Welcome to the Interactive Programme of MNF 2023

School-based integrated nutrition intervention programs for adolescents incorporate the consumption of weekly iron and folic acid tablets (WIFA) among other activities for adolescent girls. With adolescent girls expected to consume WIFA at school, access to safe drinking water in schools is critical for safe and effective program implementation. Stakeholders planning integrated nutrition and WASH interventions need to monitor WASH in schools, including testing of the school drinking water supply for E. coli contamination (an indication of fecal matter in the water supply), to ensure all students have access to basic WASH services at school. The overall purpose of this learning center will be to provide interested participants with the opportunity to learn how to conduct a drinking water test that detects and quantifies E. coli contamination in a water sample collected in a compartment bag. The compartment bag test (CBT) (www.aquagenx.com) is a quick, simple, portable, self-contained test that allows convenience testing of drinking water anywhere including remote field areas, at any time and by anyone to determine drinking water quality or safety. Booths and/or tables will be set up around the room for participants to have a hands-on technical training on eight simple steps to ascertain health risk based on the WHO guidelines for drinking water quality. Facilitators will provide step-by-step instructions and assistance. The learning center modality is preferred because it will give users a hands-on opportunity to experience a step-by-step approach to using the CBT in the field and to get guidance from facilitators where needed. Furthermore, the learning center will enable us to explore new ways of collecting drinking water samples from different types of containers used to store water globally and to also obtain feedback from users about their experiences with the CBT. The objectives for each session are as follows: •Provide participants with a brief overview of the purpose of drinking water quality testing for E. coli contamination and the WHO guidelines for drinking water quality •Explain and demonstrate drinking water point sampling procedures •Demonstrate preparation of the compartment bag test •Explain the importance of negative field and lab controls, incubation, as well as scoring and recording of the CBT results •Demonstrate decontamination of CBT and cleaning of work area afterwards •Provide participants with an opportunity to explore and use the CBT, with facilitators on hand for guidance/assistance •Provide participants with an opportunity to provide feedback on use of the CBT tools and resources including CBT kits, incubators etc.

The Learning Center will provide participants with hands-on instruction for and experience using the cost module of the Micronutrient Action Policy Support (MAPS) Tool (https://maps.micronutrient.support/maps-tool). We anticipate that the participants in this Learning Center will primarily be nutritionists, policymakers, and other decision-makers in the micronutrient intervention space. The objectives of the learning center are to (1) familiarize participants with the cost module of the MAPS Tool, (2) give participants the experience and confidence to collaborate with economists to use the MAPS cost modeling framework to generate estimates of the cost of micronutrient interventions, and (3) help participants envision how they might use the cost module as input into policy decisions around micronutrient interventions. The MAPS Tool is an open-access, online tool that uses household consumption and expenditure survey data, food balance sheet data, and, where available, biomarker data to estimate and communicate the prevalence of dietary micronutrient inadequacies and micronutrient deficiencies at national and sub-national scales in sub-Saharan Africa. The MAPS tool also includes a cost module that provides tool users with a detailed, user-friendly modeling framework to generate and compare country-specific estimates of the cost of existing and hypothetical micronutrient interventions, including large-scale food fortification, biofortification, agronomic biofortification, and supplementation. The cost module is developed to be accessible to and useful for people with varying backgrounds, including economists, nutritionists, and policy-makers. The online version of the cost model is currently under development but will be beta tested and ready for public release well before the 2023 Micronutrient Forum. During the learning center session, participants will access the MAPS tool on their laptops while the facilitators project the tool on a large screen. The facilitators will walk participants through the process of creating a new intervention, viewing and revising intervention assumptions and default cost model parameters, obtaining, visualizing, and downloading model results, and comparing costs across different micronutrient interventions. Participants will then be split into several groups to work on modeling the cost of a specific micronutrient intervention in a specific country context (e.g., group 1: the cost of the current wheat flour fortification program in Burkina Faso; group 2: the cost of scaling up orange-flesh sweet potato in Malawi; group 3: the cost of introducing agronomically biofortified maize in Ethiopia). The groups will then come together to discuss their results and learnings, and share reflections on challenges they encounter during the process. The session will conclude with a facilitated discussion about how participants might use the cost models and cost estimates in their work related to micronutrient interventions and/or feed into policy decisions. Proposed timeline (if limited to 1 hour; if longer than 1 hour, the break-out group work and subsequent discussion will be longer): Minutes 0-5: Brief introductions and objectives for the session; Minutes 5-25: Overview of and guided participant interaction with the cost module; Minutes 25-45: Break-out groups to work through assigned cost modeling scenarios; Minutes 45-60: Discuss modeling scenario results, challenges, and use of the tool in work/policy discussions

