Open AccessCompliance with and acceptability of two fortified balanced energy protein supplements among pregnant women in rural Nepal
Author(s) -
Lama Tsering P.,
Moore Katie,
Isanaka Sheila,
Jones Leslie,
Bedford Juliet,
Pee Saskia,
Katz Joanne,
Khatry Subarna K.,
LeClerq Steven C.,
Tielsch James M.
Publication year - 2022
Publication title -
maternal and child nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 63
eISSN - 1740-8709
pISSN - 1740-8695
DOI - 10.1111/mcn.13306
Subject(s) - medicine , focus group , likert scale , pregnancy , psychological intervention , environmental health , randomized controlled trial , family medicine , nursing , statistics , mathematics , marketing , biology , business , genetics
Some evidence suggests that balanced energy protein (BEP) supplements taken during pregnancy and lactation can have positive effects on birth outcomes such as small‐for‐gestational age and birthweight, but more evidence is needed on the long‐term use and acceptability of such supplements. We conducted a mixed‐methods formative research study to assess and compare compliance with and acceptability of two BEP supplements, a lipid‐based peanut paste and a biscuit, to identify BEP supplements for subsequent inclusion in an efficacy trial. We conducted an 8‐week feeding trial of daily supplementation among two groups of 40 pregnant women each in rural Nepal. Compliance data were collected and supplements distributed at the weekly visits. Sensory properties of the supplements were assessed using a 7‐point Likert scale. In addition, in‐depth interviews with women ( n = 16), family members ( n = 6) and health workers ( n = 6) and focus group discussions (FGDs) ( n = 4) were conducted to explore themes related to general use and intention of future use of the supplement. Overall self‐reported compliance was high: medians of 91.1% in the lipid‐based peanut paste group and 96.4% in the biscuit group. Both supplements were rated highly on overall likability (median score 6/7) and sensory properties. Qualitative findings showed that sustained use of the supplements was attributed to expected health benefits, favourable sensory attributes, and family support. The FGDs suggested providing the option to choose between more than one type/flavour of supplements to improve compliance. Sharing was mostly evident in the first week with higher sharing reported in the biscuit group.