The PERUSANO study: Caregivers, health centre and day care centre influences on infant and young child feeding practices: codebook for analysis for the health facilities

Qualitative data from semi-structured in-depth interviews, exit interviews and observations were collected as part of a wider interdisciplinary project (PERUSANO) aimed at addressing multiple forms of malnutrition, particularly stunting, anaemia, and risk of overweight/obesity in peri-urban Peruvian infants and young children (IYC) aged 6-23 months of age. The study took place in two peri-urban areas: Manchay in Lima and Huánuco district in the Andean highlands. <br> Interviews and observations explored drivers of infant and young child complementary feeding (IYCF) practices from the perspective of primary caregivers within the home environment, health professionals involved in CRED care (well-baby checks, nutrition counselling) and staff involved in the CUNAMAS National Programme in day care services. The CUNAMAS is a large-scale early child development programme established by the Ministry of Development and Social Inclusion in 2012. It aims to support the holistic development of children under three living in poverty. <br> Data collection in four health centres and fourteen CUNAMAS day care services took place between October and December 2019. Participants/key informants were purposefully selected to cover the main roles within the health facilities (health professionals involved in CRED care, nutritionists, primary caregivers of children), and CUNAMAS day care services (nursery caregivers, district nursery technical managers, mother guides, and primary caregivers of children). <br> Interviews and observations with primary caregivers took place between January and mid-March 2020. A purposive quota sampling was employed to recruit mothers according to the child’s age, maternal working status and nutritional status from participants who had taken part in the quantitative survey of the PERUSANO project. In March 2020, face-to-face interviews stopped due to the COVID-19 pandemic and the remaining interviews with caregivers were conducted by telephone. Observations could no longer be conducted. <br> The codebooks used for analysis for the health facilities are available in both English and Spanish languages. Detailed sampling information according to interview type, location and stakeholder group can be found in Supplementary material 1. See also the README_HP file attached. <br> The quantitative component of the study has been described elsewhere (Pradeilles et al. 2022). Quantitative survey questionnaires and data can be found at 10.17028/rd.lboro.18750458, 10.17028/rd.lboro.16691455 and 10.17028/rd.lboro.21656348.

本研究作为一项大型跨学科研究项目PERUSANO的组成部分，通过半结构化深度访谈、离职访谈与观察法收集质性数据，旨在解决秘鲁城郊6-23月龄婴幼儿（Infants and Young Children, IYC）面临的多种营养不良问题，重点关注生长迟缓、贫血以及超重/肥胖风险。本研究在两处城郊区域开展：利马的曼查伊（Manchay）与安第斯高地的瓦努科大区（Huánuco district）。
访谈与观察内容围绕婴幼儿辅食喂养（Infant and Young Child Complementary Feeding, IYCF）实践的驱动因素展开，调研对象涵盖家庭场景中的主要照料者、参与儿童常规保健（CRED care，含儿童健康检查与营养咨询）的医疗专业人员，以及参与CUNAMAS全国日托项目的日托服务工作人员。CUNAMAS是秘鲁发展与社会包容部于2012年设立的大型早期儿童发展项目，旨在助力生活贫困的三岁以下儿童实现全面发展。
数据采集于2019年10月至12月间，覆盖4家医疗中心与14家CUNAMAS日托机构。研究通过立意抽样选取关键信息提供者，涵盖医疗设施内的主要岗位人员：参与儿童常规保健的医疗专业人员、营养师、儿童主要照料者，以及CUNAMAS日托机构的相关人员：托育照料者、大区托育技术管理人员、母亲指导员与儿童主要照料者。
针对儿童主要照料者的访谈与观察于2020年1月至3月中旬开展。研究采用立意配额抽样法，依据儿童年龄、母亲就业状况与营养状况，从参与PERUSANO项目定量调查的对象中招募母亲受访者。2020年3月，受新冠疫情（COVID-19 pandemic）影响，面对面访谈被迫中止，剩余照料者访谈转为电话访谈，观察工作也随之暂停。
用于医疗设施数据分析的编码手册（codebooks）同时提供英文与西班牙语版本。根据访谈类型、采集地点与利益相关者群体划分的详细抽样信息可参见补充材料1，亦可参阅附件中的README_HP文件。
本研究的定量研究部分已在其他学术文献中发表（Pradeilles等人，2022）。定量调查问卷与相关数据可通过以下链接获取：10.17028/rd.lboro.18750458、10.17028/rd.lboro.16691455与10.17028/rd.lboro.21656348。