Culturally Appropriate Fortified Food for Iron Deficient Children

In India, 50% of girls & 33% of boys have iron deficiency anemia. We've developed a superior alternative to the iron pill, which is failing.

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I confirm that I am fully aware of the eligibility criteria, and based on its description, I am eligible to apply to the CSV Prize 2017.

  • Yes, I'm eligible

Preferred language

  • English

Organization name

Violet Health

Year founded


Initiative stage

  • Start-Up (a pilot that has just started operating)

Annual budget in 2017 (USD)

  • $100k - $250k

Number of beneficiaries impacted so far

  • 250 - 500

Organization type

  • Social enterprise

Headquarters location: Country

  • United States of America

Headquarters location: City

New York

Location(s) of impact

India: Southern Maharashtra, Karnataka, Bangalore


Problem: What problem is this initiative trying to address?

The WHO calls iron deficiency an epidemic. In India, half of adolescent girls and a third of adolescent boys have iron deficiency anemia, leading to cognitive and physical productivity losses and increased risk of maternal death as girls become mothers. To combat this, governments provide school-aged children a weekly iron folic acid pill. However, average adherence to iron pills among adolescents is extremely low, <20% in some Indian states. This problem also exists when doctors prescribe iron pills to adolescents.

Solution Summary: What is the proposed solution? What do you see as its most promising aspects for creating shared value?

Despite this staggering problem, there has been little successful innovation and no reliable, mainstream alternative to the iron pill in India. Partnering with nutritionists and doctors in India, we designed and manufactured a highly iron and folic acid fortified food that has proven higher adherence in pregnant women if substituted for an iron pill, resulting in reduced anemia and better health for mother and child. We tested the efficacy of the product in clinical trials. We see an opportunity for creating shared value in the crucially important segment of adolescents, and have tailored the formulation to meet their iron and folic acid nutritional needs. Our research reveals that the pill form itself is part of adolescents’ adherence problem as children are often averse to pills. They are difficult to swallow, frequently forgotten, and have an unappealing taste and appearance. A culturally acceptable iron supplement that increases adherence will lead to greater health and prosperity.

Impact: What is the impact of the work to date? Specify both the social and the environmental impact of your work

To date, we have conducted intensive qualitative and quantitative interviews across India, including pilots with over 260 women in four locations. This research showed our product had double the adherence of the iron pill. We also conducted clinical trials of our product that demonstrate its effectiveness for stakeholders in the health and nutrition communities. We plan to finalize the product for adolescent children, then conduct a study within Indian schools to demonstrate its efficacy for stakeholder and customer buy-in. In the long-term, we plan to reach all school-aged children who are currently provided an iron pill through government programs in addition to private channels.

Financial sustainability plan: How is this initiative financially supported? How will you ensure its financial sustainability long-term?

To date, our initiative has been supported by grants. In the future, we will generate revenue to ensure our financial sustainability long-term through sales of our products through private and public channels, reaching as many children suffering from iron deficiency as possible.

Unique value proposition: What makes your initiative innovative? How does your project differ from other organizations working in the same field?

There is no functional / fortified food product in India shown to effectively address iron deficiency by increasing adherence and replacing the iron pill. Our product provides a tasty and wholesome way for adolescents to get the iron & folic acid they need in a convenient and effective way. Our advantage comes from considering the adolescents’ point of view in terms of acceptability, and for being recognized by key stakeholders as a proven way to treat iron deficiency without pills.

Founding story: Share a story about the "Aha!" moment that sparked the beginning of this initiative.

In a clinic on the outskirts of Bangalore, India, an anemic, pregnant woman shared she had stopped taking her “terrible-tasting” iron folic pills – they upset her stomach and her mother-in-law disapproved. Face to face with her mother-in-law and the long queue of women, we grasped the complexity of the challenge and the dearth of consumer-focused solutions for iron deficiency. Later, we heard from government health officials that the problem of adherence to iron pills was even worse with adolescent children. Health officials have pursued variations of the same programs year after year without meaningful results. We realized then there was a tremendous opportunity to develop a meaningful product, beginning with the preferences of the anemic populations themselves to lead to increased health and productivity.

Where did you hear about the Nestlé Creating Shared Value Prize?

  • Other


Join the conversation:

Photo of Emily Dimiero

This seems like a great idea, but I am curious to learn more about the pill alternative. What type of product is it? Are there different products envisaged for different age groups (ie adolescents vs pregnant women)?

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