Through public engagement, issues that have an impact on people's lives can be resolved by bringing together residents, local non-profits, corporations, and the government. Without going into detail, we have enough evidence to demonstrate that micronutrient deficiency is a problem that affects everyone, regardless of income, stage of life, or even gender. Large-scale food fortification (LSFF) is a frequently used, cost-effective technique. Despite these achievements, food fortification is still far from having the influence it may have on a worldwide level at the current rate of development. In the context of micronutrient science, we need to shift from a transactional to a transformational approach, which entails raising awareness of the value of education and behaviour modification for and by the general public. A surprising variety of businesses, from stores to design studios, can act as a link between the general public and scientific inquiry. Collaboration with non-research organisations that can serve as a link between the public and research has led to some of the most effective public engagement programmes. Businesses can interact with the general population to achieve successful micronutrient sufficiency results. Building bridges between customers, or communities, and scientific communication, in all of its forms, are essential for maximising the influence of science. We will walk you through the most recent effective trends and best practises for communicating science to the public and politicians, as well as how to integrate science communication efforts into collaborative, interdisciplinary research projects, at the Final Conference in October. The practical methods and functional models for scientific engagement and knowledge mobilisation will be the main topic of an interactive session lasting an hour. How to incorporate scientific communication and engagement initiatives into multidisciplinary micronutrient research and innovation programmes from the start as a crucial funding instrument will be the key topic of discussion. The following are some specific goals: -focusing on various audiences and developing learning resources to increase the effect and value of public interaction with science. -close the communication gap between the scientific community, decision-makers, activists, and civic groups. Young researchers in particular would be the target audience for training and capacity building for academics, professionals, and social workers. The format would be a discussion-style interview with a moderator.

Effectively communicating micronutrient data to decision makers is critical for advocating for interventions to reduce micronutrient deficiencies. Given the complexities and nuance associated with micronutrient data, communication about data and translating it for decision-makers, who may not be familiar with nutrition, is challenging and a frequent barrier in advocating for appropriate interventions. In this session, participants will learn how to distill their messages for more effective communications. Specifically, the session will cover how to consider the perspective of your intended audience and frame your message in a way that will resonate with them. After learning the essentials for communicating about data, the session will become in interactive discussion in the form of small groups (depending on the size of the audience) to workshop a few examples from the field. Participants are encouraged to come with their own questions or data to summarize during the workshop period. This will give participants a more hands on approach to learning this important career development skill. Introduction to science communications – 10 minutes Framing your message and understanding your audience – 20 minutes Breakout groups to workshop examples – 20 minutes Conclusions and lessons learned from the breakout groups – 10 minutes

