COMPLEMENTARY FOOD FOR AFRICA NEW PRODUCTS AND APPROACHES FOR IMPROVED CHILDHOOD NUTRITION

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1 COMPLEMENTARY FOOD FOR AFRICA NEW PRODUCTS AND APPROACHES FOR IMPROVED CHILDHOOD NUTRITION

2 Early Childhood Nutrition Study

3 Early Childhood Nutrition Study Study the acceptability and feasibility of a soyblend weaning food made with orange-fleshed sweet potato (aka ComFA) Enrolled 176 mother-infant pairs in northern Ghana Surveyed three ComFA formulations against Weanimix

4 ECN STUDY: Treatments and key nutrients Ingredient ComFA +Anchovies +Moringa WeaniMix OFSP 70% 70% 70% - Soy meal 30% 20% 25% 15% Anchovies - 10% - - Moringa - - 5% - Maize % Groundnuts % Energy kcal/100 g db Proteing/100 g db Iron mg/100 g db Vit A ug RAE/100 g db

5 Webinar Schedule 9:00am: Introduction: Soybean Innovation Lab Introduction & What is ComFA? 9:10am: Why was ComFA developed? The nutritional content and advantages of ComFA (Dr. Francis Amagloh) 9:15am: Experiences from the field: methods and challenges implementing the study (Mawuli Asigbee and Philip Atiim from CRS) 9:20am: Video footage from the study 9:30am: Relevance of acceptability and feasibility trials & ECN Study Results (Dr. Juan Andrade) 9:40am: Institutional Partnerships: How development agencies and research institutes can partner with SIL to improve early childhood nutrition in Africa 9:45am: Q&A

6 SIL Human Nutrition Objectives Expand the use of soybeans among diverse populations in low-income settings Increase soy integration into household diets by adapting diverse forms of soy to local cuisines and flavors through NGO-capacity trainings on food processing, food safety, and nutrition education Introduce soy to institutional feeding programs through food processing instruction, soy food supplier networking, and policy lobbying School Lunch Programs Support soy food enterprises through training on equipment use, food safety and packaging, marketing, FDA certification, and business development Increase production capacity of medium and large-scale soy processing plants to increase market availability of soy foods Increase the availability of soy foods on local markets

7 COMFA: OFSP-SOY BASED INFANT FOOD FOR AFRICA Francis Kweku Amagloh, PhD Department of Food Science and Technology University for Development Studies

8 Background Most common complementary foods (CFs) given to infants in Ghana are cereal-based Maize (white predominately), millet or sorghum To improve the energy and protein amount and quality, cereals are blended with legumes (soyabean, cowpea, and groundnut/peanut) Cereal and legumes are high in phytate Limits micronutrient bioavailability Maize and groundnut have greater risk of aflatoxin contamination Associated with micronutrient deficiencies and undernutrition (stunting and underweight) White maize and legumes are low in provitamin A 8

9 What is ComFA? Proportion on as-is basis per 1 kg. Values in grammes except for water Formulation OFSP Soy Anchovies Moringa Maize Groundnut Sugar Veggie Oil ComFA Water used (kg) ComFA + Anchovies ComFA + 5% Moringa Weanimix Preparation Peeling and dicing Roasting, dehulling & milling Breaking heads off & milling Shade drying & milling Roasting and Milling Roasting, dehulling and milling Add to pot Add to pot 9

10 Compositions of Weanimix Vs. ComFA, prepared at the household-level Compounds Weanimix ComFA Simple sugar (g/100 g) Maltose (g/100 g) Starch (g/100 g) Vit A (µg RAE/100 g) Ascorbic acid (g/100 g) ND 0.03 Phytate (g/100 g) Total polyphenols (g GAE/100 g) Amagloh, F. K., & Coad, J. (2014). Orange-fleshed sweet potato-based infant food is a better source of dietary vitamin A than a maize-legume blend as complementary food. Food and Nutrition Bulletin, 35(1),

11 ECN STUDY: % ingredient contribution to energy and key nutrients

12 Acceptability test scores of Weanimix & ComFA formulations Likert scale (1-3) Overall Liking Mothers accepted all ComFA formulations in the same degree as they accepted Weanimix ComFA ComFA+Anchovies ComFA+5% Moringa WeanMix Fig. 1.: Median scores for overall degree of liking by mothers of Weanimix and ComFA formulations in two communities in Northern Ghana. 12

13 Acceptability test scores of Weanimix & ComFA formulations 4 Perception of Mother on Child liking the product Likert scale (1-3) According to the mothers, ComFA with Anchovies and Moringa were perceived as less liked by children (p<0.01) 0 ComFA ComFA+Anchovies ComFA+5% Moringa WeanMix Fig. 2.: Median scores for overall degree of liking by child s as reported by their mothers of Weanimix and ComFA formulations in two communities in Northern Ghana. 13

14 Conclusions about ComFA ComFA is a nutritious and safe alternative CF for children in rural Ghana ComFA provides energy and a significant quota of vitamin A and quality protein ComFA is naturally sweet, reducing the need to add sugar ComFA is less susceptible to aflatoxin contamination, limiting its risk During preparation, ComFA requires less fuel and water, which could result in household savings. More research needs to be done at this point to evaluate how ComFA s essential nutrition can also be more cost effective. 14

15 Thank you Healthy, Happy Ghanaian kid 15

16 ECN SURVEY METHODOLOGY AND CHALLENGES Mawuli Asigbee Agriculture Program Manager Philip Atiim Agriculture Senior Program Officer

