Small-Quantity Lipid-Based Nutrient Supplementation (SQ-LNS) among Children Aged 6 - 18 Months in Three Districts of Togo: Results of a Pilot Evaluation and Programmatic Perspectives

Background: Small-quantity Lipid-Based nutrient supplements (SQ-LNS) are a recommended intervention to contribute to the prevention of malnutrition among children living in highly vulnerable nutritional settings. This evaluation aims to document the implementation of a pilot phase of SQ-LNS supplementation among infants and young children aged 6 to 18 months in three districts in northern Togo. Methods: A non-probabilistic descriptive cross-sectional study was conducted in the Binah, Oti, and Tandjoaré districts among infants and young children aged 6 to 18 months who received SQ-LNS supplementation over a six-month period, in addition to breast milk, as well as their mothers and key informants. Quantitative data focused on the evolution of mid-upper arm circumference (MUAC) in 41 children present at the time of the evaluation. Qualitative data was collected from 90 mothers and key informants through focus group discussions and individual interviews. Results: Median MUAC increased from 134 mm to 148 mm after the supplementation period, with a statistically significant difference (Wilcoxon test, p < 0.001). Acceptability of the product was high: 93% of children consumed SQ-LNS from the first days of distribution, and 100% of households expressed willingness to continue the intervention. The main challenges reported included early cessation of breastfeeding in some children, occasional stock-outs, and instances of product sharing within households. Conclusion: This evaluation highlights positive trends associated with the implementation of SQ-LNS supplementation, particularly in terms of acceptability and changes in nutritional indicators among beneficiary children. However, these findings should be interpreted as implementation-level observations rather than evidence of causal effectiveness. Scaling up the intervention will require strengthened communication on breastfeeding, a more reliable supply system, and community-based sustainability strategies.