Ulla Ashorn1, Lotta Alho2, Mary Arimond3, Kathryn G Dewey3, Kenneth Maleta4, Nozgechi Phiri5, John Phuka4, Stephen A Vosti6, Mamane Zeilani7, Per Ashorn8. 1. Department of International Health, School of Medicine, University of Tampere, Tampere, Finland; ulla.ashorn@uta.fi. 2. Department of International Health, School of Medicine, University of Tampere, Tampere, Finland; 3. Department of Nutrition, Program in International and Community Nutrition, and. 4. College of Medicine, School of Public Health, University of Malawi, Blantyre, Malawi; 5. International Lipid-Based Nutrient Supplements (iLiNS) Project, College of Medicine, University of Malawi, Mangochi, Malawi; 6. Department of Agricultural and Resource Economics, University of California, Davis, Davis, CA; 7. Nutriset S.A.S., Malaunay, France; and. 8. Department of International Health, School of Medicine, University of Tampere, Tampere, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland.
Abstract
BACKGROUND:Lipid-based nutrient supplements (LNSs) offer a vehicle to improve children's diets in low-income countries where complementary foods are typically deficient in essential nutrients. Sustained acceptability by the intended users is essential for achieving growth-promoting effects. OBJECTIVE: We aimed to determine the sustained acceptability of LNSs among 6- to 18-mo-old children in Malawi. METHODS: In the context of a trial testing the growth-promoting effect of different formulations and doses of LNSs, we delivered LNSs to the homes of the children biweekly according to the randomization protocol. We defined acceptability to include adherence to feeding recommendations and mothers' experiences of feeding LNSs to their child. We conducted brief interviews each week with the mothers. At 2 time points we conducted knowledge, attitudes, and practices (KAP) interviews. In addition, we conducted repeated in-depth interviews with a subset of mothers. RESULTS: Of the 1612 children who received the LNS intervention, we analyzed adherence data from 1478 (91.7%) children and KAP data at 2 time points (child's age of 12 and 18 mo) from 839 (52.1%) of the children. The mean ± SD overall adherence (proportion of days when the study child reportedly consumed LNSs considering only those weeks when the supplement had been successfully delivered to the home) was 92.4 ± 9.6%, and there was no difference between children receiving milk-containing or milk-free LNSs. There was also no increasing or decreasing trend over time in any of the groups. Sharing and deviation from other feeding recommendations were common. Maternal experiences were mostly very positive. CONCLUSIONS: The acceptability of LNS products was good and was sustained for 12 mo in this rural Malawian population. However, sharing of the products with family members and deviation from other feeding recommendations were frequent, which means that individually targeted children were likely to receive less than the intended dose of the LNS. This trial was registered at clinicaltrials.gov as NCT00945698.
RCT Entities:
BACKGROUND:Lipid-based nutrient supplements (LNSs) offer a vehicle to improve children's diets in low-income countries where complementary foods are typically deficient in essential nutrients. Sustained acceptability by the intended users is essential for achieving growth-promoting effects. OBJECTIVE: We aimed to determine the sustained acceptability of LNSs among 6- to 18-mo-old children in Malawi. METHODS: In the context of a trial testing the growth-promoting effect of different formulations and doses of LNSs, we delivered LNSs to the homes of the children biweekly according to the randomization protocol. We defined acceptability to include adherence to feeding recommendations and mothers' experiences of feeding LNSs to their child. We conducted brief interviews each week with the mothers. At 2 time points we conducted knowledge, attitudes, and practices (KAP) interviews. In addition, we conducted repeated in-depth interviews with a subset of mothers. RESULTS: Of the 1612 children who received the LNS intervention, we analyzed adherence data from 1478 (91.7%) children and KAP data at 2 time points (child's age of 12 and 18 mo) from 839 (52.1%) of the children. The mean ± SD overall adherence (proportion of days when the study child reportedly consumed LNSs considering only those weeks when the supplement had been successfully delivered to the home) was 92.4 ± 9.6%, and there was no difference between children receiving milk-containing or milk-free LNSs. There was also no increasing or decreasing trend over time in any of the groups. Sharing and deviation from other feeding recommendations were common. Maternal experiences were mostly very positive. CONCLUSIONS: The acceptability of LNS products was good and was sustained for 12 mo in this rural Malawian population. However, sharing of the products with family members and deviation from other feeding recommendations were frequent, which means that individually targeted children were likely to receive less than the intended dose of the LNS. This trial was registered at clinicaltrials.gov as NCT00945698.
Authors: Sarah Style; Melody Tondeur; Carlos Grijalva-Eternod; Josephine Pringle; Ismail Kassim; Caroline Wilkinson; Allison Oman; Carmel Dolan; Paul Spiegel; Andrew Seal Journal: PLoS One Date: 2017-06-07 Impact factor: 3.240
Authors: Katherine P Adams; Harriet Okronipa; Seth Adu-Afarwuah; Mary Arimond; Sika Kumordzie; Brietta M Oaks; Maku E Ocansey; Rebecca R Young; Stephen A Vosti; Kathryn G Dewey Journal: Matern Child Nutr Date: 2018-04-15 Impact factor: 3.092
Authors: Breanne K Langlois; Ilana R Cliffer; Laetitia Nikiema; Devika J Suri; Franck Garanet; Ye Shen; Augustin N Zeba; Shelley M Walton; Hermann B Lanou; Patrick Webb; Beatrice L Rogers Journal: Curr Dev Nutr Date: 2020-01-06