Improved Information and Educational Messages on Outer Packaging of Micronutrient Powders Distributed in Indonesia Increase Caregiver Knowledge and Adherence to Recommended Use

Sutrisna, Aang; Vossenaar, Marieke; Poonawala, Alia; Mallipu, Agnes; Izwardy, Doddy; Menon, Ravi; Tumilowicz, Alison

doi:10.3390/nu10060747

Cited by 3 publications

(2 citation statements)

References 21 publications

(26 reference statements)

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“…diarrhea, darkening of stools, unusually smelly stools, and constipation) are probably not surprising, given that similar complaints have been reported from elsewhere in Sub-Saharan Africa, including change in the color, taste, smell and texture of food when mixed with MNP [ 18 , 19 , 31 ]. Similarly, mothers in Indonesia complained about MNP changing the taste and color of food [ 32 , 33 ]. It is possible there was a bias of over-reporting these possible side effects, as observed in South Africa [ 34 ], with mothers and caregivers wrongly attributing any symptom to the addition of MNPs to the children’s food.…”

Section: Discussionmentioning

confidence: 99%

Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana

et al. 2020

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Background Micronutrient deficiencies affect many children in low-income settings due primarily to over-reliance on complementary foods low in nutrients. Home-fortification (HF) could improve children’s diet quality in these settings. The Ghana Health Service, supported by UNICEF, integrated the pilot Micronutrient Powder Initiative (MPI) into Child Welfare Clinic (CWC) services in four districts (Tain, Tolon, Talensi, and Ho West), whereby micronutrient powder (MNP) is supplied for HF for children aged 6–23 months attending CWCs. This study’s main aim was to identify the facilitators, barriers and “lessons learned” after 2 years of program implementation. Methods This was a qualitative cross-sectional study. MNP distributed and children enrolled were obtained from program records. Primary data were collected from November to December 2019 and included, by district: interviews with senior program staff; key informant interviews and focus group discussion with caregivers in each of 6 sub-districts; and discussions workshop with frontline staff from at least 10 health facilities. Besides field notes, all interactions were audio-recorded and transcribed verbatim. Qualitative data were analyzed using NVivo10. Results The MPI remains on-going, with about 2.5 million MNP sachets distributed to nearly 30,000 children within 90 district-months. Caregivers generally accept the MNP; reported positive responses in children include: “increased appetite”, “less frequent illnesses, “increased energy/strength”, “increased weight”, and “walking independently relatively early”. Main facilitators are: generally regular MNP availability; increased patronage of CWC services; various contact points for supplying MNPs; fairly strong social mobilization strategy; good integration of MPI with CWC services; “one-on-one” counselling for caregivers reporting side effects; and tracing caregivers to address concerns and monitor adherence. Main barriers are: lack of counselling materials; caregivers’ suspicions towards the program; absence of refresher training for frontline workers; and perceived MNP side-effects. Key lessons learned are: incorporating MNPs into CWC services is feasible, acceptable, and could reduce child micronutrient deficiencies in program districts; and MPI’s success requires stronger community sensitization, equipping frontline workers to advise caregivers and manage side-effects, and consciously identifying and managing logistical challenges. Conclusion Further research is needed to evaluate the effectiveness of the MPI in reducing micronutrient deficiencies among 6–23-months-olds in Ghana.

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Section: Discussionmentioning

confidence: 99%

Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana

et al. 2020

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“…Overall, these papers bring out important lessons for future scale‐up of programs that provide MNP. Impact of MNP on taste/sensory characteristics are frequently reported—this is contrary to the typical statement that MNP is a virtually tasteless powder that can be mixed with a child's food without children being able to distinguish between foods with and without MNP (Sutrisna et al, ) and is very important to acknowledge, whether it is proven or not. The issue should be addressed technically, i.e.…”

Section: The Current Studiesmentioning

confidence: 85%

Micronutrient powder programs: New findings and future directions for implementation science

Pelletier

Pee

2019

Matern Child Nutr

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Improved Information and Educational Messages on Outer Packaging of Micronutrient Powders Distributed in Indonesia Increase Caregiver Knowledge and Adherence to Recommended Use

Cited by 3 publications

References 21 publications

Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana

Lessons learned from implementing the pilot Micronutrient Powder Initiative in four districts in Ghana

Micronutrient powder programs: New findings and future directions for implementation science

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