(P26-013-23) Field Experience From Designing and Implementing a Cold-Chain System for the Nigeria National Food Consumption and Micronutrient Survey 2021

Objectives: The Nigeria National Food Consumption and Micronutrient Survey 2021 is the most comprehensive national survey in Africa to date. In addition to collecting quantitative 24-hour dietary recall data in children aged 6-59 months, pregnant and non-pregnant women of reproductive age, blood, urine, and stool samples were collected across four target groups (including adolescent girls). The challenge was obtaining, transporting, processing, storing, and analyzing over 51,143 samples from enumeration areas with unreliable electricity, difficult terrain, and far from functional health facilities.

Methods: Three key activities were carried out to design and implement a functional and efficient cold-chain system for the survey. These are: the assessment of survey cold-chain requirements, the assessment and selection of cold stores, and the development of cold-chain logistics and plans.

Results: The survey successfully designed and implemented a cold-chain system across 364 enumeration areas in all 36 states and the Federal Capital Territory. This can be attributed to several factors. First, the team reviewed and documented the survey's cold-chain requirements. Second, stakeholder engagement with the federal and state governments allowed the use of Ministry of Health cold stores. This was followed by proximity mapping of survey enumeration areas to all existing cold stores, a visit to verify their suitability, and a selection of the best cold stores for the survey. The survey also procured the right equipment and supplies and trained teams on cold-chain logistics, best practices, troubleshooting, and communication. An innovation of the survey was the use of checklists for decision-making and real-time temperature data loggers and dashboards for monitoring the cold-chain.

Conclusions: Using detailed contingency plans for cold-chain logistics and leveraging cost-effective technologies can improve cold-chain transparency, efficiency, and integrity in resource-constrained settings, as was the case in Nigeria. The survey identified an unmet demand for a detailed manual with updated guidance on designing a cold-chain system for a nutrition survey.

Funding Sources: Foreign Commonwealth and Development Office (FCDO)