Qualitative Research to Inform the Implementation of Home Fortification with Nutrition Education with Seasonal Malaria Chemoprevention through Early Childhood Development Centres for Children Aged 6-59 Months in Sikasso, Mali

Abstract

Objectives: 93.4% of children aged 6-59 months old have malaria in Sikasso, Mali, and 83.5% have anemia. Our qualitative research sought to inform the home fortification with micronutrient powders (MNP) component of a malaria and anemia prevention project with seasonal malaria chemoprevention, delivered through early childhood development centers in 90 villages in Sikasso, Mali. We sought to understand the knowledge, attitudes and practices on infant and young child feeding, anemia prevention, and any opportunities and barriers for proper MNP use at the household level. Methods: 8 focus groups, and 46 in-depth interviews with stakeholders, beneficiaries and providers of the service, and 3 cooking and feeding observations were conducted in 4 villages, purposively selected to represent similar socio-economic status, accessibility to health centers and markets, agricultural and environmental climate as the remaining intervention villages. Results: Age-inappropriate feeding practices, and poor quality and quantity of complementary foods were identified. There is great awareness on the occurrence of anemia but knowledge on causes and preventive measures was lacking. All respondents showed positive interest in MNPs and additional stakeholders and potential barriers were identified, such as multiple family households and the intra-household sharing of meals. Conclusions: These results informed the creation of training materials and cooking demonstrations with MNPs as well as additional people to engage with to create a supportive and enabling environment. This helped guide the implementation of a malaria and anemia prevention project with seasonal malaria chemoprevention and MNP with nutrition education delivered through early childhood development centers in 90 villages in Sikasso, Mali.