CHALLENGES FOR IMPLEMENTATION OF SUPPLEMENTARY FOOD DISTRIBUTION AMONG MALNOURISHED CHILDREN IN IRAN: KEY INFORMANT’S EXPERIENCES

Background and Aim: This study was conducted to assess the challenges in implementation of supplementary food distribution for nourishment of malnourished or growth retarded children at national level in IRAN.Methods: The qualitative design used to explore key informants perceptions regarding challenges of implementation of national nutritional program for improvement of nutritional status of children in Iran. Semi-structured interviews at national, province and local levels were conducted. Four layers of key informants were selected purposefully for interviewing, including policy makers, senior nutrition officers, head of Hygiene, Remedy and Insurance Affairs in Imam Khomeini Relief Foundation, and community health workers. Qualitative content analysis was carried out to interpret the viewpoints of the study participants.Results: 35 semi-structured interviews were conducted. Contents analysis showed that there were some aspects that affected program’s implementation. Some of these factors were weak governance, inadequacy in human and financial resources, political instability, frequent change of executive managers, limited interest in nutrition among policy makers, limited accountability across the sectors, insufficient commitment among different sections, poor communication and supervision among different executive sections, lack of clarity in the program’s protocol and indicators, poor facilities, inattention to staff motivation, and designing program protocols regardless of practical condition.Conclusion: Based on the results, top down approach in policy making and inadequate financial and human resources were responsible for most of the challenges encountered in the implementation.

Keywords:

childhood malnutrition , Key informants’ experiences , implementation , nutritional program