The interconnectedness of environment, nutrition, and livelihoods is becoming more evident as climate change and environmental degradation continue to impact food security and hunger. The effects of climate change are expected to exacerbate malnutrition as it impacts food production, availability, access, and affordability. Additionally, the food system contributes significantly to climate change and is responsible for approximately 30% of global emissions. Given these interlinkages, the integration of climate change and environmental issues into efforts aimed at transforming food systems and improve micronutrient deficiencies is essential for sustainable change. Integrating environmental issues into nutrition programming involves exploring the co-benefits and trade-offs that arise from a more holistic approach that considers planetary health outcomes. For example, while food loss and waste reduction programmes benefit both health and the environment, improving the supply of animal-source foods without careful environmental considerations may benefit certain vulnerable groups but have a negative impact on the environment. These considerations are not often systematically explored or factored into nutrition programming. This proposed Learning Center aims to delve into the challenges and opportunities that organizations face when navigating the complexities of incorporating an environmental lens into programmes with a primary nutrition focus. It provides an opportunity to generate in-depth discussions around i) framing used to position the role of environment within nutrition organisations and their programmes; and ii) tools, resources, and strategies that can help advance integration of environmental lens into nutrition, including engagement with the environmental sector. The Global Alliance for Improved Nutrition (GAIN) will organize this Learning Center in coordination with other organizations that are working to integrate an environmental perspective into their programs. The session will be structured in the following way: various organizations will present for 10 minutes on their experience in integrating an environmental lens into their nutrition programming, followed by a 10-minute discussion with participants on the topic. Next, organizations will present their tools, resources, and strategies for environmental integration, including a short demonstration of GAIN's Environmental Screening Tool, a description of the Environmental Community of Practice, and other available tools and resources. Participants will be encouraged to apply one or two tools to a predefined hypothetical program in smaller groups and will actively engage in the discussion by sharing their own experiences and insights. This 30-minute session will be followed by a 10-minute closing to summarize the main discussion points and any follow-up actions agreed upon with participants. If there is interest, mechanisms for continuous sharing of lessons and engagement with attendees will also be identified. By the end of the session, attendees will be able to: i)Describe some common challenges and opportunities associated with integrating an environmental perspective into nutrition programs; ii)Identify at least two resources that can support the integration of environmental lens into nutrition programming; iii)Identify at least one other organization or individual who shares similar interests (and passion!) for advancing the integration of environment into nutrition programming.

The overall theme of the learning center is the importance of youth engagement in nutrition initiatives and the need for nutrition resilient youth inclusive programming, which remain a gap in both development and fragile settings. The presentation will be led and facilitated by African youth leaders, who are representatives from Organization of African Youth (OAY), Food Technology and Nutrition Students Society of Kenya (FOTANS) and Kavle Consulting Kenya, to discuss key elements of advocacy, inclusive capacity development and leadership and innovative ways to engage youth networks and nutrition graduates focusing on experiences and lessons learned from Kenya and Mozambique. The relevance of this learning center to the Micronutrient Forum conference themes is the focus on creating an enabling environment for nutrition governance and capacity building involving youth actors who can shape country programming. The successful elements and challenges of youth engagement will be discussed drawing on the Scaling Up Nutrition (SUN) youth network experience in Kenya. We will also discuss youth action for partnerships between governments, civil society organizations and other sectors (i.e. agriculture, education, social protection), including gardening. We will also discuss innovative ways to engage student nutrition clubs and build capacity of recent nutrition graduates and nutrition professionals for enlarging the health workforce from Kenya and Mozambique. Recommendations for comprehensive national youth policies that prioritize youth engagement and participation in all aspects of society will also be discussed. The presentation will be relevant to country program implementers, country policy makers, nutritionists, and young leaders interested in advancing new policy priorities, and investments for micronutrient interventions via adolescents and youth engagements in light of the COVID-19 disruptions to health and food systems. The learning center is appropriate for this theme because it offers sharing of lessons learnt from African youth leaders through concrete country examples and video stories. The learning center will be interactive with the audience members by posing open-ended questions of key themes to spur discussion and development of key country actions on youth engagement. We propose the learning session will take 60 minutes. We will have 3 examples presented by 3 African youth leaders 10 minutes each featuring a video story and interactive dialogue. We will do a short 5 minutes summary of what was presented and do an interactive engagement around nutrition governance, capacity building and youth networks with key actions outlined and presented in small groups.

