School of Biomedical and Allied Health Sciences
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Browsing School of Biomedical and Allied Health Sciences by Subject "Acceptability"
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Item A mixed method study exploring adherence to and acceptability of small quantity lipid-based nutrient supplements (SQ-LNS) among pregnant and lactating women in Ghana and Malawi(BioMed Central Ltd., 2016) Klevor, M.K.; Adu-Afarwuah, S.; Ashorn, P.; Arimond, M.; Dewey, K.G.; Lartey, A.; Maleta, K.; Phiri, N.; Pyykkö, J.; Zeilani, M.; Ashorn, U.Background: Supplementing pregnant and lactating mothers with small quantity lipid-based nutrient supplements (SQ-LNS) has resulted in improvements in birth outcomes in some low-income settings. In order to be effective, SQ-LNS must be consumed regularly over sustained periods. Methods: The objective was to assess and compare acceptability of and adherence to SQ-LNS consumption among pregnant and lactating women in Ghana and Malawi throughout 12 months of supplementation. We enrolled women before 20 gestation weeks into randomized trials in Ghana (n=1320) and Malawi (n=869). In the SQ-LNS group participants received a 20 g sachet of supplement per day during pregnancy and the first 6 months of lactation. In the control groups participants received multiple micronutrients (MMN) during pregnancy and lactation or iron and folic acid (IFA) during pregnancy and calcium during lactation. We used questionnaires to collect data on self-reported adherence to daily use of supplements and conducted in-depth interviews with women in the SQ-LNS group to examine acceptability. Results: The mean self-reported adherence during the supplementation period was lower in Ghana (79.9 %) than in Malawi (91.7 %) for all supplements (difference 11.8 %, P<0.001). Over time, adherence increased in Malawi but decreased in Ghana. In both countries, adherence in the SQ-LNS group was non-inferior to that in the control groups. Participants typically reported consuming SQ-LNS as instructed but when interviewers queried about experiences, most of the women described incidents of non-adherence. A usual reason for not consuming SQ-LNS was nausea and vomiting during pregnancy. Especially in Malawi, women reported sharing SQ-LNS with families and friends. Sustained use of SQ-LNS was attributed to expected health benefits and favorable sensory attributes. Often women compared their pregnancy to previous ones, and were of the view that SQ-LNS made a positive difference. Conclusion: Self-reported sustained adherence to consume SQ-LNS daily was high in both sites but lower in Ghana than in Malawi. In Ghana, adherence decreased over time whereas in Malawi adherence increased. Acceptability and adherence appeared interlinked, complex and context-related. Sustained consumption of SQ-LNS may require tailoring interventions by context. Trial registration: The Ghana trial was registered at clinicaltrials.gov as NCT00970866, and the Malawi trial as NCT01239693.Item Sensory attributes and acceptability of complementary foods fortified with Moringa oleifera leaf powder(Nutrition and Food Science, 2018-10) Boateng, L.; Nortey, E.; Ohemeng, A.N.; Asante, M.; Steiner-Asiedu, M.Purpose Inadequacies in several micronutrients in complementary foods, notably iron, zinc, calcium, vitamin A, vitamin B6 and riboflavin have been reported. Moringa oleifera leaf powder (MLP), prepared from dried moringa leaves is nutrient-rich and has been explored for the treatment of micronutrient deficiencies among children in developing countries. This increasing interest in the use of moringa oleifera leaves to improve complementary foods notwithstanding, the unique sensory characteristics of the leaf powder potentially holds implications for the acceptability of local diets that are fortified with it. The purpose of this paper is to investigate the levels of MLP fortification that are most acceptable for feeding infants and young children. Design/methodology/approach The authors performed a review of the literature, with the aim of investigating the sensory attributes and acceptable levels of fortification of complementary food blends fortified with different levels of MLP. Findings The minimum amount of MLP to be added to a complementary food blend to observe significant improvements in its nutritional value was estimated to be about 10 per cent. However, at this 10 per cent fortification level also, sensory attributes of the products begin to become less desirable. Practical implications For the success of nutrition interventions that involve the use of MLP to improve the nutritional quality of complementary foods, there is a need to consider the acceptability of the sensory attributes of the formulated blends in the target group. Safety of MLP as an ingredient in infant foods must also be investigated. Originality/value The authors of this paper make recommendations for the use of MLP to fortify complementary foods to ensure its success as a food fortificant in nutrition interventions. The researchers are not aware of any published study that focuses on this subject.