Investigators will use a cluster-randomized design to evaluate the overall impact of the Alive \& Thrive infant and young child feeding communication strategies in Lagos and Kaduna States, Nigeria. The impact in each state and in a subset of urban local government areas (LGAs) will also be tested.This is a mixed methods evaluation; the quantitative data will be complemented by qualitative data obtained from different groups targeted by or involved in the program.
Adequate nutrition during the first 1,000 days is necessary for children to grow and develop to their full potential. Alive \& Thrive (A\&T) contributes to better nutrition during the first 1,000 days by promoting improved infant and young child feeding (IYCF) practices. A\&T is expanding its efforts to Nigeria and will target Lagos and Kaduna States. In Nigeria, 33% of infants are breastfed within 1 hour of delivery, 60% are given other fluids in the first 3 days of life, and only 17% of children 0-5.9 months are exclusively breastfed. Approximately 60% of children 6 to 23 months achieve the minimum meal frequency for their age and 19% are fed four or more food groups per day. To address these gaps in optimal IYCF practices, A\&T will use an implementation framework for IYCF impact at scale that includes advocacy, interpersonal communication and community mobilization, mass communication, and strategic use of data. The A\&T intervention will be compared to mass media communication on IYCF, which will be provided throughout the two states. LGAs in Lagos and Kaduna will be randomly allocated such that two-thirds receive the A\&T intervention and one-third are assigned to the comparison group. The primary objectives of the evaluation are to measure the impact of the A\&T intervention on IYCF practices among mothers with children 0-23 months of age overall, in each state, and in a subset of urban LGAs. Secondary evaluation objectives are to document: the type, quantity, and timing of the implementation of A\&T program activities; coverage levels A\&T achieves with different program activities; extent to which A\&T increases knowledge and awareness of optimal IYCF practices among women with children 0 to 23 months and health providers; extent to which A\&T improves the capacity of health providers to counsel mothers on IYCF; and extent to which A\&T improves the capacity of stakeholders to implement community-based activities that support optimal IYCF practices.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
15,169
(1) Interpersonal communication through frontline workers/volunteers to increase mothers' knowledge and practice of optimal infant and young child feeding (IYCF) behaviors. Interpersonal communication will involve multiple contacts with mothers and an array of IYCF messages; (2) Community mobilization activities to raise awareness of the benefits of optimal IYCF practices among opinion leaders and family members, and increase their support to mother for IYCF; (3) Training of facility and community-based health workers on IYCF to improve their ability to support mothers and provide timely information on IYCF; and (4) Mass media communication on IYCF.
Kantar TNS RMS
Ikeja, Lagos, Nigeria
Kantar TNS RMS
Kaduna, Nigeria
Exclusive breastfeeding on the day preceding the interview.
The proportion of infants 0-5 months who were exclusively breastfed on the previous day.
Time frame: 2 years
Exclusive breastfeeding from 0-5 months.
The proportion of children who were exclusively breastfed from 0-5 months.
Time frame: 2 years
Breastfeeding within 1 hour of birth.
The proportion of children 0-23 months who were breastfed within 1 hour of birth.
Time frame: 2 years
Minimum dietary diversity.
The proportion of children 6-23 months who were fed the minimum number of food groups on the previous day based on the WHO infant and young child feeding guidelines.
Time frame: 2 years
Minimum meal frequency.
Description: The proportion of children 6-23 months who were fed the minimum number of meals on the previous day based on the World Health Organization infant and young child feeding guidelines.
Time frame: 2 years
Mothers' accurate knowledge of optimal infant and young child feeding practices.
Mothers' accurate knowledge of: * Optimal timing of breastfeeding initiation * Optimal duration of exclusive breastfeeding * Solution to common breastfeeding problems * Optimal timing to introduce complementary foods * Optimal dietary diversity and frequency of complementary feeding from 6-23 months
Time frame: 2 years
Health providers' knowledge of optimal infant and young child feeding practices.
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Providers' accurate knowledge of: * Optimal timing of breastfeeding initiation * Optimal duration of exclusive breastfeeding * Solution to common breastfeeding problems * Optimal timing to introduce complementary foods * Optimal dietary diversity and frequency of complementary feeding from 6-23 months
Time frame: 2 years