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Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels.

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dc.contributor.author Brewer, Jessica D.
dc.contributor.author Santos, Maria P.
dc.contributor.author Román, Karina
dc.contributor.author Riley-Powell, Amy R.
dc.contributor.author Oberhelman, Richard A.
dc.contributor.author Paz-Soldan Parlette, Valerie Andrea
dc.date.accessioned 2019-12-06T21:02:57Z
dc.date.available 2019-12-06T21:02:57Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7521
dc.description.abstract In Peru, nearly half of children aged 6–36 months were diagnosed with anaemia in 2017. To address this disease, the Peruvian Ministry of Health implemented a national programme in 2014, distributing free micronutrient powders (MNPs) to all children of this age. However, rates of childhood anaemia remain high. The aim of this study was to explore factors at all levels of the Social-Ecological Model that affect MNP use and adherence in Arequipa, an Andean city with childhood anaemia rates higher than the national average. We conducted in-depth interviews with 20 health personnel and 24 caregivers and 12 focus group discussions with 105 caregivers. We identified numerous barriers, including negative side effects (constipation, vomiting, and diarrhoea), poor taste of MNP, lack of familial and peer support for its use, insufficient informational resources provided by the health system, and limited human resources that constricted health personnel abilities to implement MNP programming successfully. Facilitators identified included concern about the long-term effects of anaemia, support from organizations external to the health system, well-coordinated care within the health system, and provision of resources by the Ministry of Health. We found that community or organizational and societal factors were key to limited MNP use and adherence, specifically the limited time health personnel have to address caregivers' doubts during appointments and the lack of informational resources outside of these appointments. Potential policy implications could be to increase informational resources available outside of individualized counselling by strengthening existing collaborations with community organizations, increasing media coverage, and providing group counselling. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Maternal and Child Nutrition
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject anaemia en_US
dc.subject child nutrition en_US
dc.subject micronutrient powder en_US
dc.subject nutritional interventions en_US
dc.subject Peru en_US
dc.subject Social-Ecological Model en_US
dc.title Micronutrient powder use in Arequipa, Peru: Barriers and enablers across multiple levels. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1111/mcn.12915
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.04
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.033
dc.relation.issn 1740-8709


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