Understanding Low Usage of Micronutrient Powder in the Kakuma Refugee Camp, Kenya: Findings from a Qualitative Study

Kodish, Stephen; Rah, Jee Hyun; Kraemer, Klaus; Pee, Saskia de; Gittelsohn, Joel

doi:10.1177/156482651103200315

Cited by 54 publications

(83 citation statements)

References 20 publications

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“…The vast majority of published papers report on evaluations in the context of a pilot project (Creed‐Kanashiro, Bartolini, Abad, & Arevalo, 2015; Harris et al, 2012; Jefferds et al, 2015; Korenromp et al, 2015; Loechl et al, 2009; Mirkovic, Perrine, Subedi, Mebrahtu, Dahal, & Jefferds, 2016; Mirkovic, Perrine, Subedi, Mebrahtu, Dahal, Staatz, et al, 2015; Nguyen et al, 2016; Suchdev et al, 2010, 2013; Sun et al, 2011), with the exception of Bangladesh which reports on national programmes (Afsana, Haque, Sobhan, & Shahin, 2014; Angdembe, Choudhury, Haque, & Ahmed) and three large‐scale MNP distribution in refugee camps and in emergency contexts (de Pee et al, 2007; Kodish, Rah, Kraemer, de Pee, & Gittelsohn, 2011; Rah et al, 2012). …”

Section: Resultsmentioning

confidence: 99%

“…Among the 15 published papers in Table 4, seven relied on a mixture of quantitative and qualitative activities (Afsana et al, 2014; Korenromp et al, 2015; Loechl et al, 2009; Nguyen et al, 2016; Suchdev et al, 2010), or solely qualitative activities (Creed‐Kanashiro et al, 2015; Kodish et al, 2011). The vast majority of published papers relied on one or more surveys with caregivers for data collection; four used direct observations at the delivery stage or in the household (Creed‐Kanashiro et al, 2015; Kodish et al, 2011; Korenromp et al, 2015; Loechl et al, 2009), and three conducted in‐depth interviews with key informants or focus groups (Kodish et al, 2011; Loechl et al, 2009; Suchdev et al, 2010). …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Experiences and lessons learned for programme improvement of micronutrient powders interventions

Vossenaar¹,

Tumilowicz

D’Agostino

et al. 2017

Maternal & Child Nutrition

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Continual course correction during implementation of nutrition programmes is critical to address factors that might limit coverage and potential for impact. Programme improvement requires rigorous scientific inquiry to identify and address implementation pathways and the factors that affect them. Under the auspices of “The Micronutrient Powders Consultation: Lessons Learned for Operational Guidance,” 3 working groups were formed to summarize experiences and lessons across countries regarding micronutrient powder (MNP) interventions for young children. This paper focuses on how MNP interventions undertook key elements of programme improvement, specifically, the use of programme theory, monitoring, process evaluation, and supportive supervision. Methods included a review of published and grey literature, interviews with key informants, and deliberations throughout the consultation process. We found that although much has been written and published about the use of monitoring and process evaluation to inform MNP interventions at small scale, there has been little formal documentation of lessons for the transition from pilot to scaled implementation. Supervision processes and experiences are not documented, and to our knowledge, there is no evidence of whether they have been effective to improve implementation. Improving the efficiency and effectiveness of interventions requires identification of critical indicators for detecting implementation challenges and drivers of impact, integration with existing programmes and systems, strengthened technical capacity, and financing for implementation of effective monitoring systems. Our understanding of programme improvement for MNP interventions is still incomplete, especially outside of the pilot stage, and we propose a set of implementation research questions that require further investigation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Experiences and lessons learned for programme improvement of micronutrient powders interventions

Vossenaar¹,

Tumilowicz

D’Agostino

et al. 2017

Maternal & Child Nutrition

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show abstract

“…An evaluation of MNCHW performance in Rivers State, Nigeria, in 2012 also revealed low rates (29 %) of awareness of the event, a coverage of <25 % and short supply of health commodities (14) . Procurement problems for MNP and BCC materials, the timeliness, intensity and effectiveness of social marketing, limited capacity to ensure fidelity with BCC protocols and lack of a monitoring process have also been reported in other MNP pilots and programmes regardless of the distribution model used (3,15,16) . Despite the latter shortcomings, once caregivers received the MNP, these were generally well accepted, consistent with reports from other studies (17) , and among users, the recommendation to provide MNP two or three times per week was generally adhered to.…”

Section: Discussionmentioning

confidence: 99%

Micronutrient powder distribution through Maternal, Neonatal and Child Health Weeks in Nigeria: process evaluation of feasibility and use

Korenromp

Adeosun

Adegoke

et al. 2015

Public Health Nutr.

