Effectiveness of the Communication Program on Compliance in a Weekly Multimicronutrient Supplementation Program in Chiclayo,Peru

Abstract

Background

Compliance with daily micronutrient supplementation is usually poor and the question arises whether compliance with a weekly regimen would be better.

Objectives

The inputs (messages and channels), output (increase of knowledge), and outcome (behavior changes) of a communication campaign in a micronutrient supplementation program for women and adolescent girls 12 through 44 years of age and children under 5 years of age (primary audience) were analyzed.

Methods

The communication program addressed not only the primary, but also the secondary (facilitators) and tertiary audiences. Formative research and descriptive statistics were used to analyze the communication campaign.

Results

Nearly all women and adolescent girls (89%) and children (91%) took at least 75% of the supplements over the 3-month period. The incidence rates of reported negative side effects of supplementation in children and in women and adolescent girls were less than 10%. Knowledge of micronutrient nutrition among facilitators of all ages and education levels increased significantly (p < .001).

Conclusions

A thoroughly planned and implemented nutrition communication program can secure high compliance of the beneficiaries of micronutrient supplementation programs. The necessary supplies should be available at least 3 months before program implementation. With an adequate communication program, supplementation programs can be used to foster food-based approaches for the target audience.

Keywords

Communication community micronutrients supplementation under-five children urban women

References

Gross

Lechtig

López de Romaña

. Baseline evaluation of nutritional status and government feeding programs in Chiclayo, Peru. Food Nutr Bull 2006; 27(suppl):S115–121.

Yip

. Iron supplementation: country level experiences and lessons learned. J Nutr 2002;132(4 suppl):859S–61S.

Schultink

van der Ree

Matulessi

Gross

. Low compliance with an iron-supplementation program: a study among pregnant women in Jakarta, Indonesia. Am J Clin Nutr 1993;57:135–9.

Cavalli-Sforza

Berger

Smitasiri

Viteri

. Weekly iron-folic acid supplementation of women of reproductive age: impact overview, lessons learned, expansion plans, and contributions toward achievement of the millennium development goals. Nutr Rev 2005;63(12 pt 2):S152-–8.

World Health Organization. Guidelines for the control of iron deficiency in countries of the eastern Mediterranean, Middle East and North Africa. Geneva: WHO, 1996.

ACC/SCN, Global nutrition challenges: a life-cycle approach. Ending malnutrition by 2020: An Agenda for Change in the Millennium. 7. Establishing a new agenda for change. Food Nutr Bull 2000; 21(suppl):62–6.

Griffiths

. Communication strategies to optimize commitments and investments in iron programming. J Nutr 2002;132(4 suppl):834S–8S.

Mason

Hunt

Parker

Jonsson

. Strengthened nutrition strategies, improving child nutrition in Asia. Food Nutr Bull 2001;22(suppl): 85–96.

Khan

Thanh

Berger

Hoa

Quang

Smitasiri

Cavalli-Sforza

. Community mobilization and social marketing to promote weekly iron-folic acid supplementation: a new approach toward controlling anemia among women of reproductive age in Vietnam. Nutr Rev 2005;63(12 pt 2):S87-–94.

10.

Gross

Valle

Diaz

. Effectiveness of distribution of multimicronutrient supplements in children and in women and adolescent girls of childbearing age in Chiclayo, Peru. Food Nutr Bull 2006;27(suppl):S122–9.

11.

Cohen

. Developing information, education and communication (IEC) strategies for population programmes. United Nations Population Fund, Technical Paper No. 1, New York: United Nations, 1993.

12.

López de Romaña

Verona

Aquino Vivanco

Gross

. Protective effect of multimicronutrient supplementation against anemia among children, women, and adolescent girls in lower-income areas of Chiclayo, Peru. Food Nutr Bull 2006; 27(suppl):S143–50.

13.

HealthCom. A tool box for building health communication capacity. Step 3: Draft, pretest and produce. Washington, DC: Academy for Educational Development, Social Development Division, 1995.

14.

Erhardt

. Description of the dietetic part of the software. Available at: http://www.nutrisurvey.de/dietetic/dietetic.hmt. Accessed 23 June 2006.

15.

Erhardt

. Peruvian food composition table. Available at: http://www.nutrisurvey.de/databases/peru.zip. Accessed 2 August 2006.

16.

Gross

Lechtig

López de Romaña

. We know much about what to do but little about how to do it: Experiences with a weekly multimicronutrient supplementation campaign. Food Nutr Bull 2006; 27(suppl):S111–4.

17.

Utomo

. The alleviation of maternal anemia in Indramayu regency, Indonesia. Results from the MotherCare Project (Working Paper 23). Arlington, Va, USA: MotherCare/John Snow, 1993.

18.

Ahluwalia

. Intervention strategies for improving iron status of young children and adolescents in India. Nutr Rev 2002;60(5 pt 2):S115-–7.

19.

Warnick

Dearden

Slater

Butron

Lanata

Huffman

. Social marketing improved the use of multivitamin and mineral supplements among resource-poor women in Bolivia. J Nutr Educ Behav 2004;36:290–7.

20.

Garcia

Datol-Barrett

Dizon

. Industry experience in promoting weekly iron-folic acid supplementation in the Philippines. Nutr Rev 2005;63(12 pt 2):S146-–51.

21.

Kanal K, Busch-Hallen J, Cavalli-Sforza T, Crape B, Smitasiri S, and the Cambodian Weekly Iron-Folic Acid Program Team. Weekly iron-folic acid supplements to prevent anemia among Cambodian women in three settings: process and outcomes of social marketing and community mobilization. Nutr Rev 2005;63(12 pt 2): S126–33.