Formative Research: A Necessary Step for the Implementation of a Home Fortification Program in Cameroon.

ABSTRACT

Objectives: To understand caregivers' knowledge on anemia, barriers to optimal infant and young child feeding (IYCF) practices, and the acceptability and appropriate use of micronutrient powders (MNP) in households of children 6-23 months, in order to inform an implementation of MNP in Cameroon. Methods: The study was conducted in health districts of the North and South regions, areas with high prevalence of anaemia among young children. There were two steps: 1) situation analysis including focus group discussions and key informant interviews, 2) 30 day study to assess MNP acceptability and utilization. Caregivers (N=101) were interviewed at baseline, day 10, and day 30. Data were both qualitative and quantitative. Results: The situation analysis demonstrated that knowledge on anaemia and IYCF practices were not appropriate. Potential MNP food vehicles were identified. The 30 day study showed high rates of acceptability (100%). Adherence was challenging for the group on a rigid schedule (30 MNP sachets for 30 days) mainly due to child illness related interruption, which is why a flexible schedule (15 MNP sachets for 30 days) was found more feasible. Opposition to and rumours regarding MNP were observed in some cases. The main motivation factors for giving MNP cited by caregivers were make child healthy, improve immune system and stimulate appetite. Conclusions: The formative research demonstrated the importance of a strong community sensitisation. A comprehensive communication strategy and community-based capacity building are essential to maximise acceptability, appropriate MNP utilization, adherence, and prevent rumour generation. Further, implementing MNP provides a great opportunity to strengthen IYCF.