The Home Fortification Technical Advisory Group (HF-TAG) is a global network comprised of stakeholders engaged in home fortification including members from governmental, UN, NGO, private and academic sectors.
The HF-TAG’s vision is to reduce malnutrition among women and children through home fortification solutions designed to fill the nutrient gap. The group’s mission is to provide guidance and leadership by advocating and supporting well-designed, effective home fortification interventions at scale for children and women, based on sound technical guidance and best practices. By providing standards, guidelines, and technical resources to implementers of home fortification programs including government and their supporters, as well as producers of home fortification products, HF-TAG aims to address some of the most important barriers to home fortification and support improved delivery and scale up through both public and market-based channels.
The host of the HF-TAG Secretariat provides technical expertise to set the group’s strategy, is responsible to maintain the HF-TAG website, support working groups around priority topics, supports the creation of HF-TAG resources, facilitate conference calls and in-person meetings and coordinate the activities of the Executive Committee. GAIN, served as the Secretariat from the start of the HF-TAG in 2009 up until the end of 2014. SickKids Centre for Global Child Health (C-GCH) served as the Secretariat 2014-2020. Nutrition International (NI) now currently serves as the Secretariat. The Executive Committee is co-chaired by Nutrition International and UNICEF and includes individuals from US Centres for Disease Control (CDC), University of California Davis, World Food Program (WFP), Sight and Life, World Bank, and SickKids Centre for Global Child Health.
The HF-TAG website serves as a central, online hub for home fortification. By aggregating and connecting existing resources and building a shared space for discussion, the HF-TAG aims to increase the intra-sector and multi-sector collaboration necessary to improve nutrition and health outcomes. The HF-TAG is built on the principle of inclusion and expands home fortification information/guidance within the public domain. All guidance generated by HF-TAG is based on a review of evidence, consensus among technical partners as well as on best practice and experience with policy formulation and program implementation.
What is Home Fortification?
Home-fortification consists of adding specialized, nutrient-filled products such as multiple micronutrient powders (MNP) or food-based complementary food supplements (CFS) such as small-quantity lipid-based nutrient supplements (SQ-LNS) and full-fat soy flour (and soy protein isolate) with a vitamin-mineral mix to foods prepared at home.
Home fortification is used in situations where diets do not provide enough essential nutrients. While not limited to children 6-24 months of age, home fortification has a special role to play in infant and young child feeding (IYCF). Because unfortified cereal-based complementary foods generally do not supply enough essential nutrients such as vitamins, minerals, essential fatty acids, and/or other nutrients critical for optimal growth and development, home fortification products can supplement the complementary food and fill nutrient gaps, especially when access to sufficient nutrient-dense foods is limited. Home fortification empowers caregivers to improve the quality of the diet of individuals within the family by adding nutrients to locally available foods prepared at home or other settings such as daycare centers or schools.
The home fortification approach provides the flexibility to target specific ingredients and products to the needs of certain population groups, such as young children aged 6-23 or 6-59 months, school age children or pregnant or lactating women, who are at particular risk for inadequate nutrient intake. Specifically due to the relatively high nutrient needs to support the physical and cognitive development of the developing child, home fortification is an important intervention supported by WHO, The 1,000 Days Partnership and Scaling Up Nutrition (SUN) movement.
In the context of complementary feeding, home fortification does not require any change in how the usual soft, or semi-solid age-appropriate complementary foods are prepared, nor should it interrupt continued breastfeeding. Adding a sachet of powdered or lipid-based nutrients to the locally prepared complementary food once per day can be an easy solution.
Home fortification, if used correctly, does not conflict with breastfeeding or with a timely transition from exclusive breastfeeding to introduction of complementary foods at six months of age as recommended by the WHO. Moreover, the introduction of home fortification products to caregivers of infants and young children can be a great opportunity to reinforce messages on timely introduction of complementary food and continued breastfeeding to two years of age and beyond. Home fortification products come in measured doses that are safe to consume and easy to store and use. Distribution of home-fortification products can be achieved by various means including delivery through government-led systems such as the health, education and or social protection systems, free of cost to the end-user, or through market-based systems.
Products used in home fortification have been demonstrated to have a significant health impact. Evidence for micronutrient powders (MNPs) for the prevention and control of iron-deficiency anemia, is supported by several systematic reviews, WHO Guidelines, and HF-TAG programmatic guidance and technical briefs., Research on small quantity LNS (≤120 kcal/d, ≤20 g/d) in older infants and young children is on-going and suggests benefits related to linear growth (height), infant development and micronutrient deficiencies. While there is yet to be a WHO recommendation for their use, HF-TAG is in the process of compiling best practice and technical guidance for the use of SQ-LNS in IYCF programs.