Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria

Tondeur, Mélody; Salse, U Núria; Wilkinson, Caroline; Spiegel, Paul; Seal, Andrew

doi:10.1017/s136898001600029x

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…The high LNS uptake in nutrition interventions was consistent with similar previously implemented interventions [ 59 – 63 ]. Using formative research to develop nutrition intervention messages [ 64 ] that were culturally sensitive likely influenced high levels of adoption [ 65 ].…”

Section: Discussionsupporting

confidence: 88%

Achieving optimal technology and behavioral uptake of single and combined interventions of water, sanitation hygiene and nutrition, in an efficacy trial (WASH benefits) in rural Bangladesh

Parvez

Azad

Rahman

et al. 2018

Trials

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BackgroundUptake matters for evaluating the health impact of water, sanitation and hygiene (WASH) interventions. Many large-scale WASH interventions have been plagued by low uptake. For the WASH Benefits Bangladesh efficacy trial, high uptake was a prerequisite. We assessed the degree of technology and behavioral uptake among participants in the trial, as part of a three-paper series on WASH Benefits Intervention Delivery and Performance.MethodsThis study is a cluster randomized trial comprised of geographically matched clusters among four districts in rural Bangladesh. We randomly allocated 720 clusters of 5551 pregnant women to individual or combined water, sanitation, handwashing, and nutrition interventions, or a control group. Behavioral objectives included; drinking chlorine-treated, safely stored water; use of a hygienic latrine and safe feces disposal at the compound level; handwashing with soap at key times; and age-appropriate nutrition behaviors (pregnancy to 24 months) including a lipid-based nutrition supplement (LNS). Enabling technologies and behavior change were promoted by trained local community health workers through periodic household visits. To monitor technology and behavioral uptake, we conducted surveys and spot checks in 30–35 households per intervention arm per month, over a 20-month period, and structured observations in 324 intervention and 108 control households, approximately 15 months after interventions commenced.ResultsIn the sanitation arms, observed adult use of a hygienic latrine was high (94–97% of events) while child sanitation practices were moderate (37–54%). In the handwashing arms, handwashing with soap was more common after toilet use (67–74%) than nonintervention arms (18–40%), and after cleaning a child’s anus (61–72%), but was still low before food handling. In the water intervention arms, more than 65% of mothers and index children were observed drinking chlorine-treated water from a safe container. Reported LNS feeding was > 80% in nutrition arms. There was little difference in uptake between single and combined intervention arms.ConclusionsRigorous implementation of interventions deployed at large scale in the context of an efficacy trial achieved high levels of technology and behavioral uptake in individual and combined WASH and nutrition intervention households. Further work should assess how to achieve similar uptake levels under programmatic conditions.Trial registrationWASH Benefits Bangladesh: ClinicalTrials.gov, identifier: NCT01590095. Registered on April 30, 2012.

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Section: Discussionsupporting

confidence: 88%

Achieving optimal technology and behavioral uptake of single and combined interventions of water, sanitation hygiene and nutrition, in an efficacy trial (WASH benefits) in rural Bangladesh

Parvez

Azad

Rahman

et al. 2018

Trials

View full text Add to dashboard Cite

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“…To resolve nutrition-related concerns of AMC, host countries such as Australia have designed, implemented, and evaluated culturally competent obesity-prevention programs through community-partnered participatory approaches [95]. Likewise, lipid-based nutrient supplement programs have been implemented in Algeria [96], nutrient-dense fortified spread programs in the United States [97], and maize meal fortification in Zambia [98].…”