17 Sites selection (Geographical) Two (2) sites /district were selected across 2 regions. The choices were made based on factors that included the following: Districts are covered by CRS activities Districts have had nutrition related activity implemented for the purpose of continuity & building on successes. District have a health post/clinic to facilitate easy access to lactating mothers and support from health workers. Working in two (2) regions allowed for behavior evaluation between 2 ethnic groups GHS approval for the survey process facilitated by Dr. Amagloh. Region District Community Northern Tolon Yipeligu Upper East Talensi Awaradone

18 Enumerator Selection and Training 1. Eight (2m/6f) enumerators with CITI certification were selected. Four for each site. 2. Training for enumerators was conducted by Dr. Francis Amagloh in Tamale. 3. Enumerators had full understanding of concept and methodology. 4. District and community stakeholders were informed. 5. ECN survey posters (in English and local languages) produced and posted at health centers and community market squares to help recruit mothers

19 Participant Selection The mother infant-pairs were recruited from GHS Child Welfare Clinics (CWCs) in the 2 communities. For each district, 60 mother-infant pairs were purposively sampled and randomly grouped into four for the acceptability test while 40 mothers took part in a 2 week feasibility evaluation. The feasibility group prepared and fed their kids on all the 4 recipes while the acceptability group were given ration to take home for testing. Names of participants were written and a daily register marked to ensure that all mothers attended. Both categories were coached jointly on the survey purpose and process and their roles in the survey. This was after they had signed consent forms to participate at will.

20 Survey sessions 1. Community entry and sensitization with chiefs, elders, and members of the 2 communities preceded the survey. 2. Survey grounds selected with guidance by community elders. 3. Survey set up: grouping of enumerators, allocation of cooking utensils, plates and spoons, scales and ingredients were allocated to each of the groups. 4. Nursing mothers were divided into two categories for acceptability and feasibility evaluation. 5. Four groups of nursing mothers set up with 2 enumerators to prepare each of 4 recipes in rotation. 6. Focus group discussions were employed and resourced with interviewers and voice recorders to elicit, and document data and information.

21 Data collection The different formulations of ComFA and the control Weanimix were weighed, served out to mothers to feed the children. Data collected: feeding time quantity consumed by children remaining food Both feasibility and acceptability data was captured digitally on iforms builder software using ipads. This allowed all team members to have access to the daily data as they were inputted and uploaded.

22 Presentation of Hampers Brief community forums were held in each community to close the surveys. Community leaders and stakeholders (GHS Nutrition staff) were duly acknowledged for their support. Mothers were presented with hampers (rice, oil, mackerels, tomatoes) for their time and participation.

23 2 3 Challenges with Implementing the Study Difficulty in coordinating purchasing of logistics and ingredients by different partners Difficulty in understanding the quality and units in which some ingredients had to be procured and level of processing required (including specifications for materials, gadgets and utensils). Initial complains and lack of cooperation from some mothers due to length of time spent at each session. Future sessions may start in the afternoon when mothers would have finished fetching water and other household chores.

24 2 4 THANK YOU

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26 RELEVANCE OF ACCEPTABILITY AND FEASIBILITY TRIALS & ECN STUDY RESULTS Juan E. Andrade, Ph.D. Principal Investigator, SIL Human Nutrition Research Area Department of Food Science and Human Nutrition University of Illinois-Urbana-Champaign

27 Contribution of complementary foods to energy intake Energy Intake (Kcal/day) Complementary Foods (semi-fluid) Breast Milk (fluid) Family Foods (fluid, semi-solid, and solid) 6 months 24 months Exclusive Complementary Feeding breastfeeding Child Age Modified from WHO/NUT 98.1

28 Complementary foods: ACTS Key elements Adequate Nutrition, consistency, and palatability Context-specific Culture, demographics, season Timely Time of introduction and frequent Safe Physical, chemical and biological

29 Key Elements in Food Choices Cost Convenience Food Choices Taste Sensory acceptability and feasibility studies examine these aspects of a food Culture and personal beliefs Variety Well-being Kittler PG, Sucher KP. Food and Culture. 4 th ed. Belmont, California, Wadsworth/Thompson Learning, 2004

30 Feasibility Study Women (n = ~20/group), from two communities Yipelgu and Awaradone Women tested the different food products for 2 weeks. Day one: training Day two: follow up at home Day seven: food supply Day 14: focus groups Applied a semi-structured questionnaire, mixed open-ended and closed questions Focus groups lasted 1 hour

31 Feasibility study: women ratings in terms of ease of preparation Chi-square test of independence (χ2 = 7.06; P=0.07)

32 Feasibility study: mothers perceptions about the ease of consumption of project s products by their children Chi-square test of independence (χ2 = 3.377; P=0.33)

33 Feasibility Study: Women comments from focus groups 90% of participants would recommend new complementary products to their families. I would recommend because the ingredients are simple and available for easy adoption. - Participant from Yipelgu It is nutritious especially the soya beans added. -Participant from Awaradone Those who wont recommend (9%), mentioned the strong flavor of moringa or anchovies. I would recommend because wish all community member to benefit to help alleviate poverty. - Participant from Yipelgu

34 THE WAY FORWARD

35 Needs assessment / context SIL Model for Successful Complementary Nutrition Food and nutrient analysis Sensory Feasibility and cost Knowledge creation/sharing

36 THANK YOU! Q & A: Send in your questions using the chat box!