Predictors of micronutrient powder intake adherence in a pilot programme in Nepal

Public Health Nutr. 2016 Jul;19(10):1768-76. doi: 10.1017/S1368980015003572. Epub 2015 Dec 28.


Objective: Poor adherence to recommended intake protocols is common and a top challenge for micronutrient powder (MNP) programmes globally. Identifying modifiable predictors of intake adherence could inform the design and implementation of MNP projects.

Design: We assessed high MNP intake adherence among children who had received MNP ≥2 months ago and consumed ≥1 sachet (n 771). High MNP intake adherence was defined as maternal report of child intake ≥45 sachets. We used logistic regression to assess demographic, intervention components and perception-of-use factors associated with high MNP intake.

Setting: Four districts of Nepal piloting an integrated infant and young child feeding and MNP project.

Subjects: Children aged 6-23 months were eligible to receive sixty MNP sachets every 6 months with suggested intake of one sachet daily for 60 d. Cross-sectional surveys representative of children aged 6-23 months were conducted.

Results: Receiving a reminder card was associated with increased odds for high intake (OR=2·18, 95 % CI 1·14, 4·18); exposure to other programme components was not associated with high intake. Mothers perceiving ≥1 positive effects in their child after MNP use was also associated with high intake (OR=6·55, 95 % CI 4·29, 10·01). Perceiving negative affects was not associated; however, the child not liking the food with MNP was associated with lower odds of high intake (OR=0·12, 95 % CI 0·08, 0·20).

Conclusions: Behaviour change intervention strategies tailored to address these modifiable predictors could potentially increase MNP intake adherence.

Keywords: Adherence; Compliance; Infant and young child feeding; Micronutrient powders; Nepal.

MeSH terms

  • Cross-Sectional Studies
  • Dietary Supplements*
  • Female
  • Humans
  • Infant
  • Infant Nutritional Physiological Phenomena
  • Male
  • Micronutrients / administration & dosage*
  • Nepal
  • Nutritional Status
  • Patient Compliance / statistics & numerical data*
  • Pilot Projects
  • Powders


  • Micronutrients
  • Powders