrient supplements could help low-income families overcome some of these barriers if they are made available at low cost. A number of potential commercial and partly subsidized solutions to improve the quality of complementary foods have been developed during the past few years reaching middle-income target populations and low-income groups (that constitute part of the so-called Base of the Pyramid (BoP).