Where	Pilot project in different parts of the country
When	Coordination through the newly formed MN‐TWG started in 2012. Formative research began in 2014, and SPRING's distribution began in 2016.
Partners	Private and public sector partners including UNICEF, WFP, the MoH, SPRING, and research partners.
Objectives	To develop harmonized tools and to coordinate pilots in different parts of the country to explore the potential for rollout of MNP in Uganda.
Target population	Children 6–23 months of age
Coordination	In 2012, following a regional UNICEF/CDC MNP workshop, the Uganda MoH initiated the introduction of MNP by establishing the MN‐TWG. This group is composed of representatives from UN bodies (REACH, UNICEF, WFP, and WHO), USAID‐funded projects (Community Connector, SPRING, and Harvest Plus), Uganda Health Marketing Group, Makerere University, and other development partners.
Enabling environment	The MN‐TWG collaborated with many groups within and outside of the MoH. The group participated in the development of national micronutrient guidelines (to ensure there was a policy framework for MNP distribution), formation of a draft implementation framework, and develop a harmonized social behavioral change communication plan and monitoring tools.
Evidence generated	Implementing partners conducted formative research prior to the start of implementation. These findings suggested that although MNP was acceptable in Ugandan communities, sponsorship by local officials and the MOH would be important for continued acceptance. Findings from the pilot are not yet available but will be used to inform national programming and further use of MNP in the country.
Supply issues	In SPRING's experience with MNP procurement, 6 months was required to prepare an appropriate request for proposals for MNP. The request for proposals included references, financial statements, information on formulation, data on overages (micronutrient levels beyond the WHO recommendations), product shelf life, terms of delivery, and payment. After the request for proposals, in Uganda, 14 months was required before the MNP was delivered.
	The U.S. Government considers MNP a pharmaceutical product, which, per ADS 312, is subject to U.S. Government approval and regulations regarding quality and sources (i.e., not local) of the product.
Outcomes	SPRING is conducting surveys to estimate reach/coverage, adherence/use, and cost‐effectiveness. SPRING is also carrying out qualitative work to understand the issues related to the use or nonuse of the product after 2 months. WFP and CDC conducted baseline assessments and will conduct follow‐up work to look at MNP use and anaemia prevalence to understand the effectiveness of MNP in Uganda.
Lessons learned	Procurement processes can be complex, as each implementing partner's procurement processes, in addition to the donor's processes, needs to be followed. Furthermore, there are additional processes that apply to MNP. In Uganda, SPRING learned that developing local packaging for MNP takes a long time, as several stakeholders' inputs need to be resolved (e.g., the International Baby Food Action Network wanted to ensure the product would not be misunderstood as a breast milk substitute).
	Product registration is a time‐intensive process that requires significant support and coordination from the MoH. It was also a lengthy process to develop a policy framework to allow MNP programming. This process required buy‐in from many outside of the MN‐TWG. That buy‐in ultimately helped facilitate a range of follow‐on tasks, including product registration and institutional review board approval for studies.
	Scale‐up was built into the planning from the start. The scale‐up is organized in two stages. In the first stage, MN‐TWG partners undertake implementation research studies on MNP distribution in identified districts to gauge acceptability of MNP and document distribution options in pilot districts. On the basis of lessons from this pilot process, the second step will consist of the national introduction of MNP, led by the MoH in collaboration with other stakeholders.

CDC, Centers for Disease Control and Prevention; MNP, micronutrient powders; MN‐TWG, Micronutrient Technical Working Group; MoH, Ministry of Health; REACH, Renewed Efforts Against Child Hunger; SPRING, Strengthening Partnerships, Results, and Innovations in Nutrition Globally; UNICEF, United Nations Children's Fund; USAID, United States Agency for International Development; WFP, World Food Programme; WHO, World Health Organization.

Based on information from key informant 21