Adherence to and Acceptability of Home Fortification with Vitamins and Minerals in Children Aged 6 to 23 Months: a Systematic Review

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2016 Apr 9

PMID 27056182

Citations 17

Authors

Samara Fernandes de Barros

Marly Augusto Cardoso

Affiliations

Soon will be listed here.

Abstract

Background: Vitamin and mineral deficiencies affect more than two million people worldwide. In 2011, based on recent scientific evidence and the low effectiveness of current strategies, the World Health Organization recommended home fortification of foods with multiple micronutrients in powder (MNP) as a new strategy to prevent and control anaemia during childhood. This systematic review assessed adherence to and acceptability of home fortification with multiple micronutrients in powder (MNP) in complementary feeding.

Methods: Adherence was assessed based on number or percentage of prescribed sachets that were consumed, and acceptability was assessed according to perceptions of caregivers and children about MNP.

Results: In summary, the studies indicated that home fortification with MNP has good adherence, ranging from 50% to over 90% of the prescribed sachets and that MNP was well accepted by caregivers. Caregivers reported side effects in 3% to 32% of children taking MNP in many studies; diarrhoea, vomiting, and constipation were the most common.

Conclusions: Home fortification with MNP has good adherence and acceptability in infants, with higher adherence in non-daily or flexible administration regimens. Characteristics of the target population and increased diarrhoea burden should be considered for planning public health programs with long term use of MNP. Acceptability of the MNP is satisfactory, when the use and perceived beneficial effects on children's health are considered.

Citing Articles

Acceptability of Multiple Micronutrient-Fortified Bouillon Cubes among Women and Their Households in 2 Districts in The Northern Region of Ghana.

Wessells K, Kumordzie S, Becher E, Davis J, Nyaaba K, Zyba S Curr Dev Nutr. 2024; 8(1):102056.

PMID: 38304733 PMC: 10832376. DOI: 10.1016/j.cdnut.2023.102056.

Yingyangbao Reduced Anemia among Infants and Young Children Aged 6-23 Months When Delivered through a Large-Scale Nutrition Improvement Program for Children in Poor Areas in China from 2015 to 2020.

Wang L, Huo J, Wei Y, Tang Y, Sun J, Huang J Nutrients. 2023; 15(11).

PMID: 37299597 PMC: 10255738. DOI: 10.3390/nu15112634.

Acceptance and compliance with micronutrient powder (MNP) among children aged 6-23 months in northern Nigeria.

Kodish S, Isokpunwu C, Osunkentan T, Imohe A, Ejembi C, Chitekwe S PLOS Glob Public Health. 2023; 2(10):e0000961.

PMID: 36962580 PMC: 10022258. DOI: 10.1371/journal.pgph.0000961.

The association between micronutrient powder delivery patterns and caregiver feeding behaviors in rural China.

Liu R, Ye R, Wang Q, Pappas L, Dill S, Rozelle S BMC Public Health. 2022; 22(1):1366.

PMID: 35842633 PMC: 9287899. DOI: 10.1186/s12889-022-13726-4.

Acceptability of home fortification with multiple micro-nutrients among Sri Lankan children.

Liyanage G, Anupama K, Sudarshini M PLoS One. 2021; 16(12):e0261516.

PMID: 34936678 PMC: 8694412. DOI: 10.1371/journal.pone.0261516.

References

Soofi S, Cousens S, Iqbal S, Akhund T, Khan J, Ahmed I . Effect of provision of daily zinc and iron with several micronutrients on growth and morbidity among young children in Pakistan: a cluster-randomised trial. Lancet. 2013; 382(9886):29-40. DOI: 10.1016/S0140-6736(13)60437-7. View

Bilukha O, Howard C, Wilkinson C, Bamrah S, Husain F . Effects of multimicronutrient home fortification on anemia and growth in Bhutanese refugee children. Food Nutr Bull. 2011; 32(3):264-76. DOI: 10.1177/156482651103200312. View

Tripp K, Perrine C, de Campos P, Knieriemen M, Hartz R, Ali F . Formative research for the development of a market-based home fortification programme for young children in Niger. Matern Child Nutr. 2011; 7 Suppl 3:82-95. PMC: 6860827. DOI: 10.1111/j.1740-8709.2011.00352.x. View

Avula R, Frongillo E, Arabi M, Sharma S, Schultink W . Enhancements to nutrition program in Indian integrated child development services increased growth and energy intake of children. J Nutr. 2011; 141(4):680-4. DOI: 10.3945/jn.109.116954. View

Cardoso M, Augusto R, Bortolini G, Oliveira C, Tietzman D, Sequeira L . Effect of Providing Multiple Micronutrients in Powder through Primary Healthcare on Anemia in Young Brazilian Children: A Multicentre Pragmatic Controlled Trial. PLoS One. 2016; 11(3):e0151097. PMC: 4790963. DOI: 10.1371/journal.pone.0151097. View