Anemia remains a significant public health concern with multiple causes and risk factors. To design and implement successful control and prevention programs, it is essential to understand the etiologies of anemia in a population, and accurately measuring risk factors associated with anemia is a crucial step toward achieving this goal. However, accurately measuring micronutrient deficiencies poses a unique challenge due to inflammation's impact on nutrient biomarkers like iron, vitamin A, and zinc, which can lead to incorrect diagnoses and inaccurate estimations of deficiency prevalence in populations. Therefore, a comprehensive understanding of inflammation's effect on biomarkers is crucial for accurate assessments of micronutrient deficiencies in populations. By recognizing the role of inflammation in micronutrient biomarker assessment and understanding population attributable risk to anemia, we can effectively address anemia and micronutrient deficiencies at the population level. This learning center aims to provide an in-depth exploration of anemia, covering methods to assess the attributable fraction of anemia within a population and the BRINDA inflammation adjustment method for assessing micronutrient status. This learning center is designed to appeal to a wide range of participants, from researchers and public health practitioners to students and educators. To facilitate interactive learning, attendees will participate in a variety of activities including demonstrations of the recently released R package and SAS macro for the BRINDA inflammation adjustment method and assessing population attributable factors. Attendees will have the opportunity to apply these tools to their own data or use sample data, providing valuable hands-on experience with these powerful analytical techniques. The agenda for the learning center is designed as follows: 1) Learning Center Introduction (5 min); 2) Breakout sessions (Group discussion, Q/A and hands-on application) – 50 min: 2A) BRINDA INFLAMMATION SESSION * Learning objective: Learn how to adjust micronutrient biomarkers for inflammation using the BRINDA method, 2B) ANEMIA ETIOLOGY SESSION *Learning objective: Learn how to assess the attributable fraction of anemia within a population; 3) Concluding remarks (5 min) Organizers: Melissa F Young1,2, Hanqi Luo1, Yi-An Ko3, Jiaxi Geng1, Parminder S Suchdev1,2; 1Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; 2Centers for Disease Control and Prevention, Atlanta, GA, USA; 3Department of Biostatistics and Bioinformation, Emory University, Atlanta, GA, USA

Are you a fortification program manager or decision-maker interested in analyzing your national fortification data to identify gaps and areas for program improvement? Are you a regional fortification stakeholder interested in reviewing fortification efforts in your region or comparing your region with others? Are you a researcher interested in utilizing global fortification data to assess or evaluate the design, implementation or impact of national fortification efforts? Are you from an organization supporting fortification efforts interested in understanding what data are available that could facilitate your work? If so, this learning center is for you! It will provide a hands-on, guided interpretation of the Global Fortification Data Exchange (GFDx). This open-source, visual database (www.fortificationdata.org) offers an array of information on mandatory and voluntary food fortification programs for maize flour, oil, salt, rice, and wheat flour. Information on the site is collected through desk reviews and annual surveys sent to national stakeholders implementing food fortification programs. During the learning session, the GFDx Secretariat will provide data challenges to showcase the vast analytical and visualization features the GFDx has to offer. There will also be an opportunity to work in small groups with the Secretariat to learn where to access information on the GFDx site and interpret program data, based on each participant’s specific interests in fortification. Prizes will be won and fun will be had by all in the name of data visualization! The GFDx contains country-level data on three topical and several sub-topical areas: 1. Foundational fortification documents -Availability and scope of mandatory and voluntary legislation (e.g., is there legislation for fortification; what kinds of foods the legislation applies to) -Fortification requirements/specifications (e.g. nutrients to be added through fortification, nutrient levels, types of compounds allowed, alignment with WHO fortification guidelines) -Regulatory monitoring protocols (e.g. are protocols available for import and external monitoring, comparison to a checklist of 28 best-practice items) 2. Fortification program performance -Proportion of food in the country that is fortified (compliance) -Proportion of the population consuming the fortified food (population coverage) -Potential nutrient contribution of fortified food -Data on micronutrient status and functional outcomes available for a country before and after fortification onset 3. Fortification potential -Average intake/availability of the food vehicle per person -Percentage of vehicle that is industrially processed -Proportion of the population consuming the vehicle The objectives of this learning center are to help participants: -Know what current fortification data are available and what they say about any particular country program; -Understand what fortification program data are important to collect; -Identify current data gaps in fortification programs, their implications, and steps to resolve them so that programs can be better evaluated; and -Target their efforts to improve fortification programs based on the available data. Strong program data help to save resources, establish a foundation for sustainable and scalable operations, and most importantly, illustrate how well food fortification programs are improving micronutrient intake for a better nourished population.

