Objectives
To understand barriers and enhances of uptake and utilization of micronutrient powders (MNPs) in market-based delivery models, comparing lessons from Vietnam and Bangladesh to inform and improve future programming and scale up.
Methods
The same structured questionnaire was used in Bangladesh and Vietnam to gather quantitative information from caregivers of children under-5 on utilization of MNPs. Additionally, sales monitoring data from both programs and qualitative data from key informant interviews and focus group discussions, including health staff, program implementers and community health volunteers, was included in the analysis.
Results
The data analysis demonstrates similarities across both countries in the relative importance of specific barriers and enhancers at different levels of the program impact pathway in market-based delivery models. The most frequently quoted barriers include a perceived lack of need (38%), the childs dislike of the product (9%), inability to purchase (25%), or unavailability in the market (5-10%). Amongst the most compliant caregivers, awareness of the product benefits and trust in the brand, distribution channel and source of product were the most frequency cited enhancers.
Conclusions
Good understanding of caregivers’ motives beofre and during implementation is important to enable program implementers to reinforce messages and motivators that will drive uptake and compliant utilization of MNPs, and subsequently help improve complementary feeding practices and nutitional status of children. Lessons from both Vietnam and Bangladesh could be used to inform other market based approaches who will likely face similar challenges in implementation and for sustainable impact.
