A feasibility study of multiple micronutrient supplement for home fortification of foods among Orang Asli children in Negeri Sembilan, Malaysia

Abstract

Introduction:The prevalence of child undernutrition and micronutrient deficiencies are higher in the Orang Asli (OA) than the general Malaysian population. The World Health Organization recommends the use of multiple micronutrient supplement (MMS) that is a blend of micronutrients in powder form that can be sprinkled onto foods for home fortification to prevent undernutrition among children. This pilot study aimed to assess the feasibility of using MMS among OA children. Methods: A total of 25 OA children (14 boys and 11 girls) aged 6-31 months (mean±SD = 15.7±7.2 months) in Negeri Sembilan were given three sachets of MMS weekly for 5 weeks. Caregivers were instructed to add MMS to three types of food from the same food group per week varying with a different food group weekly. Written instruction for using MMS in simple language was given prior to the supplementation. Caregivers were interviewed for information on socio-demographics, compliance, acceptance, preference and adverse effect of MMS. Results: A high level of compliance was observed (85%). All caregivers reported that the instructions for use were easy to read. No noticeable changes to the foods mixed with MMS were observed and no adverse effects were reported. Conclusion: This study demonstrated feasibility of the use of MMS for future trials among OA children. The easy to read information that comes with the MMS, frequent monitoring of MMS use and support to caregivers were required to ensure compliance. Cultural feeding practices and financial constraints may limit the types of food that can be mixed with MMS.

Caregiver perceptions of nutrition interventions in infants and children under 24 months of age: a systematic review

“…Education around interventions not always having an immediate impact, but rather long-term benefits may have solved this issue. Lastly, ease of use of packaging and storing, as well accessibility and affordability, was indicated as crucial (20,(24)(25)(26)29,31,35,(38)(39)(40) .…”

“…Within the context of patriarchal households, when mothers felt supported by their husbands, they were more inclined to adhere to an intervention (21,31,33,(35)(36)(37) . Ease in packing and storage, accessibility and affordability were keys factors in caregiver use of intervention (n 10) (20,(24)(25)(26)29,31,35,(38)(39)(40) . Education around purpose and administration of the intervention were key to ensuring acceptability and continuation of use as caregivers wanted to follow nutrition guidance when it was given (n 7) (18,19,22,25,28,33,41) .…”