For a manufacturer like Dr John Hare, a senior manager at one of Kenya’s leading cooking oil producers, the block was trust. Signing up to a multi-year fortification project with untested partners, as he put it, was like agreeing to marry someone he knew nothing about.
The 100-Day goal
Place at least three fully certified Vitamin A-fortified cooking oil or edible fat brands on store shelves.
The team’s first draft of the goal was to build a certification system. They rejected it themselves, on the reasoning that a system could exist on paper and still put no fortified product in a single shop. Rewriting the goal around brands on shelves forced them to design the system and use it.
The results
Achieved at day 130, thirty days past the 100-day mark.
On 1 March 2007 the Ministry of Health granted three brands the right to use a new fortification logo, regulated by the Ministry of Health and enforced by the Kenya Bureau of Standards. That brought 15% of the market into compliance with official fortification standards, and an estimated 3.6 million Kenyans into reach of increased Vitamin A intake.
A KNFFA official said more was achieved on fortification during the initiative than in all the years since the salt iodisation effort.
Who did the work
Nine technical staff from public and private sector organisations, meeting once every one to two weeks. Support came from the Micronutrient Initiative and the Rapid Results Institute. Senior leaders, Dr Hare among them, held to 30-minute meetings with their own team members every three to four weeks and a joint review at day 50.
How they did it
The change that made it work was senior leaders stepping back. Fortification had always been stuck at the level of senior policy discussion, which is exactly the level with no time for it. Handing the operational goal to technical staff, with leaders in a support and mentoring role, freed the work to move.
Two blockages nearly cost them the deadline. The team could not test oil-based products for Vitamin A with the existing method, and discovered late that they needed an entirely new protocol, which they researched and designed in under 30 days with MI’s technical support. This is where the thirty extra days went.
The second was the machinery of government communication. Early on, messages travelled as official memos up one organisation’s hierarchy and down another’s, meetings needed formal invitations and elaborate minutes, and anything to a private company required sign-off. The team broke with all of it. Memos became emails and SMS, formal meetings became phone calls and impromptu office visits, and one member started using email regularly for the first time in his career. The procedural shortcuts they invented were absorbed into their organisations’ other work.
What continues
The KNFFA moved straight into a second 100-day initiative on the harder problem of fortifying flour with iron, zinc and folic acid, which certified two flour brands. Plans then formed to scale up coverage across the flour and cooking oil industries and extend the logo to a wider range of staple foods. The case’s own conclusion is that outside facilitation was heavy in the first cycle and significantly scaled back in later ones, which is the capacity actually transferring.
