Adherencia a multimicronutrientes y factores asociados en niños de 6 a 35 meses de sitios centinela, Ministerio de Salud, Perú

Abstract

There was a low prevalence of adherence to a demanding cut-off point (≥ 90% of envelopes of multiple micronutrient powders), and the associated factors are associated with absence of infections, side effects, and mother's beliefs.

Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels

“…The barriers and facilitators to MNP use found in this study are consistent with those from previous studies conducted in Peru and globally Akoto Osei et al, 2014;Creed-Kanashiro et al, 2016;Sarma et al, 2016;Huamán-Espino et al, 2012;Jefferds et al, 2010;Munares-García & Gómez-Guizado, 2016;Kodish et al, 2011). Concerns for gastrointestinal side effects from MNP use have been widely discussed in the literature (Creed-Kanashiro et al, 2016;Jefferds et al, 2010;Kodish et al, 2011;Munares-García & Gómez-Guizado, 2016;Osei et al, 2014;Sarma et al, 2016), and other studies in Peru support the idea that poor taste can cause complications in MNP administration (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012). However, other studies show that the extent to which side effects influence MNP adherence can vary based on the counselling provided and that caregivers are less likely to forego administration if they are warned about these issues (Pelletier & DePee, 2019;Tumilowicz, Schnefke, Neufeld, & Pelto, 2017).…”

“…Given that we found that caregivers frequently complained about taste while health personnel said MNP were tasteless when prepared correctly, it seems unlikely that health personnel are trained to preemptively address complications with MNP. Other studies also show that interactions with the people who distribute MNP can affect caregivers' sentiments towards and use of the product (Creed‐Kanashiro et al, ; Kodish et al, ; Munares‐García & Gómez‐Guizado, ; Sarma et al, ). Similarly, we found that caregivers were dissuaded from using MNP if they felt they had received insufficient information from health personnel or had other negative experiences at health establishments.…”

“…MNPs are distributed during well-child check-ups and promoted through free home visits and informational sessions in public health establishments (Ministerio de Salud, 2014). However, an early study of the nationwide programme showed low adherence to MNP, with only 24.4% of children consuming more Research findings on MNP use in Peru suggest that misconceptions around preparation of MNP, nausea or dislike of taste upon consumption, and negative comments from family and peers were key barriers to adherence (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016). This research identifies the key facilitators as familial support, culturally appropriate counselling techniques, and recognition of improved child health (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016).…”

“…MNPs are distributed during well‐child check‐ups and promoted through free home visits and informational sessions in public health establishments (Ministerio de Salud, ). However, an early study of the nationwide programme showed low adherence to MNP, with only 24.4% of children consuming more than 90% of their allocated MNP sachets (Munares‐García & Gómez‐Guizado, ).…”

“…However, an early study of the nationwide programme showed low adherence to MNP, with only 24.4% of children consuming more Research findings on MNP use in Peru suggest that misconceptions around preparation of MNP, nausea or dislike of taste upon consumption, and negative comments from family and peers were key barriers to adherence (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016). This research identifies the key facilitators as familial support, culturally appropriate counselling techniques, and recognition of improved child health (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016). Analysis of MNP interventions in other countries shows that these barriers and facilitators are not unique to Peru and have had similar influence on programme effectiveness worldwide (Akoto Osei et al, 2014;Sarma, Uddin, Harbour, & Ahmed, 2016;Jefferds et al, 2010;Kodish, Rah, Kraemer, de Pee, & Gittelsohn, 2011;Sutrisna, Vossenaar, Izwardy, & Tumilowicz, 2017;Tripp et al, 2011).…”