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Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #16774] Fri, 01 March 2019 14:08 Go to next message
DataDENT is currently offline  DataDENT
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WHO-UNICEF Infant and young child feeding (IYCF) guidelines recommend complementary feeding counselling to caregivers of children 6-23 months. Although, most countries include counseling for breastfeeding and complementary feeding in their nutrition programming efforts, few data are available to monitor population-based coverage of counseling for IYCF. We propose two indicators on IYCF counseling that will complement the existing postnatal counseling question and provide countries with data to track coverage of IYCF counseling--promoting both breastfeeding and complementary feeding--through the first two years of life. NOTE: We have posted a separate recommendation about indicators of early breastfeeding counseling coverage--from pregnancy through age 1 month.

1. Mothers with children 6-23 months who received any Infant and Young Child Feeding (IYCF) counseling in the last 6 months
Definition: Proportion of mothers with children 6-23 months who received any IYCF counseling in the last 6 months

2. Mothers with children 6-23 months who received age-appropriate IYCF counseling in the last 6 months
Definition: Proportion of mothers with children 6-23 months who received age-appropriate IYCF counseling in the last 6 months

Attached to this post is a completed submission form with full justification for the recommendation.

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This recommendation originated in a consultation focused on measuring coverage of programs to support breastfeeding and complementary feeding, co-convened by Alive & Thrive, the International Food Policy Research Institute (IFPRI), and Data for Decisions to Expand Nutrition Transformation (DataDENT). It was further discussed and endorsed at the September 2018 Technical Consultation on Measuring Nutrition in Population-Based Household Surveys and Associated Facility Assessments--a 2-day working meeting convened by the Bill & Melinda Gates Foundation and United States Agency for International Development in collaboration with the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), and coordinated by DataDENT. The consultation included more than 60 technical experts, survey program representatives from DHS, MICS, LSMS and SMART, country data stakeholders, and donors from the nutrition measurement community.

The recommendation is also supported by a nutrition metrics working group that was previously anchored by the Countdown to 2030 initiative; this working group has co-authored a paper forthcoming in BMJ Global Health on the global gaps in nutrition coverage measurement, especially highlighting the gaps in measurement of infant feeding counseling and support interventions.

This recommendation was authored by IFPRI and reviewed by Laurence Grummer-Strawn (WHO), Chika Hayashi (UNICEF), Vrinda Mehra (UNICEF), Chessa Lutter (RTI), Monica Kothari (PATH), and Purnima Menon (IFPRI).

This recommendation is endorsed by the WHO-UNICEF Technical Expert Advisory Group on Nutrition Monitoring (TEAM). Out of the 10 sets of recommendations endorsed by TEAM, this recommendation was prioritized as Tier 2 of 3 (high priority data need).

This recommendation is also endorsed by Countdown to 2030, Alive & Thrive, Global Alliance for Improved Nutrition (GAIN), the nutrition team at the Bill & Melinda Gates Foundation, and the Department of International Health at the Johns Hopkins Bloomberg School of Public Health.

[Updated on: Fri, 01 March 2019 14:42]

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Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #16909 is a reply to message #16774] Wed, 13 March 2019 21:45 Go to previous messageGo to next message
SUN Movement MEAL Team
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The SUN Movement supports the inclusion of these two indicators to improve data available on population-based coverage of counseling for IYCF with a special emphasis on #2 (age-appropriate IYCF counseling). The SUN MEAL Results Framework has prioritized tracking the indicator "Proportion of mothers of children 023 months who have received counseling, support or messages on optimal breastfeeding at least once in the last year".
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #16911 is a reply to message #16774] Thu, 14 March 2019 02:06 Go to previous messageGo to next message
Mauro Brero is currently offline  Mauro Brero
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UNICEF Tanzania Nutrition team recommends to maintain indicator 1, but split into 2 indicators: one about IYCF counselling received from a community health worker (i.e. in the community), and one about IYCF counselling received from a health care provider (i.e. in the facility, for example during PNC visits). In fact, in the Common Results, Resources and Accountability Framework (CRRAF) of the National Multisectoral Nutrition Action Plan (NMNAP) 2016-21 these two indicators are tracked separately to measure progress towards Key Results Area (KRA) 1 on Maternal Infant and Young Child Nutrition. Please refer to the attached NMNAP document. The CRRAF is at the end of the document, in Appendix 2 (from page 151).

