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Predictors of micronutrient powder intake adherence in a pilot programme in Nepal
Kelsey R Mirkovic1, Cria G Perrine1, Giri Raj Subedi2
11US Centers for Disease Control and Prevention,4770 Buford Hwy NE,Mailstop F-77,Atlanta,GA 30341,USA.
Objective:
Poor adherence to recommended intake protocols is common and a top challenge for micronutrient powder (MNP) programmes globally. Identifying modifiable predictors of intake adherence could inform the design and implementation of MNP projects.
Design:
We assessed high MNP intake adherence among children who had received MNP ≥2 months ago and consumed ≥1 sachet (n 771). High MNP intake adherence was defined as maternal report of child intake ≥45 sachets. We used logistic regression to assess demographic, intervention components and perception-of-use factors associated with high MNP intake.
Setting:
Four districts of Nepal piloting an integrated infant and young child feeding and MNP project.
Subjects:
Children aged 6-23 months were eligible to receive sixty MNP sachets every 6 months with suggested intake of one sachet daily for 60 d. Cross-sectional surveys representative of children aged 6-23 months were conducted.
Results:
Receiving a reminder card was associated with increased odds for high intake (OR=2·18, 95 % CI 1·14, 4·18); exposure to other programme components was not associated with high intake. Mothers perceiving ≥1 positive effects in their child after MNP use was also associated with high intake (OR=6·55, 95 % CI 4·29, 10·01). Perceiving negative affects was not associated; however, the child not liking the food with MNP was associated with lower odds of high intake (OR=0·12, 95 % CI 0·08, 0·20).
Conclusions:
Behaviour change intervention strategies tailored to address these modifiable predictors could potentially increase MNP intake adherence.
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