{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T05:47:51Z","timestamp":1775281671908,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,11,1]],"date-time":"2015-11-01T00:00:00Z","timestamp":1446336000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Micronutrient Initiative, Canada"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Maternal &amp; Child Nutrition"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Iron deficiency causes anaemia and other adverse effects on the nutritional status and development of millions of children. Multi\u2010micronutrient powders (MNP) have been shown to reduce anaemia in young children. In Peru, 50% of children 6\u201336\u2009months are anaemic. Since 2009, the government has started distributing MNP. This qualitative study explored the acceptability of MNP by caregivers and the role of health personnel (HP) in three regions (Apurimac, Ayacucho and Cajamarca), piloting the MNP programme between 2009 and 2011. Data collection consisted of interviews (35) and observations (13) with caregivers and HP (11). In Cajamarca, 16 families were visited three times in their homes to understand caregivers' use and difficulties. Results showed the critical role HP has in influencing caregiver understanding and use of the MNP, as well as the need for training to avoid confusing messages and provide counselling techniques that consider cultural sensitivity to optimize HP interactions with caregivers and adapt the recommendations for MNP use to local family feeding routines. There was greater acceptance of MNP by caregivers giving semi\u2010solid foods (e.g. purees) to their children than those who served dilute preparations (e.g. soups). Acceptance was similar across regions, but there were some differences between urban and rural settings. Home visits were shown to be a key in improving the use of MNP by caregivers as misunderstandings on preparation, required consistency and optimum practices were common. These findings can contribute to strategies to enhance acceptability and use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key messages<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Acceptance and use of multi\u2010micronutrient powders (MNP) by caregivers greatly depend upon how it is presented, promoted and counselled by health personnel.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Counselling for MNP use needs to consider and adapt to the local cultural context and incorporate family and child feeding routines.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>MNP are presented as part of appropriate feeding practices, encouraging caregivers to find simple and acceptable ways of giving semi\u2010solid or solid foods with which to mix it.<\/jats:p><\/jats:list-item>\n<\/jats:list> \u00a9 2015 Blackwell Publishing Ltd<\/jats:p><\/jats:sec>","DOI":"10.1111\/mcn.12217","type":"journal-article","created":{"date-parts":[[2015,11,2]],"date-time":"2015-11-02T04:31:15Z","timestamp":1446438675000},"page":"152-163","source":"Crossref","is-referenced-by-count":33,"title":["Promoting multi\u2010micronutrient powders (MNP) in Peru: acceptance by caregivers and role of health personnel"],"prefix":"10.1111","volume":"12","author":[{"given":"Hilary","family":"Creed\u2010Kanashiro","sequence":"first","affiliation":[{"name":"Instituto de Investigaci\u00f3n Nutricional  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosario","family":"Bartolini","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Nutricional  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Abad","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Nutricional  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varinia","family":"Arevalo","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Nutricional  Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,11]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Acci\u00f3n contra el Hambre (ACH) &UNICEF Peru(2013)Sondeo cualitativo valoraciones saberes y experiencias en el consumo del suplemento con multi\u2010micronutrientes en los departamentos de Ayacucho Apur\u00edmac y Huancavelica. Lima Peru. pp43."},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1093\/ajcn\/87.4.929","article-title":"Home fortification of complementary foods with micronutrient supplements is well accepted and has positive effects on infant iron status in Ghana","volume":"87","author":"Adu\u2010Afarwuah S.","year":"2008","journal-title":"American Journal of Clinical Nutrition"},{"issue":"4","key":"e_1_2_9_4_1","first-page":"114","article-title":"Acceptability of micronutrient sprinkles: a new food\u2010based approach for delivering iron to First Nations and Inuit children in Northern Canada","volume":"26","author":"Christofides A.","year":"2005","journal-title":"Chronic Diseases in Canada"},{"key":"e_1_2_9_5_1","first-page":"14","volume-title":"Strategies for Ensuring Adequate Nutrient Intake for Infants and Young Children during the Period of Complementary Feeding","author":"Dewey K.G.","year":"2013"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2009.00190.x"},{"key":"e_1_2_9_7_1","unstructured":"Instituto Nacional de Estad\u00edstica e Inform\u00e1tica (INEI) Ministerio de Econom\u00eda y Finanzas (MEF) &USAID Peru(2011)Encuesta demogr\u00e1fica y de salud. Indicadores de resultados de los programas estrat\u00e9gicos 2010."},{"key":"e_1_2_9_8_1","unstructured":"Instituto Nacional de Estad\u00edstica e Inform\u00e1tica (INEI) Ministerio de Econom\u00eda y Finanzas (MEF) &USAID Peru(2014)Encuesta demogr\u00e1fica y de salud 2013."},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","first-page":"677.2","DOI":"10.1096\/fasebj.22.1_supplement.677.2","article-title":"Acceptability of three supplements with identical micronutrient content in Mexican children","volume":"22","author":"Flores L.","year":"2008","journal-title":"FASEB Journal"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2008.11.003"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mpg.0000189363.07040.4b"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1726-46342012000300004"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ejcn.1602917"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265100312S210"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2008.00154.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/137.4.1023"},{"key":"e_1_2_9_17_1","volume-title":"Propuesta de implementaci\u00f3n de micronutrientes en tres regiones: Apur\u00edmac, Ayacucho y Huancavelica","author":"Ministerio de Salud (MINSA) &Ministerio de la Mujer (MINDES), Peru","year":"2009"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/156482651403500109"},{"key":"e_1_2_9_19_1","unstructured":"Pan\u2010American Health Organization (PAHO) & UNICEF(2013)ProPAN \u2013 Process for the Promotion of Child Feeding.www.PAHO.org\/ProPAN"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.111.140004"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1740-8709.2011.00352.x"},{"key":"e_1_2_9_22_1","unstructured":"UNICEF Per\u00fa(2014)Sistematizaci\u00f3n de la Experiencia Peruana sobre suplementaci\u00f3n con micronutrientes en los departamentos de Apur\u00edmac Ayacucho y Huancavelica 2009\u20132011."},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.3945\/jn.109.113498"},{"key":"e_1_2_9_24_1","unstructured":"ZavaletaN. LozaD. EgoavilP. SanchezJ. MosqueiraR. HardingK. NeufeldL.M.2013Efficacy of daily and intermittent supplementation with micronutrient powders during 6 and 12 months on anemia in Peruvian infants. Abstract.PO1135.ICN Granada."},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/74.6.791"}],"container-title":["Maternal &amp; Child Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fmcn.12217","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.12217","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/mcn.12217","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/mcn.12217","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T21:47:12Z","timestamp":1696196832000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/mcn.12217"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.1111\/mcn.12217"],"URL":"https:\/\/doi.org\/10.1111\/mcn.12217","archive":["Portico"],"relation":{},"ISSN":["1740-8695","1740-8709"],"issn-type":[{"value":"1740-8695","type":"print"},{"value":"1740-8709","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11]]}}}