The overall theme of the interactive session is addressing hidden hunger (micronutrient deficiency) through sustainable systems thinking. This theme aligns well with the overall goals of the Micronutrient Forum conference, which aims to promote the sharing of knowledge and best practices related to improving micronutrient status and addressing malnutrition. The session will specifically focus on the challenges of hidden hunger, which is a prevalent issue in many parts of the world, and how sustainable systems thinking can help to address this issue. During the interactive session, participants will engage in hands-on activities and discussions to explore the challenges and potential solutions related to hidden hunger. Specific topics to be presented and discussed include innovative approaches to addressing hidden hunger aligning with the UN Sustainable Development Goals (SDGs) and the role of sustainable systems thinking in improving micronutrient security. Participants will have the opportunity to share their own experiences and perspectives related to hidden hunger and sustainable systems thinking. The learning center modality is appropriate for this theme because it allows for a more interactive and hands-on approach to learning. Participants will have the opportunity to engage with the material in a more direct and personal way, which can help to deepen their understanding and retention of the content. Additionally, the learning center modality allows for more flexibility and customization of the learning experience, which can help to better meet the diverse needs and interests of the audience. Session Title: Hidden Hunger Challenge (1 hour) Timeline: Ice-Breaking Challenge (Activity 5-10 min) Introduction (5 min) Design Thinking (5 min) Systems Thinking (5 min) Sustainability – SDG (5 min) Team Activity: Hidden Hunger Challenge (30 min)

In the lead up to the 2023 World Health Assembly (WHA) the global nutrition community joined forces with disability rights and global health advocates to pass a WHA resolution calling on member states to accelerate the use of large-scale food fortification to prevent micronutrient deficiencies and their consequences, including birth defects such as spina bifida. The effort has united an unlikely collection of advocates from Rotary Clubs in suburban Texas and Georgia to the Central Uganda Spina Bifida & Hydrocephalus Network alongside global organizations ranging from UNICEF and the World Food Programme to the World Federation of Neurosurgical Societies. The resolution is expected to pass easily at the WHA in May 2023, but continued alliance-building and advocacy at national and global levels will be essential to ensure that the resolution is implemented and has the desired impact. In this interactive learning session, we will discuss lessons learned from the campaign thus far, including practices we would repeat and things we would do differently if given the chance. We will solicit examples of other similar global/national initiatives from those in attendance and will attempt to put different examples in conversation with each other, so that participants can learn from contrasting or parallel elements, including what worked well and what did not and why. The second half of the learning session will engage participants in a discussion of how the WHA food fortification resolution once passed, might contribute to existing national efforts to strengthen national food fortification programs and/or national efforts to combat micronutrient deficiencies (for instance via the biennial reporting opportunities at WHA or utilizing regional WHA meetings). Session participants will also be engaged to identify other similar global opportunities (such as the Nutrition for Growth Summit) that could be leveraged for national progress of food fortification or micronutrient malnutrition programs. Particularly important will be to explore lessons learned the group has derived from past efforts, and how these might apply to future opportunities. "Timeline" for the proposed learning center session: The session could be 90 minutes in length. Depending on the size of the session, we might utilize breakout discussions and come back for sharing with the whole group. We would begin with a brief (no more than 15 minute) presentation of the WHA food fortification resolution campaign, followed by a discussion of other similar international initiatives that participants have been involved in (approximately 15 minutes for sharing and discussing additional examples). We would spend another 15 minutes or so drawing out lessons learned before spending 20 minutes laying out and discussing how the WHA resolution can be used to advance efforts on food fortification and micronutrient malnutrition over the coming 7 years (if passed, the resolution will be active from 2023 - 2030). We would use the remaining time to brainstorm other global opportunities that have the potential to accelerate or amplify national efforts to combat micronutrient deficiency and how lessons/best practices identified earlier in the session might apply to these upcoming opportunities.

