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. 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. 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). 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. 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. 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.本研究依托跨学科项目PERUSANO开展，通过半结构化深度访谈、退场访谈及观察法采集质性数据，该项目旨在解决秘鲁城郊地区6~23月龄婴幼儿（Infants and Young Children, IYC）的多种营养不良问题，尤其聚焦发育迟缓、贫血及超重/肥胖风险。研究选址于两个城郊区域：利马市曼查伊（Manchay）及安第斯高地的瓦努科大区（Huánuco district）。本次访谈与观察旨在从家庭环境中的主要照料者、参与CRED保健服务（含儿童健康体检、营养咨询）的卫生专业人员，以及日托服务中参与CUNAMAS国家早期儿童发展项目的工作人员的视角，探究婴儿及幼儿辅食喂养（Infant and Young Child Complementary Feeding, IYCF）实践的影响因素。CUNAMAS是秘鲁发展与社会融合部于2012年设立的大型早期儿童发展项目，旨在助力贫困家庭3岁以下儿童的全面发展。2019年10月至12月期间，研究团队在4家卫生中心及14家CUNAMAS日托服务点完成了数据采集工作。研究对象/关键信息提供者采用目的抽样法选取，覆盖卫生机构内的核心岗位（参与CRED保健的卫生专业人员、营养师、儿童主要照料者），以及CUNAMAS日托服务点的相关人员（托儿所照料者、大区托儿所技术管理人员、育儿指导员、儿童主要照料者）。针对儿童主要照料者的访谈与观察工作于2020年1月至3月中旬开展。研究采用目的配额抽样法，从参与PERUSANO项目定量调查的受试者中，按照儿童年龄、母亲就业状况及营养状况招募母亲作为研究对象。2020年3月，受新冠肺炎（COVID-19）疫情影响，面对面访谈被迫中止，剩余的照料者访谈转为电话访谈，观察工作则无法继续开展。用于卫生机构数据分析的编码手册同时提供英文与西班牙文版本。不同访谈类型、开展地点及利益相关方群体的详细抽样信息可参见补充材料1，亦可查看附件中的README_HP文件。本研究的定量研究部分已在Pradeilles等（2022）的文献中进行详细阐述。定量调查问卷及数据可通过以下链接获取：10.17028/rd.lboro.18750458、10.17028/rd.lboro.16691455及10.17028/rd.lboro.21656348。