Adherence to supplementary feeding biscuits and their effect on haemoglobin levels in underweight children aged 6-23 months: a quasi-experiment in Aceh, Indonesia

Abstract

This study aimed to analyse compliance with supplementary feeding (SF) biscuits and their impact on haemoglobin levels in underweight children aged 6-23 months. A quasi-experimental of the one-group pre-post only design was used to study 80 underweight children who were taken by the cluster sampling method, SF biscuits was given at a dose of 90 g (12-24 months of age) and 60 g (6-11 months of age) per day for 24 weeks with the assistance of cadres and supervised by nutrition workers. Compliance was measured by interviewing the mother using a form, and haemoglobin level was measured using the spectrophotometric method. Data analysis used a logistic regression test and paired T-test at the 95% confidence level (95% CI). The average adherence to biscuit consumption is 75.7%, SF biscuits consumption compliance has increased from the first to second month (77.2%) to the third to the fourth month (79.2%) and has decreased in the fifth and sixth month (70.7%). Children who had never been sick and suffered from anaemia had higher adherence to biscuit consumption (OR = 5.56; 95% CI: 1.35-22.93) and (OR = 0.12; 95% CI: 0.03-0.5) (p = 0.017 and p = 0.005) than children who are often sick and not anaemic. Most of the mothers stated that their children liked the SF biscuits (43.8%) and the mean increase in Hb levels was higher in children with consumption levels above 70%. The provision of SF biscuits with assistance can increase the compliance level of biscuits consumption, however, after 4 months of provision, it decreases. To prevent children from becoming bored while eating, a combination of biscuit formulations was required, including taste, form, and ingredient composition.