Factors affecting the acceptability and consumption of Corn Soya Blend Plus as a prenatal dietary supplement among pregnant women in rural Cambodia

Abstract

Objective: Undernutrition is prevalent among pregnant women in Cambodia. The provision of fortified dietary supplements is one strategy to help pregnant women meet their nutritional needs. Corn Soya Blend Plus (CSBP) is a widely used prenatal dietary supplement in areas with high rates of undernutrition and food insecurity. However, little is known about its acceptability during pregnancy. The present study aimed to identify factors that affected the acceptability and consumption of CSBP supplements among pregnant women. Design: Women completed a structured interview designed to provide information on facilitators of and barriers to utilization. In addition, six focus groups were conducted with a subset of women (n 70) to further explore attitudes, perceptions and experiences related to CSBP use. Setting: Two districts in Kampong Chhnang Province, Cambodia. Subjects: Pregnant women (n 288) participating in a cluster-randomized trial of CSBP. Results: The acceptability of CSBP was influenced by sensory attributes, family support, peer influences, and attitudes related to diet, nutritional status and weight gain in pregnancy. Attaining adequate nutrition was considered less important than other concerns during pregnancy, particularly anxiety related to the costs of delivery and postpartum care. Acceptance was lower among new mothers due to fears of weight gain. Health benefits were common reasons for continued use and minor side-effects, such as nausea, were not major barriers to consumption. Conclusions: CSBP was generally well accepted in this population. However, organoleptic factors and perceptions regarding nutrition and weight gain in pregnancy, particularly for first-time mothers, were barriers to increasing acceptance among Cambodian women.

Home consumption of two fortified balanced energy protein supplements by pregnant women in Burkina Faso

“…The results on drivers of supplement use collected during this study are in line with other acceptability studies, in which perceived health benefits for women and their babies appeared to be an important motivating factor for daily consumption (Adu-Afarwuah, Lartey, Zeilani, & Dewey, 2011;Iuel-Brockdorf et al, 2016;Janmohamed et al, 2015;Klevor et al, 2016). Moreover, positive attitudes of stakeholders have been found to be an important factor to promote acceptability and sustained use of supplementary foods by pregnant women in a study evaluating the acceptability of corn-soya blend in rural Cambodia (Janmohamed et al, 2015). Although we did not observe large difference in the responses to stratify the results per stakeholder group, the interviews provided valuable information that family members, community leaders and health professionals support the use of BEP supplements.…”

“…Although FBFs are often regarded as family foods, little is known about what type of ready-to-use product(s) pregnant and lactating women appreciate and how they are used. Understanding the factors that determine the acceptability of BEP supplements is however crucial to reduce the risk of poor compliance (Iuel-Brockdorf et al, 2016;Janmohamed et al, 2015;Young, Blanco, Hernandez-Cordero, Pelto, & Neufeld, 2010). Hence, prior to testing the efficacy in the main trial, a formative study to assess acceptability and utilization of BEP supplements was designed.…”

Diets and Feeding Practices during the First 1000 Days Window in the Phnom Penh and North Eastern Districts of Cambodia

“…Malnutrition in pregnancy is known to increase the risk of low birth weight [ 12 ] and early stunting, which might affect optimal development during childhood [ 15 ]. Poor eating habits have several causes in Cambodia, including, for example, women tending to compromise on food purchases to save money for childbirth expenses [ 16 ]. Additionally, ‘eating well’ in pregnancy typically means increasing intake of routinely consumed foods, namely rice, as opposed to seeking foods with a higher protein and micronutrient content, such as meat and eggs [ 16 ].…”

“…Poor eating habits have several causes in Cambodia, including, for example, women tending to compromise on food purchases to save money for childbirth expenses [ 16 ]. Additionally, ‘eating well’ in pregnancy typically means increasing intake of routinely consumed foods, namely rice, as opposed to seeking foods with a higher protein and micronutrient content, such as meat and eggs [ 16 ]. Moreover, according to recent NNP/UNICEF/Helen Keller International (HKI) [ 17 ] formative research, pregnant women, especially in Phnom Penh, limit the amount and type of food they eat to ensure that the baby does not grow ‘too big’ to guarantee an ‘easy’ delivery and postpartum recovery.…”

Thiamine fortification strategies in low‐ and middle‐income settings: a review

“…121 Restrictive diets during pregnancy are less common, but the practice of "eating down" to avoid the perceived difficult delivery of a large baby has been reported. 117,122,123 Commonly reported reasons for perinatal food avoidances, determined through qualitative research, include helping the mother's body to heal after childbirth, to avoid illness in the mother and her child, and to promote adequate quality and quantity of breastmilk, 113,114,117,123 although mothers have also stated that food taboos are passed onto them from close family members for reasons unknown. 117,123 Postpartum diets are often the most restrictive in the first 2 weeks to 1 month after childbirth, with some women in Laos limiting their diet to just rice and salt, and a tea made from herbs and roots.…”