Consumo de suplementos con multimicronutrientes Chispitas® y anemia en niños de 6 a 35 meses: estudio transversal en el contexto de una intervención poblacional en Apurímac, Perú

Huamán-Espino, Lucio; Aparco, Juan Pablo; Nuñez-Robles, Eloisa; Gonzáles, Elena; Pillaca, Jenny; Mayta‐Tristán, Percy

doi:10.1590/s1726-46342012000300004

Cited by 27 publications

(41 citation statements)

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“…MNPs are distributed during well-child check-ups and promoted through free home visits and informational sessions in public health establishments (Ministerio de Salud, 2014). However, an early study of the nationwide programme showed low adherence to MNP, with only 24.4% of children consuming more Research findings on MNP use in Peru suggest that misconceptions around preparation of MNP, nausea or dislike of taste upon consumption, and negative comments from family and peers were key barriers to adherence (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016). This research identifies the key facilitators as familial support, culturally appropriate counselling techniques, and recognition of improved child health (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016).…”

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confidence: 88%

“…Moreover, anaemia is higher in the jungle and highland regions (53.6 and 52.0%) compared with coastal areas (39.3%; Instituto Nacional de Estadística e Informática, 2018). In response to the high rates of anaemia, the Peruvian Ministry of Health implemented a pilot programme in 2009 distributing free MNP to children aged 6-36 months in three Andean regions (Huancavelica, Ayacucho, and Apurímac;Huamán-Espino et al, 2012) and in 2010, expanded to Cajamarca (Creed-Kanashiro, Bartolini, Abad, & Arevalo, 2016). The programme was then implemented nationwide in 2014 (Ministerio de Salud, 2014; Munares-García & Gómez-Guizado, them daily for 12 months, a departure from pilot tests, which recommended consumption every other day for 6 months (Creed-Kanashiro et al, 2016;Ministerio de Salud, 2014).…”

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confidence: 99%

“…However, an early study of the nationwide programme showed low adherence to MNP, with only 24.4% of children consuming more Research findings on MNP use in Peru suggest that misconceptions around preparation of MNP, nausea or dislike of taste upon consumption, and negative comments from family and peers were key barriers to adherence (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016). This research identifies the key facilitators as familial support, culturally appropriate counselling techniques, and recognition of improved child health (Creed-Kanashiro et al, 2016;Huamán-Espino et al, 2012;Munares-García & Gómez-Guizado, 2016). Analysis of MNP interventions in other countries shows that these barriers and facilitators are not unique to Peru and have had similar influence on programme effectiveness worldwide (Akoto Osei et al, 2014;Sarma, Uddin, Harbour, & Ahmed, 2016;Jefferds et al, 2010;Kodish, Rah, Kraemer, de Pee, & Gittelsohn, 2011;Sutrisna, Vossenaar, Izwardy, & Tumilowicz, 2017;Tripp et al, 2011).…”

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Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels

Brewer

Santos

Román

et al. 2019

Maternal & Child Nutrition

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In Peru, nearly half of children aged 6–36 months were diagnosed with anaemia in 2017. To address this disease, the Peruvian Ministry of Health implemented a national programme in 2014, distributing free micronutrient powders (MNPs) to all children of this age. However, rates of childhood anaemia remain high. The aim of this study was to explore factors at all levels of the Social‐Ecological Model that affect MNP use and adherence in Arequipa, an Andean city with childhood anaemia rates higher than the national average. We conducted in‐depth interviews with 20 health personnel and 24 caregivers and 12 focus group discussions with 105 caregivers. We identified numerous barriers, including negative side effects (constipation, vomiting, and diarrhoea), poor taste of MNP, lack of familial and peer support for its use, insufficient informational resources provided by the health system, and limited human resources that constricted health personnel abilities to implement MNP programming successfully. Facilitators identified included concern about the long‐term effects of anaemia, support from organizations external to the health system, well‐coordinated care within the health system, and provision of resources by the Ministry of Health. We found that community or organizational and societal factors were key to limited MNP use and adherence, specifically the limited time health personnel have to address caregivers' doubts during appointments and the lack of informational resources outside of these appointments. Potential policy implications could be to increase informational resources available outside of individualized counselling by strengthening existing collaborations with community organizations, increasing media coverage, and providing group counselling.

