Formative Research to Guide Successful Scale-up of Micronutrient Powder Programmes: Lessons Learned from a 4 Country Comparison.
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Date
2015
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Abstract
Objectives: Micronutrient Powders (MNP) have been shown to reduce anaemia among young
children and are reportedly easy-to-use for home fortification of complementary foods. Many
countries are considering implementing MNP. However, to facilitate optimal implementation,
formative research must be conducted to address country-specific household barriers such as
cultural practices, knowledge and beliefs.
1. Compare findings from 4 countries where formative research was conducted to inform MNP
protocols and communication materials.
2. Evaluate tools and share lessons learned to inform country-specific MNP programmes.
Methods: In Rwanda, Zambia, Cameroon and Lao PDR, focus groups were conducted with
caregivers; and individual caregivers, health workers and community leaders were interviewed on
IYCF knowledge, attitudes and practices, anaemia and beliefs. Home-based MNP trials then
followed children 6-23 months over 14-30 days with caregivers interviewed to evaluate
acceptability and adherence at baseline, midpoint and endline. Formative research tools, MNP and IYCF communication and training materials were tested.
Results: Practices varied considerably by country and important barriers identified, particularly
regarding complementary feeding. Age at introduction, suitable food vehicle availability and
consistency were frequently not concordant with recommendations. For example, in Rwanda
porridge was too liquid and in Laos sticky rice too dense for delivering MNP. Whereas, home
fortification was universally accepted and tools developed were highly usable.
Conclusions: Formative research was indispensible as knowledge, attitudes and practices varied
widely between countries with implications for usage, training and communication materials.
Tailoring global guidelines using our research tools will help ensure optimal development of
country-specific protocols and ultimate effectiveness of MNP home fortification scale-up.
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Sutér Melanie, Omwega Abuid, Brunet Dominique, Ejigui Jeanne, Berdaga Viorica, Ngabo Fidele, Foley Jennifer, McLean Judy. Formative Research to Guide Successful Scale-up of Micronutrient Powder Programmes: Lessons Learned from a 4 Country Comparison. European Journal of Nutrition & Food Safety. 2015 Special issue; 5(5): 792-793.