Strengthening Counseling through Improved Tools for Health Workers: USAID Advancing Nutrition’s Experiences and Insights from Designing and Implementing Counseling Tools (August 2023)

This effort aims to improve the delivery of quality nutrition, responsive care, and early learning counseling. A key service to support and improve maternal, infant, and young child nutrition (MIYCN) and child development outcomes is counseling, which is a form of interpersonal communication that involves tailored and interactive discussions to strengthen knowledge, motivation, skills, and/or confidence. Counseling can support clients to improve nutrition, responsive care, and early learning behaviors, ultimately leading to improved MIYCN and child development outcomes. However, ensuring the quality of counseling can be challenging due to limited technical counseling skills, interpersonal counseling skills, and time constraints. Tools, such as job aids, can address some of these barriers by helping to motivate, remind, and focus information for health workers. USAID Advancing Nutrition has supported the development and implementation of several counseling tools for nutrition, responsive care, and early learning. These tools help providers overcome three main barriers to quality counseling: limited technical counseling skills, limited interpersonal counseling skills, and limited time to counsel. Examples of tools include job aids to simplify processes and make necessary information or protocols quickly accessible, job aids to help problem-solve based on client needs, and illustrated cards, posters, videos, or other materials to present accessible information to clients. The development and testing of these tools have demonstrated the importance of engaging providers early in the tool design process to align with existing tools. This ensures that the new tool complements existing tools, helping providers use their time efficiently and increasing the likelihood of tool uptake. For example, in Ghana, USAID Advancing Nutrition developed a flowchart for health workers to streamline and tailor counseling on infant and young child feeding and responsive care and early learning during growth monitoring and promotion sessions. The flowchart was designed to build on existing materials, such as the Maternal and Child Health Record Book and community infant and young child feeding and responsive care and early learning counseling cards. Testing the effectiveness of the new tool when implemented with existing tools could provide further insight into feasibility and effectiveness. This might involve testing the tool over the course of a week or month when providers are likely to use multiple existing tools. Effective counseling sessions require a focus on the experience of care for clients. This involves designing tools to improve the experience of care for clients, such as the flowchart developed in Ghana. The flowchart streamlines counseling on infant and young child feeding and responsive care and early learning during growth monitoring and promotion sessions, making it easier for health workers to provide high-quality counseling. By engaging providers early in the tool design process and designing tools to improve the experience of care for clients, USAID Advancing Nutrition is working to strengthen counseling through improved tools for health workers.