Burkina Faso : nutrition communication project, 1989-1995 : final report

The project succeeded in getting high-quality educational materials (i.e., flipcharts and facilitators" guides) to 160 health facilities and in training a large cadre of health personnel to use them appropriately. The materials linked nutrition to other health interventions such as safe motherhood, growth monitoring, and control of diarrheal disease. Additionally, the project, trained some 700 rural front line workers in interpersonal counseling and use of the materials in typical work situations. The Division of Family Health (DSF) has adopted the NCP training methodology for its subsequent workshops. An innovative new counseling card, the carnet familial, was introduced in the eight targeted provinces and was well-accepted by health personnel and mothers alike. The IEC strategies were only being fully implemented at the end of the project so that its real impact will begin to be felt after its termination. A final evaluation survey, conducted in four of the intervention provinces in late 1994, found major improvements in nutrition education in the intervention areas. More than half of the women surveyed had received nutritional advice from health workers, and the carnet familial was especially well-remembered in two provinces. Radio was also relatively effective in reaching the predominantly rural population. In Oubritenga province, more than half of the men and women surveyed remembered hearing the radio drama and spots. Women reported significantly higher levels of exposure than men to the educational materials and aids used by health workers, to nutritional advice given by health personnel, and to the carnet familial. Men reported significantly higher levels of exposure to the radio broadcasts. Thus, exposure to certain NCP strategies and messages was associated with modestly but statistically significant higher levels of knowledge and application of recommended feeding and nutritional behaviors. However, many messages did not appear to be well assimilated by target audiences. Also, radio was not in use long enough to have a strong impact. Perhaps the project"s most important accomplishment was the development of a solid IEC capability within the MOH. By the end of Phase II, MOH staff at the central and regional levels had acquired extensive experience in planning and carrying out each aspect of a rigorous communication methodology. This included assessment and indepth analysis of nutrition IEC activities and training needs; implementation of field research; development and production of nutrition education materials; preparation of training modules and conducting workshops; development and broadcast of mass media programs, including entertainment formats; management of supervision systems for IEC activities; and the use of Knowledge, Attitude, and Practice (KAP) surveys to evaluate project impact. Although the strategy of working through the MOH delayed project start-up, this institution-building focus paid off and ensured its sustainability. Indeed, the establishment of the National Nutrition Center, with parallel status to the Division of Family Health (DSF), is considered by the national team to be a direct result of NCP"s efforts in this area.