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ORIGINAL RESEARCH article

Front. Nutr.
Sec. Nutrition and Sustainable Diets
Volume 11 - 2024 | doi: 10.3389/fnut.2024.1429526

Barriers and enablers in the micronutrient powder supply chain: lessons from a process evaluation of a home fortification programme in Bangladesh

Provisionally accepted
Md Fakhar Uddin Md Fakhar Uddin 1*Md Aminul Islam Md Aminul Islam 1Mahfuzur Rahman Mahfuzur Rahman 2Tahmeed Ahmed Tahmeed Ahmed 1Haribondhu Sarma Haribondhu Sarma 3
  • 1 International Centre for Diarrhoeal Disease Research (ICDDR), Dhaka, Bangladesh
  • 2 School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, Queensland, Australia
  • 3 National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, Australian Capital Territory, Australia

The final, formatted version of the article will be published soon.

    Background: Bangladesh Rural Advancement Committee (BRAC), a leading non-governmental organization (NGO), implemented a large-scale Home Fortification (HF) with Micronutrient Powder (MNP) programme from 2013 to 2018 aimed to reduce undernutrition and iron deficiency anemia among children aged below five years old. An adequate and timely supply of MNP was crucial for successful implementation of the programme, but very few studies have documented implementers' MNP supply chain experiences. Therefore, this study aimed to explore the barriers and enablers in the MNP supply chain in Bangladesh.We conducted this process evaluation in five rural sub-districts and three urban slums from March 2016 to February 2017. We conducted 15 Key Informant Interviews (KIIs) with HF programme personnel, 41 In-depth Interviews (IDIs) with direct HF programme implementers and reviewed relevant documents. We analyzed data using thematic and root-cause analysis approaches.Results: Participants reported the barriers in the MNP supply chain included lack of raw material for MNP production by local manufacturer, political unrest and insufficient transport facilities, a lack of space for MNP buffer stock at BRAC's central warehouse, and coordination gaps between BRAC's national and sub-national level staff. Enablers to each of the barriers mentioned include ensuring buffer stock at all levels, raising separate transport requisition for MNP supply, and recruiting dedicated supply chain officers.Concurrent course-corrections based on process evaluation findings improved MNP supply chain performance, resulting in higher MNP sales and coverage. The identified barriers and enablers provide useful insights for similar programs, emphasizing the importance of a resilient and well-managed MNP supply chain.

    Keywords: barriers, Enablers, Micronutrient powders, supply chain, Bangladesh

    Received: 08 May 2024; Accepted: 11 Dec 2024.

    Copyright: © 2024 Uddin, Islam, Rahman, Ahmed and Sarma. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Md Fakhar Uddin, International Centre for Diarrhoeal Disease Research (ICDDR), Dhaka, Bangladesh

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.