Knowledge and attitudes of mothers and health providers toward home‐complementation with micronutrients in Baja Verapaz, Guatemala
Authors: García‐Meza Rosario , González Wendy , Tumilowicz Allison , Solomons Noel W. 
Published: November 2023

Background

Micronutrients are essential for growth, development, and disease resistance in the period of complementary feeding. Infectious diseases and inadequate diets, among other factors, have led to micronutrient deficiencies. Home fortification programs are implemented worldwide, targeted to vulnerable population including children between 6–24 months old. Micronutrient powders (MNP) and lipid‐based micronutrient supplements (LNS) are commonly‐used home supplements in geographical areas in which micronutrient‐dense foods and healthy environments have not been achieved. Efforts to understand local knowledge and attitudes on the use of supplements are key elements to design and implement public and private complementation programs

Objective

To describe knowledge and attitudes toward home fortification of complementary foods with micronutrient supplements, currently provided by the Public Health System, among mothers of 6–24 months old children and health providers from two municipalities of Baja Verapaz, Guatemala.

Methods

This reports from the first phase of a qualitative formative research study conducted in two health centers of Cubulco and Purulhá municipalities, Baja Verapaz, Guatemala. Ethical approval was obtained from the Human Subjects Committee of CeSSIAM. Participation was consented and voluntary. A total of 9 mothers of children, three each between 6–8, 9–11 and 12–24 month‐olds and 8 health providers (medial doctors, nurses and health educators) were interviewed. Face‐to‐face interviews were voice recorded and transcribed verbatim. Coding and analysis were done using NVivoPro 11® software and qualitative themes mainly defined in the Focalized Ethnographic Studies®‐FES‐methodology.

Results

Mothers identified supplements for complementary foods provided by health centers include MNP and LNS. Mothers that had use MNP (n=5) and LNS (n=2) described their use or preparation process at home and perceived benefits of their child included improved health and appetite. Challenges in the use of supplements at home comprised confusion on the instructions for use and perceived adverse secondary effects. For the MNP's case, the refusal of supplemented food is usually due to perceived changes in the micronutrient supplement “package” (formula) that influences flavor. Health providers reported disposition to promote home fortification products if they are provided with training on their use and if the supply of the product is constant. Health providers also perceived mothers' willingness to use MNP after 6 months and LNS after the children's first year of age and when frequency of daily dosing does not exceed once per day.

Conclusion

Interviewed mothers and health workers were familiar with MNP and LNS; however, confusion existed on recommendations for appropriate use and inconsistent supply of products hampered promotion and utilization. Improved training and availability of products are needed to guarantee the success of extant home‐fortification programs in Baja Verapaz.