DHS 2020/21 will be used to evaluate progress towards NMNAP / CRRAF targets at the end of the implementation period of the NMNAP 2016-21. Therefore, it is very important for Tanzania to measure IYCF counselling provided by community health workers and health care providers, as these two interventions (i.e. integration of IYCF in the health system and community level IYCF for intense communication for behavior change to caregivers) are strongly prioritized as stunting reduction strategies in the NMNAP, and evidence is needed to track coverage of those interventions and further improve them.

We believe that the second indicators proposed here (i.e. age-specific counselling) is relevant as it measures quality of service, but might not be well understood by interviewees. Also, at this stage of implementation of IYCF interventions in Tanzania, it is better for the moment to prioritize generation of data on coverage.

UNICEF Tanzania Nutrition Team.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #16912 is a reply to message #16774] Thu, 14 March 2019 02:53 Go to previous messageGo to next message
SOML-PforR Nigeria is currently offline  SOML-PforR Nigeria
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As the National Programme Manager of the Saving One Million Lives Programme for Results for the Government of Nigeria, I endorse this recommendation and a few others. We rely on data from nationally-representative surveys such as the DHS to triangulate with the National Nutrition and Health Surveys to monitor progress in our key interventions and to make performance-based financial disbursements to states demonstrating improvement in results through performance........DR. Ibrahim Kana
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17005 is a reply to message #16911] Fri, 15 March 2019 06:20 Go to previous messageGo to next message
kdearden is currently offline  kdearden
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IMA feels these indicators are important and strongly concurs with UNICEF\Tanzania that it would be very helpful to split indicator 1 into two parts (health facility workers and community health workers).
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17013 is a reply to message #16774] Fri, 15 March 2019 06:54 Go to previous messageGo to next message
Nsia is currently offline  Nsia
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I endorse these questions
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17015 is a reply to message #16774] Fri, 15 March 2019 06:55 Go to previous messageGo to next message
Nsia is currently offline  Nsia
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I endorse these questions
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17017 is a reply to message #16774] Fri, 15 March 2019 06:59 Go to previous messageGo to next message
Paula Kawiche is currently offline  Paula Kawiche
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I indorse this question
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17043 is a reply to message #16774] Fri, 15 March 2019 08:08 Go to previous messageGo to next message
Marie Ruel is currently offline  Marie Ruel
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These questions are critically important and I endorse their proposed addition.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17053 is a reply to message #16774] Fri, 15 March 2019 08:55 Go to previous messageGo to next message
aperry is currently offline  aperry
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Given the lack of data at present on the coverage of priority nutrition interventions - including IYCF counselling - this is an important addition and the DFID Nutrition Policy team endorses it.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17072 is a reply to message #16774] Fri, 15 March 2019 10:35 Go to previous messageGo to next message
Olutayo
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I support the inclusion of this indicator. There is a need to know the determinants of nutrition outcomes such as poor infant and young child feeding practices so that appropriate interventions can be designed. Representative information about prevalence of inadequate nutrition knowledge and coverage of nutrition counseling does not exist for most countries so this will be a big value-added for DHS
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17090 is a reply to message #16774] Fri, 15 March 2019 12:50 Go to previous messageGo to next message
Rolf Klemm is currently offline  Rolf Klemm
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Helen Keller International (HKI) endorses the inclusion of these questions to track coverage of IYCF counseling through the first two years of life.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17100 is a reply to message #16774] Fri, 15 March 2019 13:20 Go to previous messageGo to next message
salayon is currently offline  salayon
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I view the lack of data on coverage of IYCF counseling as a huge gap in the available data on nutrition interventions. We can't continue to rely on IYCF behavioral data as proxies for service provision. Save the Children endorses this recommendation.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17123 is a reply to message #16774] Fri, 15 March 2019 14:28 Go to previous messageGo to next message
jruelbergeron is currently offline  jruelbergeron
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The Global Financing Facility (GFF) Secretariat supports the proposal put forth by DataDENT.

