Predictors of micronutrient powder sachet coverage and recent intake among children 12–23 months in Eastern Uganda

Abstract

We evaluated predictors of micronutrient powder (MNP) sachet coverage and recent intake using data from a cross‐sectional survey representative of children aged 12–23 months in Amuria district, Uganda. In June/July 2016, caregivers were interviewed 12 months after implementation of an integrated MNP and infant and young child feeding pilot (N = 761). Logistic regression described predictors of (a) high‐MNP sachet coverage (received at least 60 sachets/6 months) and (b) recent intake (consumed MNP during the 2 weeks preceding the survey) among children who had ever received MNP and had complete data (N = 683). Fifty‐nine percent (95% Confidence Interval [CI] [53.8, 64.2]) of children had high‐MNP sachet coverage, and 65.4% (95% CI [61.0, 69.9]) had recent intake. MNP ration cards (Adjusted Odds Ratio [AOR] 2.67, 95% CI [1.15, 6.23]), organoleptic changes to foods cooked with soda ash (AOR 1.52, 95% CI [1.08, 2.14]), having heard of anaemia (AOR 1.59, 95% CI [1.11, 2.26]), knowledge of correct MNP preparation (AOR 1.89, 95% CI [1.11, 3.19]), and current breastfeeding (AOR 2.04, 95% CI [1.36, 3.08]) were positively associated with MNP coverage whereas older child age (18–23 vs. 12–17 months) was inversely associated with coverage (AOR 0.32, 95% CI [0.23, 0.50]). MNP ration cards (AOR 2.86, 95% CI [1.34, 6.09]), having heard an MNP radio jingle (AOR 1.40, 95% CI [1.01, 1.94]), knowledge of correct MNP preparation (AOR 1.88, 95% CI [1.04, 3.39]), and the child not disliking MNP (AOR 1.90, 95% CI [1.13, 3.22]) were positively associated with recent intake. Interventions that increase caregiver knowledge and skills and focus on older children could improve MNP coverage and recent intake.

Micronutrient powder programs: New findings and future directions for implementation science

“…Use of MNP is a long-term preventive intervention that requires continued and sustained practice. Programs should hence both promote new behaviours and sustained practice (D'Agostino et al, 2019) for caretakers to adopt a complex series of behaviours and maintain them (Ford et al, 2019, Locks et al, 2019, Tumilowicz, Habicht, et al, 2019. The behaviours include obtaining sachets initially and over time (coverage) and initiating and continuing to prepare and serve food with MNP to children (sustained intake).…”

Insegurança alimentar e nutricional e interface com fortificação alimentar com múltiplos micronutrientes em pó na implementação da estratégia nutrisus no Brasil: revisão integrativa da literatura

“…Em Uganda, em que 65,4% dos pesquisados apresentaram ingestão recente (seis sachês de MNP nas últimas duas semanas), houve associação positiva com o aleitamento materno atual. Assim, destaca-se também a relação entre o aleitamento materno exclusivo e total com a utilização de MNP e no enfrentamento da InSAN no público infantil (FORD et al, 2019;LEYVRAZ et al, 2018;ANDRÉ et al, 2018).…”

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

“…Twenty-one studies reported the design quality and packaging as barriers to the compliance of MNP, including a monotonous taste and a change in the smell of the food [11,[29][30][31][32][33][34][35][36][37][38][39], a lack of information on the ingredient base of the packaging [21,29], and occasional negative side effects [19,29,31,[36][37][38][40][41][42]. Notwithstanding the convenience to use or store the product, the attractive appearance and the improved taste were observed to improve the acceptability of MNP [24,31,34,[43][44][45].…”

“…Specifically, caregivers' perception of children's nutritional improvement highly improved the intervention adherence [11,24,28,32,36,41,44,46,54,56]. However, the lack of awareness and inadequate knowledge of the product in caregivers prevailed [21,30,31,37,43,45,46]. Additionally, caregivers were not adequately aware of the proper use of MNP, which, in part, led to the poor taste of the MNP [22,57].…”