Adherence to multiple micronutrient powder among young children in rural Bangladesh: a cross-sectional study

Mirak Raj Angdembe,Nuzhat Choudhury,Tahmeed Ahmed,Mohammad Raisul Haque

doi:10.1186/s12889-015-1752-z

Abstract

BackgroundMultiple micronutrient powder (MMNP) can be sprinkled onto any semisolid food and can be given to young children to address iron deficiency anemia. The female community health volunteers of BRAC (an NGO) known as Shasthya Shebikas (SS) sell MMNP sachets during their regular household visits. Currently there are no data on adherence or real uptake of MMNP by children. The objective of the study was to assess adherence to MMNP and associated factors among children aged 6–59 months in rural Bangladesh.MethodsA cross sectional study was conducted in Saturia Sub-district among 78 children aged 6–59 months who were fed MMNP supplied by BRAC SS in the past 60 days. A one stage cluster sampling technique was used to select mothers with eligible children. Semi-structured questionnaire was used for interviews. A logistic regression model was developed to obtain adjusted odds ratios (AOR) with 95% CI.ResultsSample mean adherence was calculated to be 70%. In multivariate analysis, age of mother in years (AOR = 0.74, 95% CI: 0.61-0.88), households belonging to poorer (AOR = 0.01, 95% CI: 0.00-0.68), middle (AOR = 0.04, 95% CI: 0.00-0.35) and richer (AOR = 0.11, 95% CI: 0.01-0.84) wealth quintiles and mothers who prefer to feed flexibly (AOR = 0.03, 95% CI: 0.00-0.26) were significantly associated with high adherence. Further, for every one unit increase in visit by BRAC SS in the past 60 days, the odds of having high adherence significantly increased by 55% (AOR = 1.55, 95% CI: 1.09-2.20).ConclusionsSS are the key to improving adherence through regular visits to households of MMNP users. However, expanding coverage beyond the vicinity of the SS’s household is a challenge. Perception of families whose children have low adherence should be studied.

Highlights

Multiple micronutrient powder (MMNP) can be sprinkled onto any semisolid food and can be given to young children to address iron deficiency anemia
In order to alleviate these problems multiple micronutrient powder (MMNP) was developed which is available as single dose sachet of dry powder containing lipidencapsulated iron and other micronutrients that can be sprinkled onto any semisolid food [6] and given to young children
About 36% of households had sanitary latrine while others had slab latrine (60%), pit latrine (1%) and hanging latrine (3%) (Data not presented in Table)

Summary

Introduction

Multiple micronutrient powder (MMNP) can be sprinkled onto any semisolid food and can be given to young children to address iron deficiency anemia. In order to alleviate these problems multiple micronutrient powder (MMNP) was developed which is available as single dose sachet of dry powder containing lipidencapsulated iron and other micronutrients that can be sprinkled onto any semisolid food [6] and given to young children. The lipid-encapsulation coating prevents iron from dissolving into the food and prevents any change in color, flavor or taste [6]. This is the concept of home fortification

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