Acceptance and Compliance With Micronutrient Powder and Complementary Food Blend Use by Filipino Mothers and Their Promotion by Community Workers

Abstract

Background: Despite the nationwide micronutrient powder (MNP) supplementation, the Philippines only saw limited success in reducing the prevalence of anemia-a condition that has remained a public health concern among young children. Objective: To assess and explore the acceptability and compliance to MNP and Bigas-Mongo (BigMo) complementary food blend among mothers/caregivers of children aged 6 to 23 months and the promotion of these products by community health workers (CHWs). Methods: This study was part of the randomized controlled trial involving 3 methods of data collection: (1) bimonthly visits to mothers and caregivers for 6 months to determine the level of acceptability and compliance of the 4 intervention groups; (2) initial and final interviews with mothers/ caregivers (initial ¼ 141; final ¼ 130) to gather their experiences and difficulties in MNP and BigMo preparation and feeding; and (3) focus group discussion (n ¼ 4) among CHWs (n ¼ 13) to understand their perceptions and difficulties in promoting MNP and BigMo. Results: The overall compliance to MNP consumption was 74.7%, with some difference between the groups. Analysis of the information received from mothers/caregivers showed that maternal adaptive strategies in preparing and feeding MNP to their children could affect MNP use, while nonreceptiveness of mothers to integrating MNP into the child's feeding routine, perceived side effects, and perceived unfavorable taste and smell were key factors considered to limit MNP use.

Role of home visits by volunteer community health workers: to improve the coverage of micronutrient powders in rural Bangladesh

“…They do this by interacting with caregivers and discussing their problems with the programme team (10) . There are some barriers to a successful implementation of MNP interventions, such as misconceptions around MNP, side-effects of MNP and inconsistent supply of MNP product (12) , and regular home visits (expected at least one visit per month) by CHWs might help overcome these (11,29,30) .…”

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

“…Also highly cited was the interventions' ability to prevent disease, illness and malnutrition, with the intervention even being compared with medication (22)(23)(24)(25) , as similarly reported in previous studies (55,57) . Interestingly, when noting improved growth, such as weight, height and strength, some caregivers also noted neurodevelopmental improvements (17)(18)(19)(20)(21)(24)(25)(26)(27)(28)(29)(30)(31)(32) . Caregivers did report organoleptic changes in food (colour, taste, smell and texture) when micronutrient powders were added (29,37) .…”

“…One of the most noted reasons for low acceptability was poor communication and/or understanding such as lack of caregiver self-efficacy and forgetfulness, limited social support and/or availability/accessibility to the intervention. Appropriate training of intervention use is essential; in one study, a participant reported stopping the intervention when the infant needed medication, counter to the intention of the study ( 27 ) . One caregiver simply gave no reason, they just did not want to use the intervention, and another cited seeing no impact from the intervention ( 17 , 20 , 26 ) .…”

“…Side effects that were noted, but not in the context of low acceptability were diarrhoea, vomiting, and constipation, nausea, lack of appetite and abdominal discomfort, respectively, from most to least cited (21,23,27,32,36,37,44) .…”

Effects of Virtual Health Messages on Maternal Therapeutic Adherence for Childhood Anemia

“…However, the expected results have not been obtained due to the absence of qualified personnel to verify and supervise its continuity (8). In Perú, the government has promoted various nutritional programs for several decades, nevertheless, there are still high rates of anemia in several regions of the country (9). Therefore, it is necessary to take measures and join efforts to improve therapeutic adherence to ferrous sulfate, as well as having trained and qualified personnel for their adequate management in the continuous assessment of the effectiveness of these interventions (10,11).…”