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Iron deficiency anaemia is estimated to be the leading cause of years lived with disability among children. Young children's diets are often inadequate in iron and other micronutrients, and provision of essential vitamin and minerals has long been recommended. With the limited programmatic success of iron drop/syrup interventions, interest in micronutrient powders (MNP) has increased. MNP are a mixture of vitamins and minerals, enclosed in single‐dose sachets, which are stirred into a child's portion of food immediately before consumption. MNP are an efficacious intervention for reducing iron deficiency anaemia and filling important nutrient gaps in children 6–23 months of age. As of 2014, 50 countries have implemented MNP programmes including 9 at a national level. This paper provides an overview of a 3‐paper series, based on findings from the "Micronutrient Powders Consultation: Lessons Learned for Operational Guidance" held by the USAID‐funded Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project. The objectives of the Consultation were to identify and summarize the most recent MNP programme experiences and lessons learned for operationalizing MNP for young children and prioritize an implementation research agenda. The Consultation was composed of 3 working groups that used the following methods: deliberations among 49 MNP programme implementers and experts, a review of published and grey literature, questionnaires, and key informant interviews, described in this overview. The following articles summarize findings in 3 broad programme areas: planning, implementation, and continual programme improvement. The papers also outline priorities for implementation research to inform improved operationalization of MNP.

Dryland soils provide different societal and environmental services, such as food supply and biodiversity support. In Europe, most of the dryland areas are devoted to agriculture. In the next decades, both European and worldwide drylands are expected to suffer with increased intensity due to the expected climate change-derived rise in aridity. Many studies have focussed on aridity-induced changes in major nutrients in drylands, but little is known of the impact of environmental and biogeochemical factors on micronutrients with critical roles in life, and as inorganic contaminants with ecotoxicological implications. We analysed and explored drivers of total and available concentrations of micronutrients (Co, Cu, Fe, Mo, Mn, Ni and Zn) and contaminants (As, Cd and Pb) in 148 soil samples collected from European drylands covering a wide range of aridity and of other geochemical parameters. The availability of micronutrients increased with their total content, decreased with pH and was enhanced by organic C content. Aridity decreased the availability of Fe, a key element in human diet. Our findings also highlight the scarcity of this micronutrient in European drylands, as well as of some other important micronutrients like Zn and Mo in agricultural soils. Total content was the main driver of the availability of Cd and Pb, and organic matter exerted synergistic effects on contaminant release. Our data show the need for precise management practices to be incentivised by agricultural and environmental policies in order to ensure micronutrient supply and avoid contamination, thus maintaining adequate levels of agricultural productivity and simultaneously preserving dryland ecosystems. Highlights: Drylands are important for food production in Europe and sensitive to climate change. The occurrence of metals in European Union dry soils and the drivers influencing them were studied. Some micronutrients (Fe, Mo and Zn) were scarce while contaminants were abundant. SOC, pH and clays were the main drivers of element availability; aridity reduced Fe. Agricultural practises are needed to ensure nutrient supply and prevent contamination ; We thank all the people involved in sampling soils for LUCAS soil database. This work was funded by a 2018 Leonardo Grant for Researchers and Cultural Creators of the Fundacion BBVA (Spain)

SummaryIn the Terai region, despite its ecological richness, the people have long suffered from a deficiency of micronutrients such as vitamin A, iron and zinc. The aim of this study was to investigate dietary and nutritional intakes among people in the Terai region of Nepal. The results were compared by sex and ethnicity. Food consumption surveys (one-day weighed records) were conducted among 114 people (55Musharand 59Tharu). Nutritional intakes were calculated using Nepali food composition and other tables. The diet in the Terai region was characterized by a large amount of rice consumed with a tiny amount of curry ordalas a side dish. Intakes of vitamin A, iron, riboflavin and selenium were less than 50% of the recommended daily allowance irrespective of ethnicity or sex (with the exception of iron intake amongTharumales). Intakes of thiamine, riboflavin, niacin, phosphorus and zinc were higher among theTharuthan theMushar, while intakes of selenium and iodine were higher among theMusharthan theTharu. The nutritional significance of these differences was slight. Protein intake (per kg body weight) was lower in females than in males, while the energy-adjusted micronutrient intakes did not differ by sex. Intakes of vitamin A, iron, riboflavin and selenium were deficient among the participants. Intervention projects such as the introduction of kitchen gardens or fish farming may be effective, but will increase the degree of inequality between the two ethnic groups.

