1. Predictors of micronutrient powder ( <scp>MNP</scp> ) knowledge, coverage, and consumption during the scale‐up of an integrated infant and young child feeding ( <scp>IYCF‐MNP</scp> ) programme in <scp>N</scp> epal
- Author
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Bikash Lamichhane, Rajkumar Pokharel, Zuguo Mei, Maria Elena Jefferds, Stanley Chitekwe, Pradiumna Dahal, Lindsey M. Locks, Ralph D. Whitehead, Aashima Garg, Nira Joshi, and Naveen Paudyal
- Subjects
Adult ,Male ,0301 basic medicine ,Health Knowledge, Attitudes, Practice ,infant and young child feeding (IYCF) ,Mothers ,coverage ,Supplement Articles ,Appropriate use ,Health centre ,03 medical and health sciences ,0302 clinical medicine ,Nepal ,Environmental health ,Humans ,micronutrient powders (MNP) ,Medicine ,Micronutrients ,adherence ,030212 general & internal medicine ,Infant Nutritional Physiological Phenomena ,implementation ,Health worker ,Consumption (economics) ,anaemia ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Young child ,business.industry ,Public Health, Environmental and Occupational Health ,Infant ,Obstetrics and Gynecology ,Micronutrient ,Correct response ,Cross-Sectional Studies ,Dietary Supplements ,Food, Fortified ,Pediatrics, Perinatology and Child Health ,Community health ,Female ,Supplement Article ,Powders ,business ,Program Evaluation - Abstract
Large‐scale programmes using micronutrient powders (MNPs) may not achieve maximum impact due to limited/inappropriate MNP coverage, consumption, and use. We identify predictors of MNP coverage, maternal knowledge of appropriate use, and child MNP consumption in Nepal. A cross‐sectional survey was conducted in 2,578 mother–child pairs representative of children 6–23 months in two districts that were part of the post‐pilot, scale‐up of an integrated infant and young child feeding‐MNP (IYCF‐MNP) programme. Children aged 6–23 months were expected to receive 60 MNP sachets every 6 months from a female community health volunteer (FCHV) or health centre. Outcomes of interest were MNP coverage (ever received), maternal knowledge of appropriate use (correct response to seven questions), repeat coverage (receipt ≥ twice; among children 12–23 months who had received MNP at least once, n = 1342), and high intake (child consumed ≥75% of last distribution, excluding those with recent receipt/insufficient time to use 75% at recommended one‐sachet‐per‐day dose, n = 1422). Multivariable log‐binomial regression models were used to identify predictors of the four outcomes. Coverage, knowledge of appropriate use, and repeat coverage were 61.3%, 33.5%, and 45.9%, respectively. Among MNP receivers, 97.9% consumed MNP at least once and 38.9% of eligible children consumed ≥75% of last distribution. FCHV IYCF‐MNP counselling was positively associated with knowledge, coverage, repeat coverage, and high intake; health worker counselling with knowledge and coverage indicators; and radio messages with coverage indicators only. FCHV counselling had the strongest association with knowledge, coverage, and high intake. Community‐based counselling may play a vital role in improving coverage and intake in MNP programmes. more...
- Published
- 2019
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