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confidence: 88%

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confidence: 99%

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confidence: 99%

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Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels

Brewer

Santos

Román

et al. 2019

Maternal & Child Nutrition

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“…Realizamos un análisis secundario de la base de datos de la Evaluación de la suplementación con MNP en niños de 6 a 35 meses de edad de Apurímac, ejecutada por el Centro Nacional de Alimentación y Nutrición (CENAN) (9) . El diseño del estudio original comprendía dos evaluaciones transversales; la evaluación basal en 2009 (sin distribución de MNP) y la final en 2010 (con distribución de MNP), para el estudio usamos la información de las dos evaluaciones.…”

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“…Se eligió este suplemento porque la evidencia mostraba mayor aceptabilidad frente al sulfato ferroso (7,8) . A la fecha, se han publicado dos estudios sobre la efectividad de esta intervención piloto, con resultados diferentes, el primer estudio no encontró efectividad de los MNP para reducir la anemia al comparar las prevalencias regionales en Apurímac para los 2009 y 2010 (9) . Mientras que, el segundo estudio, con un diseño de vigilancia centinela en 29 establecimientos de salud del Ministerio de Salud (MINSA) de las tres regiones, reportó una reducción de 37 puntos porcentuales en la prevalencia de la anemia (10) ; sin embargo, la estimación del impacto podría tener algunos sesgos, debido a la pérdida de la muestra (11) (42% del total) y por no contar con grupo control (12) .…”

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Impacto de micronutrientes en polvo sobre la anemia en niños de 10 a 35 meses de edad en Apurímac, Perú

Aparco

Bullón

Cusirramos

2019

Rev Peru Med Exp Salud Publica

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a Licenciado en Nutrición, magíster en Nutrición Pública; b ingeniero estadístico, magíster en Estadística; c licenciada en Nutrición Humana, magíster en Nutrición Pública. El presente estudio forma parte de la tesis de Juan Pablo Aparco para obtener el grado de Magister en Nutrición RESUMENObjetivos. Evaluar el impacto de la suplementación con micronutrientes en polvo (MNP) en la reducción de anemia en niños de 10 a 35 meses de edad de Apurímac, Perú. Materiales y métodos. Se realizó un análisis secundario de la base de datos de la Evaluación de suplementación con MNP en la región de Apurímac, realizada por el Centro Nacional de Alimentación y Nutrición (CENAN) entre 2009 y 2010. Se definió como grupo de intervención a los niños que consumieron 60 o más sobres de MNP, para generar los controles (niños sin consumo de MNP) aplicamos un propensity score matching (PSM), y en la estimación del impacto de los MNP comparamos la prevalencia de anemia en cada grupo de estudio, ponderada por la probabilidad de participación, aplicando tres algoritmos de emparejamiento: vecino más cercano, kernel y regresión lineal local. Todos los cálculos se realizaron en el programa estadístico Stata 14 SE. Resultados. La prevalencia de anemia fue significativamente menor hasta en 11 puntos porcentuales en el grupo de intervención comparado con los controles (p=0,001) y que el promedio de hemoglobina aumentó en 0,3 g/dL en el mismo grupo (p<0,001). Conclusiones. La suplementación con MNP mostró impacto para reducir la anemia e incrementar el nivel de hemoglobina en niños que consumieron 60 o más sobres de MNP en un periodo de seis meses. Se deben continuar los esfuerzos por reducir la anemia empleando los MNP para prevenir esta deficiencia nutricional.Palabras clave: Anemia; Hierro; Micronutrientes; Evaluación del Impacto en la Salud; Niño (fuente: DeCS BIREME). ABSTRACTObjective. Objective. To assess the impact of micronutrient powder supplementation (MNP) in reducing anemia in children aged 10 to 35 months in Apurimac, Peru. Materials and Methods. A secondary analysis of the database of the Evaluation of supplementation with MNP in the Apurímac region, conducted by the National Food and Nutrition Center (CENAN, in Spanish) between 2009 and 2010, was conducted. The intervention group was defined as children who consumed 60 or more packets of MNP; to generate the controls (children who did not consume MNP), we applied a propensity score matching (PSM); and, to estimate the impact of the MNP, we compared the prevalence of anemia in each study group, weighted by the probability of participation, applying three matching algorithms: nearest neighbor, kernel and local linear regression. All calculations were performed in the Stata 14 SE statistical program. Results. The prevalence of anemia was significantly lower by up to 11 percentage points in the intervention group compared to controls (p=0.001), and mean hemoglobin increased by 0.3 g/dL in the same group (p<0.001). Conclusions. MNP supplementation showed impact in reducing anemia and in...

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Point-of-use fortification of foods with micronutrient powders containing iron in children of preschool and school-age

De-Regil

Jefferds

Peña-Rosas

2017

Cochrane Database of Systematic Reviews

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Consumo de suplementos con multimicronutrientes Chispitas® y anemia en niños de 6 a 35 meses: estudio transversal en el contexto de una intervención poblacional en Apurímac, Perú

Cited by 27 publications

References 28 publications

Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels

Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels

Impacto de micronutrientes en polvo sobre la anemia en niños de 10 a 35 meses de edad en Apurímac, Perú

Point-of-use fortification of foods with micronutrient powders containing iron in children of preschool and school-age

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