通过志愿者一线卫生工作者推广基于市场的方法，促进家用强化饮食用微营养素粉：一项定性研究。
Market-based approach to promoting home fortification of diets with micronutrient powder through volunteer frontline health workers: A qualitative study.
机构信息
Nutrition and Clinical Services Division, icddr,b, Mohakhali, Dhaka, Bangladesh.
National Centre for Epidemiology and Population Health, The Australian National University, Canberra, ACT, Australia.
出版信息
PLoS One. 2023 Mar 23;18(3):e0283306. doi: 10.1371/journal.pone.0283306. eCollection 2023.
BACKGROUND
The potential of market-based approach in distributing micronutrient powder (MNP) through volunteer frontline health workers has been recognized. BRAC, the largest non-government organization (NGO) in Bangladesh, uses Shasthya Shebikas as volunteer frontline health workers to sell MNP for promotion of home fortification (HF) of diets for under-5 children. We aimed to understand the opportunities and challenges of BRAC's market-based approach in promoting HF with MNP.
METHODS
We conducted a descriptive qualitative study in the four selected districts of Bangladesh: Faridpur, Gaibandha, Rangpur, and Rajbari. In-depth interviews, key informant interviews, and focus group discussions were deployed to collect data from purposively-selected Shasthya Shebikas and their immediate supervisors at the field level-Shasthya Kormis, Field Organizers, Managers, and mothers or caregivers of under-5 children. We performed thematic analysis to analyze data.
RESULTS
We have found that the Shasthya Shebikas play a critical role in promoting access of MNP by the mother/caregivers of children aged 6-59 months at the community level. They counsel the caregivers to seek primary advice about the product and also informally identify undernourished children so that they can receive special attention regarding the use of MNP. However, low profit margins, over-due payments for the sold sachets, poor collaboration with and free distribution of MNP by other NGOs, and inadequate training of Shasthya Shebikas on marketing of MNP have posed major challenges for them to perform as effective sales agents of the product.
CONCLUSION
The market-based approach in promoting HF with MNP through frontline volunteer health workers shows much potential, with ample opportunities and few possible challenges. Considering the dynamics, the intervention should fine-tune the factors crucial to maximizing the potentials of Shasthya Shebikas for marketing MNP and promoting HF in order to improve nutrition status of the infants and young children.
背景
通过志愿一线卫生工作者以市场为基础的方法分发微量营养素粉（MNP）的潜力已得到认可。BRAC 是孟加拉国最大的非政府组织（NGO），它利用 Shasthya Shebikas 作为志愿一线卫生工作者销售 MNP，以促进 5 岁以下儿童家庭强化饮食。我们旨在了解 BRAC 以市场为基础的方法在促进 MNP 家庭强化饮食方面的机遇和挑战。
方法
我们在孟加拉国的四个选定地区：法里德布尔、加伊班达、兰普尔和拉杰巴里进行了一项描述性定性研究。我们从 Shasthya Shebikas 和他们在实地的直接主管人员（Shasthya Kormis、现场组织者、经理、5 岁以下儿童的母亲或照顾者）中收集数据，采用深入访谈、关键人物访谈和焦点小组讨论。我们进行了主题分析来分析数据。
结果
我们发现，Shasthya Shebikas 在社区一级促进 6-59 月龄儿童的母亲/照顾者获得 MNP 方面发挥了关键作用。他们向照顾者提供关于该产品的初步咨询建议，并非正式地确定营养不良的儿童，以便他们能够获得关于使用 MNP 的特别关注。然而，低利润率、销售袋的逾期付款、与其他 NGO 合作不佳和免费分发 MNP、以及 Shasthya Shebikas 在 MNP 营销方面的培训不足，对他们作为该产品的有效销售代理的表现构成了重大挑战。
结论
通过一线志愿卫生工作者以市场为基础的方法促进 MNP 家庭强化饮食显示出很大的潜力，有很多机会和很少的可能挑战。考虑到这种动态，干预措施应调整对最大限度发挥 Shasthya Shebikas 营销 MNP 和促进 HF 潜力至关重要的因素，以改善婴儿和幼儿的营养状况。
Zotero 插件