The document discusses the Ghana Nutrition Improvement Project (GNIP), which aims to address infant malnutrition in Ghana by creating context-relevant complementary food supplements and enhancing caregiver knowledge on optimal infant nutrition. Key outcomes include improved nutrient density of food and demonstrated efficacy against stunting and iron-deficiency anemia. The project combines product development, social behavior-change communication, and market-based distribution to sustain nutrition improvements in the first 1,000 days of a child's life.

1. Sustaining Good Nutrition in the
First 1000 Days: The Synergy of Localization,
Advocacy and Markets
Kennedy Bomfeh, PhD
Director (Projects & Academic Affairs)
KOKO Plus Foundation LBG
kbomfeh@kokoplusfoundation.org
1

2. What we saw: The Problem
Ahead
What we did: The Project
What we found: The Results
What we propose: The Prospects

3. THE PROBLEM: INFANT NUTRITION SITUATION IN GHANA
Source: 2022
Demographic and
Health Survey;
Ghana Statistical
Service
28%

4. THE PROBLEM: INFANT NUTRITION SITUATION IN GHANA
Source: 2022
Demographic and
Health Survey;
Ghana Statistical
Service
78.3%

5. THE PROBLEM: INFANT NUTRITION SITUATION IN GHANA
Minimum Acceptable Diet
2009 2022
29.9%
12%
Source: 2022 Demographic
and Health Survey; Ghana
Statistical Service

6. Nutrition
deficiency
effects in the
“First 1,000
days”
are
irreversible

7. Effects of Malnutrition
Nutrition deficiency
effects in the “First
1,000 days”
are irreversible

8. THE PROJECT:
THE GHANA NUTRITION IMPROVEMENT PROJECT (GNIP)
A partnership to develop a context-relevant complementary food supplement to
support closure of the nutrition gap
COLLABORATORS
LEAD PARTNERS

9. GNIP APPROACH
PROBLEM
Infant and young child malnutrition
(especially stunting)
CAUSE
(nutrition-related)
SOLUTION
(GNIP input)
Caregivers’ nutrition
knowledge
Food availability and access
Inadequate intake of nutritious food
① Improve nutrient density of foods
➁ Enhance caregiver knowledge on infant nutrition
➂ Connect ① and ➁ sustainably by social business

10. GNIP APPROACH
SOLUTION
b) Efficacy trial
a) Product development
① Improve nutrient density
➁ Enhance caregiver knowledge on optimal
infant & young child nutrition
GHS Collaboration for SBC on optimal
complementary feeding
➂ Sustainability: Market-based distribution
GHS – Ghana Health Service
SBC – Social behaviour-change
communication

11. 1. Product type: Point-of-use supplement
2. Nutrition focus: stunting and iron-deficiency anaemia
3. Target age: from 6 months
4. Production: Localization (respect food culture,
strengthen local production systems)
(a) Use Local raw materials
(b) Add to Local traditional foods
(c) Produce in a Local factory
5. Ingredients: Soybean flour, lysine, palm olein, vitamin
and mineral premix
1a: PRODUCT DEVELOPMENT
Net weight: 15g/sachet
Intake: 1 sachet/day

12. Product impact on nutrient density
Nutrient % RNI met
Total energy 30%
Utilizable protein 60%
Lysine 56%
Iron 60%
Vitamin A 50%
Foil acid 50%
Riboflavin 63%
Thiamin 63%
Vitamin D 50%

13. Impact of KOKO Plus® on nutrient density
0
20
40
60
80
100
Vitamin E
Vitamin K
Vitamin B6
Vitamin B12
Vitamin C
Vitamin M(folic
acid)
Vitamin B3
Vitamin B2
Vitamin B5
Vitamin B1
Lysine score
PDCAAS*
Utilizable
protein(g)
PE Ratio
The nutritional composition of corn porridge (koko) and of koko
supplemented with KOKO Plus®, calculated as percentages of RNI
Corn porridge
Corn porridge+ KOKO Plus

14. 1a: PRODUCT DEVELOPMENT

15. 1b: EFFICACY STUDY
Lowest
prevalence of
stunting
Highest hemoglobin
levels
Lowest
prevalence of
acute infection
Infants who received KOKO Plus® had:
1 2 3

16. EFFICACY STUDY: FINDINGS PUBLISHED

17. GNIP APPROACH
SOLUTION
b) Efficacy trial
a) Product development
① Improve nutrient density
➁ Enhance caregiver knowledge on optimal
infant & young child nutrition
GHS Collaboration for SBC on optimal
complementary feeding
➂ Sustainability: Market-based distribution
GHS – Ghana Health Service
SBC – Social behaviour-change communication

18. SBC activities
- Nutrition education/counseling
- Cooking demonstrations
- Role play
Public
effort
Private
effort
Public private partnership
(PPP) for behaviour
change AND market-based
distribution
SBC
National
benefit
Beneficiary
response

19. Impact of SBC + market delivery
Purchase decision = proxy for nutrition knowledge

20. The distribution network of 11,639
shops in 152 districts (60% national
coverage)
2,785
2,880
823
629
769
593
457
276 1070
680
291
70
146
101
69
Market-based distribution
for sustainable gains
This is a strong and growing network
of distribution channels for market-
based delivery of PMNP for nutrition
improvement

21. GNIP Outcomes
1. Protein and micronutrients powder (PMNP)
developed based on WHO recommendations for
optimal IYCF
Product
Development
1
2. Demonstrated efficacy of PMNP against stunting, iron-
deficiency anaemia and acute infection
Product
Efficacy
2
3. advocacy for optimal feeding practices AND
establishment of local delivery systems for sustainability
SBC +
Market-based
delivery
3

22. GNIP Outcomes
Approved by the World Food Programme for
their Ghana Food Basket
2018

23. GNIP is a successful example of sustainable nutrition
improvement through a combination of:
1. science-based, context-driven nutritious food product development
2. social behavior-change communication (SBC) through public-private
partnership (PPP) for improved IYCF knowledge among caregivers
market-based distribution of the product for sustainability
PROSPECTS
1
2
3
It is a promising model for tackling nutrition challenges, especially in resource-limited contexts

24. Thank you
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