Section: Nutritionmentioning

confidence: 99%

A Scoping Review of the Health of African Immigrant and Refugee Children

Salami

Fernández‐Sánchez

Fouché

et al. 2021

IJERPH

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Migration is a growing phenomenon around the world, including within the African continent. Many migrants, especially African children, face challenges related to health and social inclusion and can face increased health risks. A systematic scoping review of available literature on the health of African migrant children across the globe was conducted to offer insight into these health risks. The review was conducted over a 15-month period from January 2019 to April 2020, yielding 6602 articles once duplicates were removed. This search included electronic databases, reference lists of articles reviewed, and searches of libraries of relevant organisations. A total of 187 studies met the inclusion criteria, of which 159 were quantitative, 22 were qualitative, and 6 used mixed methods. The findings reveal decreased health in this population in areas of nutrition, infectious diseases, mental health, birth outcomes, sexual and reproductive health, physical and developmental health, parasitic infections, oral health, respiratory health, preventative health, endocrine disorders, health care services, and haematological conditions. The findings offer insights into factors influencing the health of African immigrant and refugee children. Further studies, especially qualitative studies, are needed to determine barriers to service access after migration and to investigate other underexplored and overlooked health concerns of African migrant children, including pneumonia and child maltreatment.

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“…Studies describing the acceptability of the sensory attributes of MNP in community settings typically rely on the caregiver’s perceptions of the child’s reaction to the food with MNP; these document some children “liking” [ 19 , 20 ], “disliking” [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], or even refusing to consume [ 24 , 25 , 26 , 27 , 28 , 29 ] foods with added MNP. Few studies in programmatic settings confirm that MNPs do not affect organoleptic properties of food [ 30 , 31 , 32 , 33 , 34 ], and a greater number report changes to the color, taste or appearance of foods [ 19 , 26 , 27 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. A handful of studies published in peer-reviewed journals report ratings for color, flavor, taste, and smell of foods with added MNP in community settings; some report perceptible changes with MNP with persistent high acceptability [ 43 , 44 ], whereas others report no changes [ 31 , 45 ].…”

Section: Introductionmentioning

confidence: 99%

Sensory Evaluation of Foods with Added Micronutrient Powder (MNP) “Taburia” to Assess Acceptability among Children Aged 6–24 Months and Their Caregivers in Indonesia

et al. 2017

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Although it is generally accepted that the addition of micronutrient powders (MNPs) to foods causes no or negligible changes to organoleptic properties, there are anecdotal reports of low acceptability of the MNP (locally known as “Taburia”) distributed in Indonesia. We hypothesized that the organoleptic properties of Taburia do not reduce the acceptability of foods if used as recommended. Acceptability of Taburia and a comparison MNP (MixMe™) were evaluated among 232 children aged 6–24 months and their caregivers. Both caregivers’ perceptions of child acceptance, and their own assessments of organoleptic qualities when added to rice porridge or meals commonly consumed by young children, were assessed. Changes to the organoleptic properties of foods mixed with Taburia and comparison MNP were reported by caregivers, even when following preparation instructions. Taburia was found to enhance texture, sweetness, saltiness, and umami taste, but was also perceived as slightly bitter. Ratings for overall appearance and taste did not differ between rice porridge, plain or with Taburia, but the overall taste of Taburia was preferred over comparison MNP (p = 0.012). Meals consumed by children were preferred without the addition of MNP (p < 0.001). We demonstrate that the addition of Taburia to foods, commonly consumed by Indonesian infants and young children, affects organoleptic properties of the foods, even when prepared according to recommendations. However, these changes are unlikely to be the cause of reported adherence problems in Indonesia. This needs to be taken into consideration for product development and communication strategies promoting adherence.

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Rapid acceptability and adherence testing of a lipid-based nutrient supplement and a micronutrient powder among refugee children and pregnant and lactating women in Algeria

Cited by 5 publications

References 21 publications

Achieving optimal technology and behavioral uptake of single and combined interventions of water, sanitation hygiene and nutrition, in an efficacy trial (WASH benefits) in rural Bangladesh

Achieving optimal technology and behavioral uptake of single and combined interventions of water, sanitation hygiene and nutrition, in an efficacy trial (WASH benefits) in rural Bangladesh

A Scoping Review of the Health of African Immigrant and Refugee Children

Sensory Evaluation of Foods with Added Micronutrient Powder (MNP) “Taburia” to Assess Acceptability among Children Aged 6–24 Months and Their Caregivers in Indonesia

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