Despite evidence from two recent, large surveys in Malawi that stunting rates are declining, more than 30 percent of children under five are still stunted, posing a threat for the long-term development prospects of the country. Most growth faltering in children occurs between the ages of 6 and 15 months, the time at which complementary foods (CF) are first meant to be introduced to children, in conjunction with breastfeeding. Providing safe and appropriate complementary foods is an urgent issue in Malawi, where infants are commonly fed maize and legume-based porridges. Although these porridges vary in content and quality, many are bulky with low nutrient density, low bioavailability of zinc and iron, and at risk of containing contaminants like pathogens and aflatoxin.
In a recent IFPRI Malawi Brown Bag seminar on 29 August 2018, Leland International Hunger Fellow Rachel Gilbert presented the methodology and preliminary results from an ongoing study of infant and young child feeding practices and fortified, premixed cereals in Central Malawi. The study, being carried out through Tufts University, used a market-intercept survey to elicit mothers' and caregivers’ willingness to pay for a range of locally-available fortified and premixed infant cereals. The study also looked at caregivers’ preferences for feeding their children more broadly, and the willingness to substitute fortified infant cereals for nutrient-poor maize-based porridges relative to nutrient-dense family foods. Key informant interviews with infant cereal producers and other policy actors related to standards for cereal-based infant foods were also conducted, along with the collection and testing of infant cereal samples for nutritional content and mycotoxin contamination.
Highlights from the presentation include:
- While nearly three-quarters of caregivers fed their infant a porridge made at home in the past 24 hours, only 12% of children had received a fortified, premixed porridge like likuni phala. When asked about the ideal diet for their infant, 52% of mothers said likuni phala would be included while 81% said a homemade porridge would be included.
- The average willingness to pay for infant cereals was lower than the observed supply cost for all products except Lunda Likuni Phala and Rab’s Sunshine Likuni Phala, two local brands, yet average willingness to pay was much higher for the foreign brand, Nestlé Cerelac.
- Knowledge about the impacts of mycotoxins on animals and in animal-source foods was particularly low among respondents.
- Only half of locally-produced infant cereals met current Malawi standards for aflatoxin (12.5 parts per billion), compared to 100 percent of foreign brands. Only 13 percent of local brands would have met the proposed, more stringent standard for high-protein cereal-based infant foods (0.1 ppb). Ten percent of all cereals had total aflatoxin levels above 20 ppb.
During the question and answer period, attendees were interested in tangible steps forward and policy recommendations. Among those discussed were third-party certification, additional funding for and better enforcement from Malawi Bureau of Standards, as well as an increased focus in nutrition programs about the potential impacts of aflatoxin on children's health. However, policy recommendations will be better informed once the analysis has been completed, and will be discussed during the dissemination of the final study results.
