Early Childhood Nutrition and Anaemia Prevention Project – Tjiitji Marrka Manguwa

The Early Childhood Nutrition and Anaemia Prevention Project was a collaborative project across Northern Australia that aimed to determine the feasibility and acceptability of a community nutrition program to improve nutrition and prevent iron deficiency anaemia of Aboriginal infants and young children aged 6 months to 2 years. This involved home-based micronutrient fortification using a product called ‘Sprinkles’.

This pilot project was implemented in six remote Aboriginal communities across northern Australia (Northern Territory, North Queensland and Kimberley). Tjiitji Marrka Manguwa (kids will be strong) is the name of the Kimberley arm of the project and was based in Balgo in the Kutjungka region.

A very special thank you to the families who participated in the Early Childhood Nutrition and Anaemia Prevention Project and shared their stories in the evaluation of the project. Many thanks to the communities that participated in the project: Ngukurr, Borroloola, Jilkminggan, Ti Tree and Pmara Jutunta, Balgo and Kowanyama. The Early Childhood Nutrition and Anaemia Prevention Project would not have been possible without the dedication and enthusiasm of the community based workers and health professionals involved.

The key achievements from this project were:

  • High participation rate: 84% of the estimated 6 month – 2 year old population were enrolled in the project.
  • Increased understanding of the extent of anaemia in Aboriginal infants and young children and potential strategies which can be implemented to prevent and treat anaemia.
  • Insight in to the dietary patterns of Aboriginal infants and young children in remote northern Australian communities.
  • Adaptation of the WHO Infant and Young Child Feeding Counselling Course to meet the needs of health and community services workers supporting Aboriginal families in remote communities; this modified program is now available as Talking about Feeding Babies and Little Kids.
  • Improvements in the research capacity, nutrition knowledge and confidence of Aboriginal Community Based Workers (CBWs), establishing a valuable resource for future research and programs.
  • Good retention of Aboriginal CBWs, and the establishment of partnerships between non-Indigenous health practitioners and CBWs.

The key findings were:

  • Infants and young children had much higher rates of anaemia, and at an earlier age, than expected.
  • Adequate supply of ‘Sprinkles’ appears to maintain haemoglobin levels in non-anaemic children.
  • ‘Sprinkles’ and other program activities were accepted by the communities.
  • Adequate distribution of ‘Sprinkles’ was not achieved for widespread effect.
  • Community Based Workers were important in their communities but experienced difficulties in their role.
  • A limited variety of foods were consumed, in particular nutrient rich foods.
  • Implementation of nutrition counselling and education was limited.
  • Routine child health check/growth assessment and anaemia treatment protocols were poorly adhered to.


Aquino D, Marley JV, Senior K, Leonard D, Helmer J, Joshua A, Huddleston A, Ferguson H, Hobson V, Hadgraft N. Early Childhood Nutrition and Anaemia Prevention Project: Summary Report. Darwin: The Fred Hollows Foundation, Indigenous Australia Program 2013.

Dympna Leonard, Danielle Aquino, Nyssa Hadgraft, Fintan Thompson, Julia V Marley. Poor nutrition from first foods: a cross sectional study of complementary feeding of infants and young children in six remote Aboriginal and Torres Strait Islander communities across northern Australia. Nutr Diet 2017; DOI:10.1111/1747-0080.12386.

Danielle Aquino, Dympna Leonard, Nyssa Hadgraft, Julia V Marley. High prevalence of early onset anaemia among Aboriginal and Torres Strait Islander infants in remote Northern Australia. Aust J Rural Health 2017; DOI: 10.1111/ajr.12403.


Executive Summary (572 KB . pdf)

Summary Report (2 MB . pdf)

TMM Story Book (8MB .pdf)

Community Newsletter July 2011 (1.3 MB .pdf)

Kimberley Team:

  • Carol Green
  • Deanne Hector
  • Loretta Mudgedell
  • Sophie Moora
  • Theresa Sunfly
  • Meleseini Tai-Roche
  • Robyn Smythe
  • Tracy Leon
  • Steve Stevetts
  • Nyssa Hadgraft
  • Assoc Prof Julia Marley
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