Examination of facilitators and barriers to home‐based supplemental feeding with ready‐to‐use food for underweight children in western Uganda

Abstract

Poor complementary feeding practices and low quality complementary foods are significant causes of growth faltering and child mortality throughout the developing world. Ready-to-use foods (RUF) are energy dense, lipid-based products that do not require cooking or refrigeration, that have been used to prevent and treat malnutrition among vulnerable children. The effectiveness of these products in improving child nutritional status depends on household use by caregivers. To identify the key facilitators and barriers that influence appropriate in-home RUF consumption by supplemental feeding program beneficiaries, we conducted individual interviews among caregivers (n=80), RUF producers (n=8) and program staff (n=10) involved in the Byokulia Bisemeye mu Bantu (BBB) supplemental feeding program in Bundibugyo, Uganda. By documenting caregiver perceptions and feeding practices related to RUF, we developed a conceptual framework of factors that affect appropriate feeding with RUF. Findings suggest that locally produced RUF is well received by caregivers and children, and is perceived by caregivers and the community to be a healthy supplemental food for malnourished children. However, child feeding practices, including sharing of RUF within households, compromise the nutrient delivery to the intended child. Interventions and educational messages informed by this study can help to improve RUF delivery to targeted beneficiaries.

Impact of lipid‐based nutrient supplementation (LNS) on children's diet adequacy in Western Uganda

“…Potential confounders in the regression models were selected based on findings from an earlier qualitative study (Ickes et al . ) and theoretical knowledge of factors that influence children's diets in developing countries (Black et al . ).…”

“…; Ickes et al . ). Further, caregivers in this remote setting found it difficult to attend weekly programme sessions because of the opportunity costs of foregone household responsibilities, as well as a long commuting distance.…”

Peanut-based ready-to-use therapeutic food: acceptability among malnourished children and community workers in Bangladesh

“…Overall, 121 (81%) children had SAM and 28 (19%) had MAM. Nearly 51% of the included children had received PPN for 3 weeks and the remainder had received it for >3 weeks (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

“…While some studies in Africa have shown that peanut-based RUTF has good acceptability and compliance among severely malnourished children, 10-12 other studies have demonstrated barriers to its use and inadequate compliance, mainly due to sharing within the households. 13,14 There is, however, limited published literature on PPN acceptability in South Asia.In the present study, we assessed the acceptability of PPN among 1) care givers of malnourished children and 2) community health workers (CHWs), in Kamrangirchar slum, Dhaka, Bangladesh. …”

Considerations in developing lipid‐based nutrient supplements for prevention of undernutrition: experience from the International Lipid‐Based Nutrient Supplements (iLiNS) Project

“…To date, the acceptability of LNS with peanut as a main ingredient has also been confirmed in a number of trials in Africa, including in Burkina Faso, Ghana, Malawi, Niger, Uganda and Zimbabwe (Flax et al 2009;Adu-Afarwuah et al 2011;Hess et al 2011;Parker et al 2011;Phuka et al 2011;Tripp et al 2011;Cohuet et al 2012;Ickes et al 2012;Paul et al 2012). Peanut-flavoured LNS have also been found acceptable in other regions [Haiti (Heidkamp et al 2012); Guatemala (Matias et al 2011); and Bangladesh (Mridha et al 2012)].…”