The Use of Home Fortification Products in Humanitarian Settings: A Scoping Review.

Abstract

Home fortification products (HFPs), including multiple micronutrient powders and small-quantity lipid-based nutrient supplements, are specialized, nutrient-filled products added to foods with the aim of filling critical nutrient gaps. Despite their potential, there is limited documentation of the use of HFPs in humanitarian settings. The aim of this scoping review was to explore the evidence base and feasibility of implementing HFP programming in humanitarian settings specifically among young children 6-59 months of age and pregnant and lactating women. Electronic databases (PubMed, Embase, and CINAHL) were searched in December 2024, yielding 70 articles after duplicates were eliminated. Two research assistants independently selected articles that met inclusion criteria and analyzed them thematically. A total of eight studies (six quantitative, one qualitative, and one mixed methods) were included. The limited studies examined indicate that the use of HFPs is more feasible when carried out in the context of ongoing humanitarian programming, including general food distribution, growth monitoring, and behaviour change communication. Adherence and acceptability monitoring, along with sensitization and education efforts, also contributed to successful HFP programming. Hindering the use of HFPs were logistical issues, including delays in obtaining the products, sharing of HFPs across household members, and a lack of trust in both implementers and HFPs. HFPs appeared to have mixed results regarding improving health outcomes, such as growth, anaemia, and morbidities, though effects were difficult to isolate. Overall, this review demonstrates that HFPs are feasible to implement and potentially beneficial; however, more studies, including implementation research and effectiveness trials, are needed to better determine whether and how HFP programming should be implemented in humanitarian settings.