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Objective: To determine the feasibility of distributing micronutrient powders (MNP) for home fortification during biannual Maternal, Neonatal and Child Health Week (MNCHW) events, as a strategy to improve young child nutrition. Design: We evaluated the coverage, delivery, use and adherence of MNP, and associated behaviour change communication (BCC) materials and social mobilization, through cross-sectional surveys of caregivers attending healthservice distribution events and health workers involved in MNP distribution, facility-based observations of MNP distribution activities and a repeated survey of caregivers in their homes who received MNP for their child. Setting: Four Local Government Areas in Benue State, Nigeria. Subjects: Caregivers of children 6-59 months of age attending health-service distribution events. Results: The 8 million MNP delivered in this pilot during three distribution events were estimated to reach about one-third of eligible children in the area at each event. Programme fidelity was limited by shortages of MNP, BCC materials and inadequate social mobilization, with some limitations in health worker training and engagement. MNP use was consistent with the recommended two or three sachets per week among 51-69 % of caregivers surveyed at home. Conclusions: MNP coverage was low, but consistent with that typically achieved with other services delivered through MNCHW in Benue. Among caregivers who received MNP, acceptance and use among targeted children was high. While some weaknesses in knowledge and delivery of MNP by health workers were observed, health system strengthening and more extensive social mobilization would be key to achieving higher coverage with MNP and other health services provided through MNCHW.

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“…Las entrevistas se aplicaron a madres de niños menores de tres años en el ES o en sus hogares y tuvieron una duración promedio de 73 minutos. Los ejes temáticos o dimensiones se definieron en función de la dinámica de la suplementación con MNP y los antecedentes abordados por estudios previos (7,12,15,16), los cuales fueron: a) conocimientos sobre MNP, b) atención en suplementación con MNP, c) barreras y facilitadores para la suplementación con MNP, d) Beneficios percibidos del MNP y d) recomendaciones para mejorar la suplementación con MNP. El instrumento se aplicó en pilotos en las cuatro regiones para adecuar las preguntas al contexto.…”

Section: Entrevistasunclassified

“…Otros países también encontraron barreras a la suplementación con MNP y dado que el objetivo biológico de aumentar la hemoglobina estaba mediado por los servicios de salud, por el cuidador (madre, familiar, etc.) y por el producto; estudiaron estos tres procesos como las vías de impacto del programa y como factores que ocasionan fallas a la implementación del mismo (7,15,16) . Las intervenciones socialmente complejas, que involucran múltiples actores con diversos roles y con una forma propia de entender y experimentar el proceso, como el caso de la suplementación con MNP; deben evaluarse en su contexto y con la finalidad de comprender el proceso (17) .…”

Section: Introductionunclassified

Barreras y facilitadores a la suplementación con micronutrientes en polvo. Percepciones maternas y dinámica de los servicios de salud

Aparco

Huamán-Espino

2017

Rev Peru Med Exp Salud Publica

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Understanding Low Usage of Micronutrient Powder in the Kakuma Refugee Camp, Kenya: Findings from a Qualitative Study

Cited by 54 publications

References 20 publications

Experiences and lessons learned for programme improvement of micronutrient powders interventions

Experiences and lessons learned for programme improvement of micronutrient powders interventions

Micronutrient powder distribution through Maternal, Neonatal and Child Health Weeks in Nigeria: process evaluation of feasibility and use

Barreras y facilitadores a la suplementación con micronutrientes en polvo. Percepciones maternas y dinámica de los servicios de salud

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