Strengthen national and decentralised capacity and contact points within agriculture, health and WASH systems/programmes to facilitate the delivery of skilled counselling and SBC.
Strengthen linkages with other delivery platforms, eg, social protection to deliver key messages.
Develop/adopt/deliver SBC approaches using multiple channels and platforms (traditional, local, digital and others) to address barriers to good practice for health and nutrition.
Identify all the groups from the community that might influence IYCF practices: mothers, fathers, grandmothers, mothers–in–law, traditional healers, religious leaders, male groups, elders, siblings etc. These are known as the key influencers or the gatekeepers to change.
Prioritise individual level behaviour change (for caregivers as well as key influencers) over mass campaigns.
Identify barriers to optimal IYCF practices and then use those barriers to design relevant activities.
Conditions and considerations
Nutrition counselling needs to go beyond providing information; work with individuals, families and community leaders to understand their needs and motivations, identify their strengths, and lower barriers to positive change.
Mass campaigns are useful to communicate messages but show limited influence on individual behaviours.
Healthcare providers must be knowledgeable and skilled in supporting mothers with evidence–based care for breastfeeding and young child feeding.
Regular supervision is required to support community and health workers in the delivery of quality nutrition education and counselling.
Wherever SBC interventions are implemented, contextually–appropriate gender equality promotion should form a core element of the approach.
Pregnant women, mothers, families and health care workers need to be protected from exploitative marketing from manufacturers and distributors of breastmilk substitutes.
Designing behaviour change interventions requires engagement with the target population, understanding their barriers and motivation to change and adapting interventions to the contexts that facilitate change, including the environment and social networks. This can include:
Formative research on gaps in knowledge, skills, practices, acceptability, desirability and affordability linked to complementary feeding may be required.
Understanding the enabling environment and supportive services required to enable women to continue breastfeeding, eg, access to breastfeeding counselling, actions/services that support women to breastfeed outside the home/when they are working.
Consideration of caregivers’ WASH and CND–related practices and beliefs, their overall workload and social position when designing behaviour change interventions.
Empowering women, through knowledge, resources and child care support, to adopt best practice.
Consideration of resources/time available, eg, responsive feeding requires caregivers to have time to be present while the young child eats or self–feeds and have resources so that food loss during self–feeding does not present a problem.
Counselling and SBC to support recommended best hygiene practices for child nutrition, eg, for nomadic groups, awareness–raising about the safe burial of feces (eg, safe distances from water points and homes, “cat pit/hole” methodology).
