Mixed methods evaluation explains bypassing of vouchers in micronutrient powder trial in Mozambique
| Autor: | Augusto Norte, Wendy Gonzalez, Lynnette M. Neufeld, Marieke Vossenaar, Kirstine Kjaer, Alison Tumilowicz, Maria Elena Jefferds, Julia Vettersand, Nadia Osman, Katia dos Santos Dias, Edna Possolo, Gretel H Pelto, Alia Poonawala |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Program evaluation Adult Male medicine.medical_specialty Health Knowledge Attitudes Practice mixed methods Adolescent Cross-sectional study Mothers Supplement Articles ethnography World health Formative assessment 03 medical and health sciences Young Adult 0302 clinical medicine Intervention (counseling) medicine Humans 030212 general & internal medicine Micronutrients Child Infant Nutritional Physiological Phenomena Mozambique Motivation 030109 nutrition & dietetics Nutrition and Dietetics evaluation business.industry Public Health Environmental and Occupational Health Obstetrics and Gynecology Infant Micronutrient Voucher infants and young nutrition Cross-Sectional Studies Caregivers Family medicine Pediatrics Perinatology and Child Health Dietary Supplements Food Fortified Patient Compliance Supplement Article Female Process evaluation Powders business Program Evaluation |
| Zdroj: | Maternal & Child Nutrition |
| ISSN: | 1740-8709 1740-8695 |
| Popis: | Micronutrient powders (MNP) are recommended by the World Health Organization as an effective intervention to address anaemia in children. A formative process evaluation was conducted to assess the viability of a model using free vouchers in two districts of Mozambique to deliver MNP and motivate adherence to recommendations regarding its use. The evaluation consisted of (a) an examination of programme outcomes using a cross‐sectional survey among caregivers of children 6–23 months (n = 1,028) and (b) an ethnographic study to investigate delivery experiences and MNP use from caregiver perspectives (n = 59), programme managers (n = 17), and programme implementers (n = 168). Using a mixed methods approach allowed exploration of unexpected programme outcomes and triangulation of findings. The survey revealed that receiving a voucher was the main implementation bottleneck. Although few caregivers received vouchers (11.5%, CI [9.7, 13.6]), one‐fourth received MNP by bypassing the voucher system (26.3%, CI [23.6, 29.0]). Caregivers' narratives indicated that caregivers were motivated to redeem vouchers but encountered obstacles, including not knowing where or how to redeem them or finding MNP were not available at the shop. Observing these challenges, many programme implementers redeemed vouchers and distributed MNP to caregivers. Virtually, all caregivers who received MNP reported ever feeding it to their child. This study's findings are consistent with other studies across a range of contexts suggesting that although programmes are generally effective in motivating initial use, more attention is required to improve access to MNP and support continued use. |
| Databáze: | OpenAIRE |
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