Proposed format: 20-min pre-recorded session (unless organizers deem relevant to have more time)* Malnutrition is gendered, so eradicating malnutrition demands gender-transformative approaches. Gender inequality is both a cause and a consequence of malnutrition, undermining women’s, girls’ and people of diverse gender identities’ overall wellbeing and threatening opportunities across both their own lives and their families into the future. Fully understanding and effectively implementing the needed shifts from gender-sensitive to gender-transformative nutrition programs requires practical guidance to support day-to-day activities throughout project cycles and across the humanitarian-development nexus. Our team engaged with the Gender Transformative Framework for Nutrition (GTFN) (https://www.gendernutritionframework.org/), an aspirational framework yet to be operationalized by nutrition practitioners, to co-create guidance for gender-transformative nutrition programming. We conducted mix-methods needs assessment to understand practitioners’ needs and priorities for advocacy-focused guidance to undertake intersectional and gender-transformative nutrition programming. Our protocol was informed by descriptive landscaping of existing multi-sectoral tools on nutrition-gender relationships that highlighted current guidance gaps and which tools may be leveraged for advocacy-focused guidance. Our 20-minutes pre-recorded session aims to raise awareness on the GTFN and our results from our mix-methods needs assessments, including barriers and facilitators likely faced by practitioners during planning, designing, implementing monitoring, evaluating and advocating for gender-transformative nutrition interventions. We will also provide an overview of the advocacy tool aimed at providing guidance on trigger-points that national and global policymakers need to address to ensure micronutrient programmes are gender-transformative and address the full social complexity of malnutrition. The target audience for this pre-recorded session focuses on communities and nutrition practitioners to drive gender-transformative change across the nutrition project cycle through directly tackling gender inequalities and strengthening micronutrient resilience among equity-seeking gender groups. Contents from a previously recorded webinar on these topics may also be embedded within the session.

iCheck is a portable device that can quantitatively measure the micronutrient content of fortified foods within a matter of minutes. Together with ready-to-use consumables, iCheck significantly reduces measurement efforts compared to conventional laboratory methods. The current range of iCheck devices can measure micronutrients such as vitamin A, vitamin E, carotenoids, iron, and iodine in various food and biological matrices. Theme: The learning center will provide an interactive session where the use and function of iCheck devices will be demonstrated to measure micronutrients in various food samples. The specific topics covered during the session will include: •Showcase the use of the iCheck to assess essential micronutrients in fortified foods (e.g., oil, milk, flour, rice, sugar, salt). Estimated time: 15 minutes •Demonstrate sample preparation and subsequent analysis of various food samples. Estimated time: 30 minutes •Discussion with our experts. Estimated time: 15 minutes The learning center will be a perfect opportunity to demonstrate innovative solutions to multiple stakeholders and assess its performance in real-world scenarios. It will also allow the participants to have a hands-on experience and to engage directly with our experts concerning current solutions and potential future needs. This will help us to tailor future product developments to the specific needs of the users, ensuring increased adoption and promoting long-term use.