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Predictors of micronutrient powder sachet coverage and recent intake among children 12-23 months in Eastern Uganda
Nicole D Ford1,2, Laird J Ruth1,2, Sarah Ngalombi3
1Nutrition Branch, Division of Nutrition, Physical Activity, and Obesity, United States Centers of Disease Control and Prevention, Atlanta, Georgia, USA.
Insights
Micronutrient powder (MNP) coverage reached 59% and recent intake was 65.4% in Ugandan children. Interventions improving caregiver knowledge and targeting older children can enhance MNP use.
Area of Science:
- Public Health Nutrition
- Child Health Interventions
- Micronutrient Supplementation
Background:
- Micronutrient deficiencies pose a significant threat to child development.
- Micronutrient powders (MNP) are a key strategy for improving infant and young child nutrition.
- Understanding factors influencing MNP coverage and intake is crucial for program success.
Purpose of the Study:
- To identify predictors of high micronutrient powder (MNP) sachet coverage and recent MNP intake among children aged 12-23 months in Uganda.
- To inform the design of future nutrition interventions.
Main Methods:
- Cross-sectional survey data from 761 caregivers in Amuria district, Uganda, 12 months post-implementation of an MNP pilot program.
- Logistic regression analysis was used to determine predictors of high MNP sachet coverage (≥60 sachets/6 months) and recent MNP intake (within 2 weeks prior to survey).
Main Results:
- High MNP sachet coverage was observed in 59% of children, and recent intake in 65.4%.
- Positive predictors for coverage included MNP ration cards, awareness of anemia, knowledge of MNP preparation, and current breastfeeding. Older child age was a negative predictor.
- Positive predictors for recent intake included MNP ration cards, hearing MNP radio jingles, knowledge of MNP preparation, and the child not disliking MNP.
Conclusions:
- Caregiver knowledge, skills, and targeted approaches for older children are vital for improving MNP coverage and intake.
- Programmatic strategies should leverage tools like ration cards and educational messaging through various channels.
- Addressing factors like palatability and ensuring consistent supply are important for sustained MNP utilization.
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.
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