title: Predictors of micronutrient powder intake adherence in a pilot programme in Nepal.
abstract: Poor adherence to recommended intake protocols is common and a top challenge for micronutrient powder (MNP) programmes globally. Identifying modifiable predictors of intake adherence could inform the design and implementation of MNP projects.
  
  
  
  We assessed high MNP intake adherence among children who had received MNP ≥2 months ago and consumed ≥1 sachet (n 771). High MNP intake adherence was defined as maternal report of child intake ≥45 sachets. We used logistic regression to assess demographic, intervention components and perception-of-use factors associated with high MNP intake.
  
  
  
  Four districts of Nepal piloting an integrated infant and young child feeding and MNP project.
  
  
  
  Children aged 6-23 months were eligible to receive sixty MNP sachets every 6 months with suggested intake of one sachet daily for 60 d. Cross-sectional surveys representative of children aged 6-23 months were conducted.
  
  
  
  Receiving a reminder card was associated with increased odds for high intake (OR=2·18, 95 % CI 1·14, 4·18); exposure to other programme components was not associated with high intake. Mothers perceiving ≥1 positive effects in their child after MNP use was also associated with high intake (OR=6·55, 95 % CI 4·29, 10·01). Perceiving negative affects was not associated; however, the child not liking the food with MNP was associated with lower odds of high intake (OR=0·12, 95 % CI 0·08, 0·20).
  
  
  
  Behaviour change intervention strategies tailored to address these modifiable predictors could potentially increase MNP intake adherence.
authors.affiliation: 1US Centers for Disease Control and Prevention,4770 Buford Hwy NE,Mailstop F-77,Atlanta,GA 30341,USA.
authors.forename: Kelsey R
authors.initials: KR
authors.lastname: Mirkovic
authors.affiliation: 1US Centers for Disease Control and Prevention,4770 Buford Hwy NE,Mailstop F-77,Atlanta,GA 30341,USA.
authors.forename: Cria G
authors.initials: CG
authors.lastname: Perrine
authors.affiliation: 2Child Health Division,Ministry of Health and Population,Kathmandu,Nepal.
authors.forename: Giri Raj
authors.initials: GR
authors.lastname: Subedi
authors.affiliation: 3Nutrition Section,UNICEF,Kathmandu,Nepal.
authors.forename: Saba
authors.initials: S
authors.lastname: Mebrahtu
authors.affiliation: 3Nutrition Section,UNICEF,Kathmandu,Nepal.
authors.forename: Pradiumna
authors.initials: P
authors.lastname: Dahal
authors.affiliation: 4Rollins School of Public Health,Emory University,Atlanta, GA,USA.
authors.forename: Colleen
authors.initials: C
authors.lastname: Staatz
authors.affiliation: 1US Centers for Disease Control and Prevention,4770 Buford Hwy NE,Mailstop F-77,Atlanta,GA 30341,USA.
authors.forename: Maria Elena D
authors.initials: ME
authors.lastname: Jefferds
mesh_terms: D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009390:Nepal; D009752:Nutritional Status; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010865:Pilot Projects; D011208:Powders
chemical_list: D018977:Micronutrients; D011208:Powders
keywords: Adherence; Compliance; Infant and young child feeding; Micronutrient powders; Nepal