title: Using formative research to inform the design of a home fortification with micronutrient powders (MNP) Program in Aileu District, Timor-Leste.
abstract: BACKGROUND
  Using formative research to guide the planning and implementation of home fortification programs is critical if they are to achieve the desired level of acceptance and coverage by the target beneficiaries.
  
  
  OBJECTIVE
  To explore contextual factors that could influence acceptance, delivery, and use of micronutrient powders (MNP) in Aileu District, Timor-Leste.
  
  
  METHODS
  Two focus group discussions were conducted with mothers of children 6 to 23 months of age, and 56 in-depth interviews were conducted with mothers (n = 18), fathers (n = 14), grandmothers (n = 14), health workers (n = 8), and Catholic catechists (n = 2). These were followed by a 14-day usability trial during which 45 mothers fed their children MNP daily and were interviewed about their experience. Participants were selected from three villages.
  
  
  RESULTS
  The findings revealed limited exclusive breastfeeding and early introduction of complementary foods due to traditional beliefs and poor knowledge. MNP was generally liked by the respondents. Thirty of the 45 children in the trial consumed all of the 14 MNP sachets provided to them. The majority of mothers (n > or = 30) split and fed the daily dose of MNP at different times of the day. They gave several reasons for this practice, including changes in the color of food when a whole sachet of MNP was added. Only six mothers shared MNP-fortified food among siblings. The participants suggested contextual attributes that could influence their adoption of MNP including preferred name, packaging design, and delivery channel. They preferred orange-colored sachets with a picture of a "healthy" Timorese baby, the logo of the Ministry of Health, and instructions on how to use the product.
  
  
  CONCLUSIONS
  The findings offer context-specific knowledge that could guide the success of the MNP program in this district and similar settings.
authors.forename: Akoto
authors.initials: A
authors.lastname: Osei
authors.forename: Andi
authors.initials: A
authors.lastname: Septiari
authors.forename: Julia
authors.initials: J
authors.lastname: Suryantan
authors.forename: Md Monjur
authors.initials: MM
authors.lastname: Hossain
authors.forename: Faraja
authors.initials: F
authors.lastname: Chiwile
authors.forename: Mayang
authors.initials: M
authors.lastname: Sari
authors.forename: Paulino
authors.initials: P
authors.lastname: Pinto
authors.forename: Dirce
authors.initials: D
authors.lastname: Soares
authors.forename: Silvana
authors.initials: S
authors.lastname: Faillace
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D003258:Consumer Behavior / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D005527:Food, Fortified / Q000706:statistics & numerical data*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007407:Interviews as Topic / Q000379:methods; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D011208:Powders; D015397:Program Evaluation / Q000379:methods*; D012107:Research Design; D049648:Timor-Leste; D055815:Young Adult
chemical_list: D018977:Micronutrients; D011208:Powders