The GFF Secretariat feels strongly that data on growth monitoring and promotion coverage should be included in the new DHS 8 questionnaires. Data on coverage of growth promotion that is tied to growth monitoring activities can be collected by additions to two of the categories of proposed questions put forth by DataDENT. The first is through an addition to DataDENT's proposal on child growth (labeled #6, please see comment there). The alternative option would be to include the source of information from which counseling on IYCF was received, building on DataDENT's proposal on IYCF counseling 6-23 months questions (labeled as #5, this thread). This recommendation is tied to the need to better understand how much growth promotion is being done as part of national growth monitoring and promotion programs/activities.

Evidence has demonstrated that growth monitoring as a stand-alone intervention produces little to no effect on child nutrition outcomes (Mangasaryan et al., 2011; Bhutta et al., 2008; Garner et al., 2000). Thus, its use is not recommended without adequate nutrition counselling and referrals (Bhutta et al., 2008). Without data on the extent to which growth monitoring is accompanied by promotion as it is meant to be by design, however, policy makers and program planners are limited in the degree to which they can inform program improvement decisions. As stated in DataDENT's proposal, 61% of the 167 member states who responded to the WHO 2016-17 Global Nutrition Policy review are implementing GMP, making it the second most widely implemented nutrition intervention globally. Moreover, over half of countries report that GMP happens monthly, representing an important opportunity to seize data on its coverage and functioning to stimulate appropriate, data-informed action.

References:
Ashworth A, Shrimpton R, Jamil K. Growth monitoring and promotion: review of evidence of impact. Maternal & child nutrition. 2008 Apr;4:86-117.
Bhutta ZA, Ahmed T, Black RE, et al. Maternal and Child Undernutrition 3 What works ? Interventions for maternal and child undernutrition and survival. 2008;371.
Garner P, Panpanich R, Logan S. Is routine growth monitoring effective? A systematic review of trials. Arch Dis Child 2000;82(3):197201.
Mangasaryan N, Arabi M, Schultink W. Revisiting the concept of growth monitoring and its possible role in community-based nutrition programs. Food Nutr Bull 2011;32(1):4253.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17156 is a reply to message #16774] Fri, 15 March 2019 15:15 Go to previous messageGo to next message
PATH is currently offline  PATH
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Thanks to DataDENT for compiling these recommendations.

For question Q1a, please consider adding a couple more categories on "breastfeeding problems" and possibly another on "not feeding sugar-sweetened foods" (Page 4 of 9 of document 5. + IYCF counceling_25+Feb).
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17181 is a reply to message #16774] Fri, 15 March 2019 15:30 Go to previous messageGo to next message
1000 Days is currently offline  1000 Days
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1,000 Days is the leading non-profit organization working in the U.S. and around the world to improve nutrition and ensure women and children have the healthiest first 1,000 days.
We support this recommendation and especially urge the need for the second indicator, in addition to the first, so that there is a better understanding of the quality of nutrition counseling that is being given to mothers and caregivers. We are pleased that the proposed questionnaire associated with the second indicator includes counseling on the types of foods that children should consume, as well as those that should not be consumed, including sugar-sweetened beverages.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17334 is a reply to message #16774] Fri, 15 March 2019 17:46 Go to previous messageGo to next message
Erin Milner is currently offline  Erin Milner
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USAID supports this recommendation.
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17345 is a reply to message #17334] Fri, 15 March 2019 18:02 Go to previous messageGo to next message
ktripp is currently offline  ktripp
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Abt associates support this recommendation
Re: Infant and Young Child Feeding (IYCF) Counseling 6-23 Months [message #17414 is a reply to message #17334] Fri, 15 March 2019 23:24 Go to previous message
Judy Canahuati is currently offline  Judy Canahuati
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La Leche League International supports this recommendation
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