Republic of Niger : evaluation of the vitamin A social marketing project (mini-project)

The project is carried out by the Ministry of Health and Helen Keller International, with TA from the USAID/W Nutrition Communication Project. The region was selected because of the availability of water and the existence of dry-season vegetable cultivation. Phase I was a pilot intervention which tested six message concepts, which were communicated to pregnant and nursing women and their husbands to increase consumption of particular Vitamin A rich foods; to gardeners to encourage cultivation of traditional dark green leafy vegetables; and to community leaders, to motivate them to support the project. The messages were communicated by Village Animation Committees, primarily through community-based events, such as skits, and other traditional media. Local health workers, teachers, and agricultural agents provided technical support to the committees and carried out specific communication activities. Results of interviews and questionnaires in 12/92 indicated that consumption of vitamin A-rich foods increased: 90% of adults eat green leaves more frequently and 87% eat liver more frequently; the percentage of women who had eaten liver in the past week rose from 51% to 69%. Exposure to nutrition messages was high, particularly among men. (Women are more cloistered.) Theater was popular, and perceived by villagers as a good source of information; 61% of men and 34% of women saw at least one play. Many who saw plays took steps to improve their own and their children's nutritional status, although messages about children's nutritional needs seem to have been less emphasized in the storylines. Village-sponsored activities continued without outside support after the project ended. Lessons and recommendations are as follows. (1) Messages about child nutrition should be intensified, as behavior change was lower in this group. Close to half the children under age 6 either don't eat leafy vegetables or eat them less than once a week. Some parents feel children under a year are not old enough to eat leaves. (2) One Village Animation Committee per village should be created; members should be chosen by villagers according to willingness, motivation, talent, and stability, and should include women and be recruited outside of the growing season. (3) The committees should address a number of nutrition themes beyond vitamin A, and all of their skits should be compiled as material for radio dramas and other program. (4) Gifts could be budgeted for the committees as the idea of volunteering is not well understood, and the general poverty makes it difficult for people to participate without remuneration. There is a perception on the part of health workers and extension agents that the "foreign" money is kept by those in Niamey, and a perception among the committee members that the technical field agents keep the money. More contact between Niamey and the villages might stem these rumors. (5) Traditional, religious, and opinion leaders should have a more active role. (6) Local artists should be used to create visual aids to ensure they are culturally appropriate. (7) Extension workers and other field personnel should live in the villages they are advising. (8) Delays in wiring funds from the U.S. to Niger must be shortened. (Author abstract, modified)