Geltman P, Hironaka L, Mehta S, Padilla P, Rodrigues P, Meyers A . Iron supplementation of low-income infants: a randomized clinical trial of adherence with ferrous fumarate sprinkles versus ferrous sulfate drops. J Pediatr. 2008; 154(5):738-43. DOI: 10.1016/j.jpeds.2008.11.003. View

Menon P, Ruel M, Loechl C, Arimond M, Habicht J, Pelto G . Micronutrient Sprinkles reduce anemia among 9- to 24-mo-old children when delivered through an integrated health and nutrition program in rural Haiti. J Nutr. 2007; 137(4):1023-30. DOI: 10.1093/jn/137.4.1023. View

Christofides A, Schauer C, Sharieff W, Zlotkin S . Acceptability of micronutrient sprinkles: a new food-based approach for delivering iron to First Nations and Inuit children in Northern Canada. Chronic Dis Can. 2006; 26(4):114-20. View

Rosado J, Gonzalez K, Caamano M, Garcia O, Preciado R, Odio M . Efficacy of different strategies to treat anemia in children: a randomized clinical trial. Nutr J. 2010; 9:40. PMC: 2955680. DOI: 10.1186/1475-2891-9-40. View

10.

De-Regil L, Suchdev P, Vist G, Walleser S, Pena-Rosas J . Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age (Review). Evid Based Child Health. 2013; 8(1):112-201. DOI: 10.1002/ebch.1895. View

11.

Adu-Afarwuah S, Lartey A, Brown K, Zlotkin S, Briend A, Dewey K . Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana. Am J Clin Nutr. 2008; 87(4):929-38. DOI: 10.1093/ajcn/87.4.929. View

12.

Inayati D, Scherbaum V, Purwestri R, Wirawan N, Suryantan J, Hartono S . Combined intensive nutrition education and micronutrient powder supplementation improved nutritional status of mildly wasted children on Nias Island, Indonesia. Asia Pac J Clin Nutr. 2012; 21(3):361-73. View

13.

Kounnavong S, Sunahara T, Mascie-Taylor C, Hashizume M, Okumura J, Moji K . Effect of daily versus weekly home fortification with multiple micronutrient powder on haemoglobin concentration of young children in a rural area, Lao People's Democratic Republic: a randomised trial. Nutr J. 2011; 10:129. PMC: 3266642. DOI: 10.1186/1475-2891-10-129. View

14.

Hyder S, Haseen F, Rahman M, Tondeur M, Zlotkin S . Effect of daily versus once-weekly home fortification with micronutrient Sprinkles on hemoglobin and iron status among young children in rural Bangladesh. Food Nutr Bull. 2014; 28(2):156-64. DOI: 10.1177/156482650702800204. View

15.

Elena D Jefferds M, Ogange L, Owuor M, Cruz K, Person B, Obure A . Formative research exploring acceptability, utilization, and promotion in order to develop a micronutrient powder (Sprinkles) intervention among Luo families in western Kenya. Food Nutr Bull. 2010; 31(2 Suppl):S179-85. DOI: 10.1177/15648265100312S210. View

16.

Ip H, Hyder S, Haseen F, Rahman M, Zlotkin S . Improved adherence and anaemia cure rates with flexible administration of micronutrient Sprinkles: a new public health approach to anaemia control. Eur J Clin Nutr. 2007; 63(2):165-72. DOI: 10.1038/sj.ejcn.1602917. View

17.

Lundeen E, Schueth T, Toktobaev N, Zlotkin S, Hyder S, Houser R . Daily use of Sprinkles micronutrient powder for 2 months reduces anemia among children 6 to 36 months of age in the Kyrgyz Republic: a cluster-randomized trial. Food Nutr Bull. 2010; 31(3):446-60. DOI: 10.1177/156482651003100307. View

18.

Sharieff W, Yin S, Wu M, Yang Q, Schauer C, Tomlinson G . Short-term daily or weekly administration of micronutrient Sprinkles has high compliance and does not cause iron overload in Chinese schoolchildren: a cluster-randomised trial. Public Health Nutr. 2006; 9(3):336-44. DOI: 10.1079/phn2006841. View

19.

Zlotkin S, Schauer C, Christofides A, Sharieff W, Tondeur M, Hyder S . Micronutrient sprinkles to control childhood anaemia. PLoS Med. 2005; 2(1):e1. PMC: 545194. DOI: 10.1371/journal.pmed.0020001. View

20.

Jack S, Ou K, Chea M, Chhin L, Devenish R, Dunbar M . Effect of micronutrient sprinkles on reducing anemia: a cluster-randomized effectiveness trial. Arch Pediatr Adolesc Med. 2012; 166(9):842-50. DOI: 10.1001/archpediatrics.2012.1003. View