title: Key Informants' Perceptions on the Implementation of a National Program for Improving Nutritional Status of Children in Iran.
abstract: BACKGROUND
  Childhood malnutrition is a major public health issue. Multidisciplinary approach for Improvement of Nutritional Status of Children in Iran was implemented in order to reduce malnutrition among children.
  
  
  OBJECTIVE
  This study aimed to evaluate the implementation aspect of the program and to explore key informants' perceptions and experience regarding the factors affected its implementation.
  
  
  METHODS
  Data were collected through the review of secondary data and semistructured interviews at national, province, and local levels. Four layers of key informants were selected purposefully for interviewing, including policymakers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out based on Supporting the Use of Research Evidence framework and Tailored Implementation for Chronic Diseases' checklist to interpret the viewpoints of the study participants.
  
  
  RESULTS
  Results showed that the program had successes in improving mother's knowledge on health, nutrition, and child care through health system and increased families' access to food, but there were some aspects that affected program's implementation. Some of these factors are the lack of clarity in the program's protocol and indicators, human shortage and inadequate financial resources, poor facilities, inattention to staff motivation, insufficient commitment among different sections, poor communication and supervision among different executive sections, and program protocols designing regardless of practical condition.
  
  
  CONCLUSIONS
  Based on the results, top-down approach in policymaking and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.
authors.affiliation: 1 Department of Community nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Delaram
authors.initials: D
authors.lastname: Ghodsi
authors.affiliation: 1 Department of Community nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Omidvar
authors.affiliation: 2 School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Arash
authors.initials: A
authors.lastname: Rashidian
authors.affiliation: 3 Department of Economics, Alzahra University, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Raghfar
authors.affiliation: 1 Department of Community nutrition, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Eini-Zinab
authors.affiliation: 4 Department of Social Pathology, Academic Center of Education and Culture and Research, Kharazmi University, Tehran, Iran.
authors.forename: Marziyeh
authors.initials: M
authors.lastname: Ebrahimi
keywords: childhood malnutrition; implementation; key informants’ perception; multidisciplinary approach; program evaluation; qualitative methods