Evaluation of Nigeria's Community Infant and Young Child Feeding Counselling Package Progress Report 4

The package aims to promote optimal maternal, infant, and young child nutrition (MIYCN) practices through community-based promotion, counseling, and support. The package includes information and guidance for community volunteers (CVs) and primary health workers to support mothers, fathers, and other caregivers in optimally feeding their infants and young children. The package includes materials for training health workers and CVs to increase their knowledge of MIYCN practices and to improve skills in group facilitation, interpersonal communication and counseling, support to mothers and caregivers, problem-solving, and negotiation. The interactive training is based on adult learning principles and focuses on the effective use of a series of counseling cards during support groups and individual counseling sessions with pregnant women and mothers of infants and young children. The package was translated into six local languages and has been adapted for the Nigerian context. Nigeria has committed to a national roll-out of the counseling package, with funding secured for 29 out of 36 Nigerian states. The FMOH, UNICEF, and SPRING initiated a mixed-methods evaluation of the C-IYCF Counselling Package in Kaduna State to assess its effectiveness when adapted for the local context and implemented at scale in one local government area (LGA), Kajuru. The evaluation aims to assess the environment or context in terms of how it enabled or hampered the success of the C-IYCF Counselling Package, assess the C-IYCF program processes, implementation achievements, and costs, evaluate the outcomes of the C-IYCF Counselling Package on counseling and communication skills and CVs knowledge of MIYCN, and establish the impact of the C-IYCF program on caregivers' knowledge, attitudes, beliefs, and practices related to MIYCN. During the last six months, the focus has been on implementing the package. The research team conducted a mid-process assessment. Following the training of health facility staff and health authorities, nominating CVs, training CVs, and forming support groups, the C-IYCF Counselling Package was implemented. This included advocacy meetings with key stakeholders, community sensitization and mobilization events, support groups, home visits, and monthly review meetings, and supportive supervision for CVs and health workers. Between January and June 2016, the following activities were completed: advocacy meetings with key stakeholders, community sensitization and mobilization, support groups, home visits, and monthly review meetings. The number of people who attended support group meetings increased over the six months, with a total of 3,733 support group meetings held, reaching 42,633 contacts made, for a total of 6,145 unique individuals reached. The majority of participants were pregnant women and mothers of children under 23 months of age. The number of home visits that CVs reported conducting ranged between 213 and 536. To date, 5,354 home visits were conducted, reaching 2,822 unique individuals; 1,699 people were referred to the health facility for additional care. The decline in support group participants and the increase in home visits will be explored by the LGA.