Where	Currently rolled out to 20 districts covering one third of the country.
When	The intervention started with a small‐scale feasibility study on MNP distribution linked with IYCF in 2009, which led to an implementation of large‐scale pilot in six districts to design an approach to scale up the intervention nationally.
Partners	The initiative has been led by the MoH with lead support from UNICEF‐Nepal. The program design and implementation have also been supported by the CDC, the National Planning Commission, the Institute of Medicine, WFP, and Micronutrient Initiative. Funding was provided by the European Union, Australian Aid, Work Bank, International Zinc Association, UNICEF, and the Government of Nepal.
Objectives	The main goal of the IYCF‐MNP (“Baal Vita”—Vitamins for Children in Nepali) program is to reduce anaemia in young children by ensuring more than 80% of 1.5 million children 6–23 months of age consume a course of MNP twice a year by progressively scaling up the intervention nationally by 2017. The program also aims to promote optimum feeding practices to improve growth of 3.7 million children under 5.
Target population	The primary target for the national program is children 6–23 months of age. In emergency settings, such as general food ration distribution in food‐insecure areas by WFP and in a UNHCR‐supported Bhutanese refugee camp, MNP distribution has covered children under 5.
Coordination	A multistakeholder committee chaired by the National Planning Commission was formed to design the program. MoH coordinated rollout with strong engagement with various stakeholders.
Enabling environment	A national situational anaemia analysis in 2003 underscored the urgent need to address anaemia in children. Almost half of children under 5 and around 75% of children under 2 were suffering from anaemia. In 2005, the National Nutrition Strategy and Anemia Plan of Action endorsed MNP as a key intervention. In 2007, the Joint Stakeholder National Nutrition Priority Workshop approved MNP piloting, with strong emphasis on IYCF promotion.
	With the feasibility study and pilot, the “strategic plan for initiating and scaling up IYCF community promotion linked with MNP” was formulated to serve as the road map. Furthermore, it has also been highlighted as a key intervention in the Multi‐Sector Nutrition Plan for national scale‐up.
Evidence generated	The pilot phase demonstrated that for both health facility and community‐based distribution, female community health volunteers can help achieve strong and equitable coverage and compliance. Regular social mobilization through community‐based organizations is also important for maintaining good performance.
Supply issues	In Nepal, MNP is considered a food supplement. Initially, the product was procured by UNICEF, but over time, the government has started procuring it with its own resources through a Health SWAp pooled funding mechanism. The distribution of MNP and communication materials has been integrated into the government's logistics management system and the reporting of supply status has been institutionalized.
Outcomes	The coverage of MNP distribution has consistently reached over 60% and as high as 83% in the past 5 years of implementation. An evaluation is ongoing to document the impact of the intervention, including its contribution in reducing anaemia and providing guidance to enhance efficiency and effectiveness of the future programming.
Lessons learned	Nepal has adopted a phased approach to initiate and scale up MNP, starting with generating strong acceptance for the intervention through extensive advocacy and stakeholder engagement, and then designing a national approach based on a large‐scale pilot. One of the key factors for success is integrating MNP with IYCF promotion.

CDC, Centers for Disease Control and Prevention; IYCF, infant and young child feeding; MNP, micronutrient powders; MoH, Ministry of Health; SWAp, Sector‐Wide Approach; WFP, World Food Programme; UNHCR, United Nations High Commissioner for Refugees; UNICEF, United Nations Children's Fund.

Based on information from key informant 15