Factors Associated with Micronutrient Powder Acceptability among Women of Reproductive Age in El Alto, Bolivia 公开

Kusnezov, Lara Kristine (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/f1881m434?locale=zh
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Abstract

Background: Women in Bolivia suffer from a high prevalence of micronutrient deficiency contributing to high rates of maternal and child mortality. Consequentially, micronutrient deficiency is among the top public health priorities in Bolivia. Because of this, the Bolivian Ministry of Health and Sports has partnered with Micronutrient Initiative to introduce micronutrient powders as a tool to improve maternal and child health. As a precursor to the development of a national nutrition program targeting the maternal population, this study aimed to assess the acceptability of micronutrient powder supplementation among women of reproductive age in El Alto, Bolivia.

Methods: Quantitative data were collected from surveys and included questions about demographic information, knowledge, practices, and attitudes of vitamins and micronutrient powder supplementation. Multivariable logistic regression was performed to investigate the contribution of the independent variables (vitamin knowledge, vitamin use, demographic factors, perceived barriers, and experience with Chispitas) to the acceptability of micronutrient powder supplements among women of reproductive age.

Results: A total of 70 women between 15 and 50 years old were included in the final sample. Women with the following factors were more likely to accept micronutrient powders: high levels of education (OR: 3.88 [95% CI, 1.58-9.55]), young age (OR: 1.73, [95% CI, 1.09-1.82]), and married or in a domestic partnership (OR: 2.19 [95% CI, 1.01-4.76]).

Conclusions: Improving maternal micronutrient status could greatly improve maternal and child health in Bolivia. Less educated, older, and single women are least likely to accept the use of micronutrient powders. Developing programs that target basic nutrition promotion through education systems and community-based organizations are essential to improving acceptability of micronutrient powders among women and ultimately, to improving micronutrient status in women and children in Bolivia.

Table of Contents

BACKGROUND AND LITERATURE REVIEW...1

GLOBAL BURDEN OF MICRONUTRIENT DEFICIENCIES...1

EPIDEMIOLOGY...1

ECONOMIC IMPACT...2

BURDEN IN WOMEN...3

MICRONUTRIENT POWDER SUPPLEMENTATION...4

DEVELOPMENT AND HISTORY...4

EFFICACY AND EFFECTIVENESS...5

USE IN MATERNAL POPULATIONS...5

ACCEPTABILITY AND ADHERENCE AMONG WOMEN...6

MICRONUTRIENT DEFICIENCIES IN BOLIVIA...10

EPIDEMIOLOGY...10

MICRONUTRIENT POWDER SUPPLEMENTATION "CHISPITAS" IN BOLIVIA...11

INTRODUCTION OF CHISPITAS IN BOLIVIA...11

MECHANISM AND EFFICACY...12

USE IN MATERNAL POPULATIONS...13

GAPS IN KNOWLEDGE AND NEED...13

STUDY GOALS AND AIMS...14

SIGNIFICANCE...14 MANUSCRIPT...17 ABSTRACT...17 INTRODUCTION...18 METHODS...22

PROJECT SITE AND STUDY POPULATION...22

RECRUITMENT, ENROLLMENT, AND INFORMED CONSENT...22

QUALITATIVE PILOT INTERVIEW...23

QUANTITATIVE SURVEY...23 DATA COLLECTION AND MANAGEMENT...23

VARIABLE CLASSIFICATION...24
STATISTICAL ANALYSIS...24

RESULTS...26 DISCUSSION...28 STRENGTHS AND LIMITATIONS...31 CONCLUSIONS...33 REFERENCES...34 TABLES...43 PUBLIC HEALTH IMPLICATIONS AND FUTURE DIRECTIONS...46 APPENDIX...48

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