A Mixed-Methods Study of Factors Influencing Access to and Use of Micronutrient Powders in Rwanda

Abstract

In Rutsiro district, the unavailability of multiple micronutrients powder (MNP) was mentioned as a major barrier to accessing it. Factors that appeared to limit the use of MNP included perceived side effects and the perceptions that MNP is designed for undernourished children, coupled with inappropriate child feeding practices, particularly feeding thin/watery complementary foods.n Mothers of older children (aged 12-23 months) had about 4 times higher odds of using MNP than mothers of younger children (aged 6-11 months), while mothers whose children participated in the supplementary food program had about 3 times higher odds of using MNP than mothers whose children have never participated in the program. Food insecurity, as indicated by increasing household hunger score, was significantly associated with reduced odds of using MNP.

Strategies for better integrating nutrient supplementation and dietary diversity approaches for stunting reduction and improved nutrition outcomes: A Rwandan case study

“…A regional study in Rwanda reveals that, while 64% of mothers had given micronutrients to their children, only 38% had done so over the preceding seven days (Dusingizimana et al, 2021). recognized, evaluating actual compliance to these interventions and quantifying the explicit costs of any corrective measure would require field research which is beyond the scope of this article.…”

Barriers to and Facilitators of the Implementation of a Micronutrient Powder Program for Children: A Systematic Review Based on the Consolidated Framework for Implementation Research

“…In several countries, unavailable MNP was generated by a lack of local suppliers and unstable supply chains. Several studies also cited that adequate allocation of financial and human resources was essential but limited in many countries [12,23,29,30,40,45,46,50,52]. For example, primarylevel workers were often too busy to perform intervention activities.…”

“…The most common driving factor was the good coordination of the MNP program within the health system. Relying on the primary health care system, primary-level workers undertook the tasks of MNP distribution, social and behavior change communication (SBCC), and program monitoring (such as making regular visits to evaluate if MNPs were used correctly and effectively) [3,20,31,39,[44][45][46][52][53][54]. In this way, the users were more receptive to interventions considering the authority of primary-level workers.…”

Micronutrient Powders for Infants and Young Children

“…The article by Dusingizimana et al 14 in this issue of Global Health: Science and Practice documents the performance of an MNP program in Rwanda. As they report, MNPs have been implemented in Rwanda with support from United Nations Children's Fund (UNICEF) and other partners.…”

“…In this study, 14 program performance was assessed in Rutsiro district, 1 of 19 in the first wave of scale-up. The district was selected for this study primarily because it was found to have a particularly poor baseline nutrition status.…”