Action - Chispitas program - Iron supplementation - Infants and young children

Programme: Chispitas program

Programme description

Ferrous sulfate syrup has been the major source of iron supplementation until 2006 for the Bolivian children. Although not documented in a systematic fashion, it was generally accepted in the country that acceptance of the syrup was low due to taste and frequently reported side effects. This and the persistently high prevalence of anemia provided the case for seeking alternative approaches to micronutrient supplementation. Stressing the importance of anemia prevention and control among children 6-59 months of age in Bolivia, the Pan American Health Organization (PAHO) and the Micronutrient Initiative (MI) proposed to the Ministry of Health and Sports (MSD) to replace syrup with Micronutrient powder (MNP) at the national level. The free distribution of MNP in Bolivia was integrated into the Desnutricion Cero (Zero Malnutrition) program, an integrated strategy to combat malnutrition in Bolivia, launched by the Morales government in 2006. The Centro de Abastecimiento de Suministros de Salud (CEASS), a national procurement agency for the MSD managed the distribution of the sachets to all 9 departments on behalf of the MSD.

Programme type



Municipalities purchase directly from the manufacturers at prices ranging from 14.50Bs (US$2.07) to 15Bs (US$ 2.15) for a box of 60 sachets.

Start date:

Target group: 
Infants and young children
Age group: 
6-23 months
Primary health care center
Other delivery: 
Free distribution through the government’s universal health care program, Seguro Universal Materno Infantil (SUMI).
Implementation details : 

Each child is provided with 60 Chispitas sachets every year. Caregivers are recommended to provide one sachet everyday for 60 days to their children.

Target population size : 
400000 (50%)
Coverage level (%): 
Outcome indicator(s): 

Anemia prevalence

M&E system: 

Both qualitative and quantitative information were collected from three different sources to evaluate diverse aspects of the implementation of the Chispitas program with an objective to:1. Asses efficiency of logistics systems management across different departments and health districts,2. Assess the acceptability of Chispitas by the caregivers across urban and rural areas, and 3. Know the adequacy of Chispitas preparation by caregivers. An external evaluation was done by the Asociacion de Instituciones de Promocion y Educacion (AIPE), a private firm, to achieve the first three objectives using the program monitoring data and external survey data in 2008. In addition, a workshop was conducted in September 2009 by researchers from Cornell University, MI and MSD to review the Chispitas program and provide feedback to further strengthen it. Later in 2010, a study was conducted provide data to develop a communications strategy by a private firm (TICs Communications) contracted by MI, and allow a comparison post-implementation (focus groups were also conducted). All studies/reviews only looked at the program from the public health system distribution point of view. The 2010 TICs study collected data from households and public health centers in both rural and urban municipalities in Bolivia, in each of the 9 departments of the country. The sample sizes are not large enough however to be nationally representative.

Outcome reported by social determinants: 


Revision log

Tue, 03/11/2014 - 17:34engesveenkEdited by admin.published
Wed, 03/27/2013 - 16:11bloessnermEdited by admin.published
Wed, 11/21/2012 - 09:22bloessnermEdited by admin.published
Tue, 11/13/2012 - 12:48ginaContribEdited by admin.draft
Mon, 10/29/2012 - 12:05ginaContribEdited by admin.published
Mon, 10/29/2012 - 11:14bloessnermEdited by admin.published
Wed, 10/24/2012 - 23:45ginaContribEdited by admin.draft