Creed-Kanashiro Hilary, Bartolini Rosario, Abad Melissa, Arevalo Varinia
Instituto de Investigación Nutricional, Lima, Peru.
Matern Child Nutr. 2016 Jan;12(1):152-63. doi: 10.1111/mcn.12217. Epub 2015 Nov 1.
Iron deficiency causes anaemia and other adverse effects on the nutritional status and development of millions of children. Multi-micronutrient powders (MNP) have been shown to reduce anaemia in young children. In Peru, 50% of children 6-36 months are anaemic. Since 2009, the government has started distributing MNP. This qualitative study explored the acceptability of MNP by caregivers and the role of health personnel (HP) in three regions (Apurimac, Ayacucho and Cajamarca), piloting the MNP programme between 2009 and 2011. Data collection consisted of interviews (35) and observations (13) with caregivers and HP (11). In Cajamarca, 16 families were visited three times in their homes to understand caregivers' use and difficulties. Results showed the critical role HP has in influencing caregiver understanding and use of the MNP, as well as the need for training to avoid confusing messages and provide counselling techniques that consider cultural sensitivity to optimize HP interactions with caregivers and adapt the recommendations for MNP use to local family feeding routines. There was greater acceptance of MNP by caregivers giving semi-solid foods (e.g. purees) to their children than those who served dilute preparations (e.g. soups). Acceptance was similar across regions, but there were some differences between urban and rural settings. Home visits were shown to be a key in improving the use of MNP by caregivers as misunderstandings on preparation, required consistency and optimum practices were common. These findings can contribute to strategies to enhance acceptability and use.
Acceptance and use of multi-micronutrient powders (MNP) by caregivers greatly depend upon how it is presented, promoted and counselled by health personnel. Counselling for MNP use needs to consider and adapt to the local cultural context and incorporate family and child feeding routines. MNP are presented as part of appropriate feeding practices, encouraging caregivers to find simple and acceptable ways of giving semi-solid or solid foods with which to mix it.
缺铁会导致贫血，并对数百万儿童的营养状况和发育产生其他不利影响。多种微量营养素粉（MNP）已被证明可减少幼儿贫血。在秘鲁，50%的6至36个月儿童患有贫血。自2009年以来，政府已开始分发MNP。这项定性研究探讨了三个地区（阿普里马克、阿亚库乔和卡哈马卡）的照顾者对MNP的接受程度以及卫生人员（HP）的作用，这三个地区在2009年至2011年期间试行MNP项目。数据收集包括对照顾者和卫生人员（11人）进行访谈（35次）和观察（13次）。在卡哈马卡，对16个家庭进行了三次家访，以了解照顾者的使用情况和困难。结果表明，卫生人员在影响照顾者对MNP的理解和使用方面起着关键作用，同时需要进行培训，以避免信息混淆，并提供考虑文化敏感性的咨询技巧，以优化卫生人员与照顾者的互动，并根据当地家庭喂养习惯调整MNP使用建议。与给孩子喂稀食（如汤）的照顾者相比，给孩子喂半固体食物（如泥糊）的照顾者对MNP的接受程度更高。各地区的接受程度相似，但城乡之间存在一些差异。家访被证明是提高照顾者对MNP使用的关键，因为在准备、所需的一致性和最佳做法方面存在误解是很常见的。这些发现有助于制定提高接受度和使用率的策略。
照顾者对多种微量营养素粉（MNP）的接受和使用很大程度上取决于卫生人员的呈现、推广和咨询方式。MNP使用咨询需要考虑并适应当地文化背景，并纳入家庭和儿童喂养习惯。MNP被视为适当喂养做法的一部分，鼓励照顾者找到简单且可接受的方式来喂半固体或固体食物，并与MNP混合。
