Improvement of the maternal and infant diet project

External evaluation covered the period through 9/89. The project largely achieved its objectives and developed several approaches to service delivery that are appropriate for broader implementation. Its five components were evaluated: Lactation Management Education (Wellstart); the Weaning Project (Manoff Group); Dietary Management of Diarrhea (Johns Hopkins); the Clearinghouse on Infant Feeding and Maternal Nutrition (American Public Health Association - APHA); and the Research on Maternal Nutrition and Health Care Program (International Center for Research on Women - ICRW). The subproject (SP) to provide training in lactation management was very successful. Some 200 professionals from 20 countries were trained, and these in turn trained an estimated 13,000 health practitioners in their countries. The SP had quantifiable impact in terms of increased breastfeeding, decreased morbidity and mortality, and economic savings as a result of rooming- in/breastfeeding changes introduced in hospitals. The weaning SP exceeded objectives, despite inadequate funding. Its major accomplishment was the development of a practical, field-oriented research methodology designed to identify existing knowledge of and attitudes toward weaning. The SP uses focus group interviews and household observations to identify inappropriate behaviors and then implements social marketing and multi-media techniques to change them. The SP to control diarrheal diseases involved multidisciplinary research in two countries. Surveys determined local feeding habits when a child has diarrhea and catalogued the local foods and their preparation. Special diets were then tested in the laboratory and the community. The research SP was added at mid-term, in recognition that maternal nutrition had been neglected. Twenty research grants have been awarded, but none of the studies are yet complete. Finally, the Clearinghouse on Infant Feeding and Maternal Nutrition almost doubled its number of documents and responds to more than 100 requests per month for information. Newsletter circulation more than doubled. An action decision is to design a 10-year follow-on project -- Women"s and Infant"s Nutrition (936-5117).