Malnutrition, anemia, and micronutrient deficits may be associated with Enterobius vermicularis infection. Hence, the subject has recently received a lot of attention. The goal of this study was to analyse the nutritional, hematological and micronutrient status of children infected with E. vermicularis. This research was carried out in Baghdad from October 2021 to the end of March 2022. The study comprised 100 children of both sexes, ranging in age from 3-16 years. All individuals nutritional status was assessed using the weight-for-age Z score and the height-for-age Z score. As well as cellophane tape samples and blood samples were collected from all individuals. The cellophane tape samples were examined under microscope for E. vermicularis detection. Whereas blood samples were processed to assess many factors which were: haemoglobin, ferritin, total binding capacity (TIBC), serum iron, serum zinc and serum magnesium. Results revealed significant correlations between E. vermicularis infection occurrence and each of age and gender, even though most infections were noticed among females and among those who were between 3-9 years. The results also showed that the nutritional status, based on weight for age Z score, was significantly (P˂0.05) related to E. vermicularis occurence. Moreover haemoglobin, ferritin, serum iron, serum zinc and serum magnesium were noted to have significantly (P˂0.05) decreased among those who were E. vermicularis positive compared with E. vermicularis negative group. While total iron-binding capacity (TIBC) increased significantly among E. vermicularis positive children. The current investigation revealed that E. vermicularis infection had significant implications on several haematological elements, as well as stunting nutritional shortages. As a result, a lower prevalence of intestinal parasite infection (particularly enterobiasis) among children would almost certainly benefit their growth, development and educational outcomes.

Realistic planning for a nutrition intervention is a critical component of implementation, yet effective approaches have been poorly documented. Under the auspices of "The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance," 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powders (MNP) interventions for young children. This paper focuses on programmatic experiences in the planning stages of an MNP intervention, encompassing assessment, enabling environment and adaptation, as well as considerations for supply. Methods included a review of published and grey literature, key informant interviews, and deliberations throughout the consultation process. We found that assessments helped justify adopting an MNP intervention, but these assessments were often limited by their narrow scope and inadequate data. Establishing coordinating bodies and integrating MNP into existing policies and programmes have helped foster an enabling environment and support programme stability. Formative research and pilots have been used to adapt MNP interventions to specific contexts, but they have been insufficient to inform scale‐up. In terms of supply, most countries have opted to procure MNP through international suppliers, but this still requires understanding and navigating the local regulatory environment at the earliest stages of an intervention. Overall, these findings indicate that although some key planning and supply activities are generally undertaken, improvements are needed to plan for effective scale‐up. Much still needs to be learned on MNP planning, and we propose a set of research questions that require further investigation.

Micronutrient deficiency conditions are a major global public health problem. While the private sector has an important role in addressing this problem, the main responsibility lies with national governments, in cooperation with international agencies and donors. Mandatory fortification of basic foods provides a basic necessary intake for the majority and needs to be supported by provision of essential vitamin and mineral supplements for mothers and children and other high risk groups. Fortification by government mandate and regulation is essential with cooperation by private sector food manufacturers, and in the context of broader policies for poverty reduction, education and agricultural reform. Iron, iodine, vitamin A, vitamin B complex, folic acid, zinc, vitamin D and vitamin B12 are prime examples of international fortification experience achieved by proactive governmental nutrition policies. These are essential to achieve the Millennium Development Goals and their follow-up sustainable global health targets. National governmental policies for nutritional security and initiatives are essential to implement both food fortification and targeted supplementation policies to reduce the huge burden of micronutrient deficiency conditions in Southeast Asia and other parts of the world.

As part of a formative evaluation of a micronutrient powder (MNP) trial in Ethiopia that was organized according to a programme impact pathway model, we conducted in‐depth focused ethnographic interviews with caregivers of children between 6 and 23 months who had accepted to try "Desta," a locally branded MNP. After stratification into two subgroups by child age, respondents were randomly selected from lists of caregivers who had received MNP from government health workers between 1 and 3 months prior to the interview date. Thirty women who were either currently giving Desta to their child ("continuing users," n = 14) or had stopped feeding Desta ("noncontinuing users," n = 16) were purposefully recruited from both urban and rural areas in the two different regions where the trial was conducted. Interviews were recorded, transcribed and translated, and coded for both emerging and prespecified themes. On the basis of identifiable components in the caregiver adherence process, this paper focuses exclusively on factors that facilitated and inhibited "appropriate use" and "continued use." For "appropriate use," defined as the caregiver preparing and child consuming MNP as directed, we identified four common themes in caregiver narratives. With respect to "continued use," the caregiver providing and child consuming the minimum number of MNP sachets over a recommended time period, our interviews spontaneously elicited five themes. We also examined caregivers' perceptions related to problems in obtaining refills. Attention to caregivers' perspectives reflected in their narratives offers opportunities to improve MNP utilization in Ethiopia, with potential application in other social and cultural settings.