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Comparison of Methods to Assess Consumption of Micronutrient Powders (MNP) Among Young Children in Nepal
Author(s) -
Ngeno Bernadette,
Perrine Cria,
Subedi Giri,
Mebrahtu Saba,
Dahal Pradiumna,
Jefferds Maria Elena
Publication year - 2016
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.30.1_supplement.1172.4
Subject(s) - medicine , micronutrient , consumption (sociology) , environmental health , demography , pediatrics , toxicology , biology , social science , pathology , sociology
Background Assessing micronutrient powder (MNP) consumption is a key component of monitoring program performance; there is no gold standard for assessing MNP consumption in publichealth program settings. Objective To compare estimates of MNP consumption among young children assessed by maternal reportversus observation of unopened MNP sachets in the household. Methods Cross‐sectional household cluster surveys representative of children 6–23 months were conductedto assess an integrated infant and young child feeding and MNP pilot project inNepal. Mothers were given sixty sachets of MNP and instructed to give the childone sachet daily. Consumption of MNP was assessed by asking the mother toreport number of MNP sachets consumed and by observation of unused MNP sachetsin the household. Mothers who reported the child consumed 60 sachets were stillasked to show any remaining sachets. If none were shown, 0 sachets wererecorded. Among mothers who received 60 MNP sachets ≥2 months beforethe assessment, 205 mothers reported that the child did not consume all MNPsachets received, but did not show the remaining MNP sachets. The remaining 605children had maternal report of MNP consumption and valid data for observationof unopened MNP sachets including zero. Directly observed difference (DOD) ofMNP consumption was calculated by subtracting the number of observed unopened sachets from 60 sachets. We assessed the median difference, Spearman correlation coefficient, end digit preference, and categories of consumption ofDOD and maternal report of use. Results Median MNP consumption was 51.0 sachets by DOD and 57.0 sachets by maternal report. Median difference between DOD and maternal report of MNP consumed was 6.0 sachets; the correlation coefficient was 0.91. Among mothers, 68% and 6% reported the number of consumed MNP sachets ending with 0 and 5, respectively, whereas by DOD, 70% and 4% ended with 0 and 5, respectively. When we excluded children whose consumption of MNP was 60 sachets by either method, 16.9% and 8% reported the number of consumed MNP sachets ending with 0 and 5, respectively, whereas by DOD, 14.2% and 6.1% ended with 0 and 5, respectively. With MNP consumption grouped into 0–14 sachets, 15–29 sachets, 30–44 sachets, and 45–60 sachets, the percent categorized into the same groupings by the DOD and maternal reported consumption was 100%, 80.6%, 80.7% and 91.2% respectively. Conclusions Had the observation of the unused sachets been used aloneto assess MNP consumption, it would not have been possible to assess intake ofMNP for approximately 20% of children who had received MNP. Estimates ofMNP consumption by DOD and maternal report were similar.