"It is good for my family's health and cooks food in a way that my heart loves": qualitative findings and implications for scaling up an improved cookstove project in rural Kenya.

The use of indoor, three-stone fire pits in resource-poor countries is a substantial burden on human health and the environment. We conducted a pilot intervention promoting the purchase and use of an improved cookstove in rural Kenya. The goals of this qualitative inquiry were to understand the motivation to purchase and use; perceived benefits and challenges of cookstove use; and the most influential promotion activities for scaling up future cookstove promotion. Purposive sampling was used to recruit 10 cookstove promoters and 30 cookstove purchasers in the Luo community. Qualitative semi-structured interviews were transcribed and a thematic analysis conducted. Women reported the need for less firewood, fuel cost savings, reduced smoke, improved cooking efficiency, reduced eye irritation, lung congestion and coughing as major benefits of the cookstove. Cost appeared to be a barrier to wider adoption. The most persuasive promotion strategies were interpersonal communication through social networks and cooking demonstrations. Despite this cost barrier, many women still considered the improved cookstove to be a great asset within their household. This inquiry provided important guidance for future cookstove implementation projects.

Monitoring the marketing, distribution, and use of Sprinkles micronutrient powders in rural western Kenya.

BACKGROUND: In 2007, the US Centers for Disease Control and Prevention partnered with local Kenyan institutions to implement the Nyando Integrated Child Health and Education Project, an effectiveness study that used social marketing and a community-based distribution program to promote the sale of Sprinkles and other health products. OBJECTIVE: To describe monitoring of wholesale sales, household demand, promotional strategies, and perceived factors influencing Sprinkles sales among vendors. METHODS: Ongoing quantitative and qualitative monitoring of Sprinkles sales began in May 2007 in 30 intervention villages. Data sources included baseline and follow-up cross-sectional surveys; office records of Sprinkles sales to vendors; biweekly household monitoring of Sprinkles use; and qualitative data collection, including vendor focus groups and key informant interviews. RESULTS: A total of 550 children aged 6 to 35 months were enrolled at baseline, and 451 were available at 12-month follow-up. During this period, nearly 160,000 sachets were sold wholesale to vendors, with variability in sales influenced by the social, political, and economic context. Vendors living closer to the wholesale office purchased more Sprinkles, so a second office was opened closer to remote vendors. On average, 33% of households purchased Sprinkles during household monitoring visits. Training sessions and community launches were important for community support and raising awareness about Sprinkles. Vendor incentives motivated vendors to sell Sprinkles, and consumer incentives promoted purchases. CONCLUSIONS: Sprinkles program monitoring in Kenya was critically important for understanding sales and distribution trends and vendor perceptions. Understanding these trends led to strategic changes to the intervention over time.

Formative research exploring acceptability, utilization, and promotion in order to develop a micronutrient powder (Sprinkles) intervention among Luo families in western Kenya.

BACKGROUND: There is a lack of peer-reviewed literature describing in detail the formative research to develop Sprinkles interventions. OBJECTIVE: To describe community members' reactions to and experiences using Sprinkles, with an emphasis on acceptability, utilization, and promotion. METHODS: Fourteen initial focus group discussions on Sprinkles and a 25-family home study were conducted. For the home study, each child 6 to 59 months of age in the household received 30 sachets (1 per day). The initial 14 focus group discussions included mothers, grandmothers, vendors, women who purchased from vendors, and adults in the general population. Home study families were recruited from participants in the initial 14 focus group discussions who had at least one child 6 to 59 months of age. RESULTS: Sprinkles were highly acceptable to adults and most children; some children thought Sprinkles were sugar. Most home study families prepared and used Sprinkles correctly. All families reported positive effects, particularly increased appetite, and recommended Sprinkles; none experienced major problems. Potential barriers identified were lack of knowledge of and experience with Sprinkles, availability of Sprinkles, and cost. Promotional messages targeted to mothers, fathers, all child-care providers, and doctors focused on the positive health effects of Sprinkles. CONCLUSIONS: Issues related to Sprinkles preparation, use, and barriers required attention before implementation. Locally appropriate visual and written instructions were developed for dissemination. Intervention training sessions and promotions were tailored to answer frequently asked questions, increase knowledge of Sprinkles, and provide tangible evidence of health benefits. Information needs and perceptions changed quickly after use of Sprinkles. Existing levels of Sprinkles awareness and knowledge should be considered when designing interventions.