Food Security and Nutrition (FSN) Network Technical Meeting Maputo 22 nd Sept 2011

1. Influence of Grandmothers and Men on Infant and Young Child Feeding Practices during the first 1000 days Food Security and Nutrition (FSN) Network Technical Meeting Maputo 22nd Sept 2011 Name: Faith M. Thuita Nutrition Technical Advisor - Kenya Infant & Young Child Nutrition (IYCN) Project

2. The Infant & Young Child Nutrition Project • USAID’s flagship project on infant and young child nutrition • Aims to prevent malnutrition for mothers and children during the critical time from pregnancy until two years of age. • Led by PATH in collaboration with CARE, The Manoff Group, and University Research Co., LLC

3. The 1000 Days Initiative and the Scale up Nutrition Movement • Promotes targeted action and investment to improve nutrition for mothers and children from pregnancy to the age of 2 years • Why: The impact of maternal and child malnutrition during this period is irreversible

4. Lancet Series on maternal and child nutrition (2008) – Evidence base • Globally, malnutrition is an underlying cause in more than a 1/3 of child deaths and, • 11% of the total disease burden worldwide is due to maternal and child undernutrition. • More than 3.5 million children die each year

5. Quality of nutrition in the first 1000 days determines ….. • Whether a mother and child survive a pregnancy • Whether a child will contract a common childhood disease • Experience enough brain development to go to school and hold a job as an adult.

6. Feeding practices enhance child survival • Exclusive breastfeeding – Estimated to prevent 13 per cent of all deaths of children under five • Appropriate complementary feeding can help prevent a further 6% of all child deaths

7. High Impact Nutrition Interventions • Promotion of good maternal nutrition during pregnancy and lactation • Exclusive breastfeeding for 6 months • Appropriate complementary feeding (6- 24 mons) • Micronutrient supplementation

8. Focus of Community Programs on Young Child Nutrition • Most programs, research and policies on infant and young child nutrition focus on mothers of young children. • Literature review – Africa, Asia and Latin America revealed only 14 programs involved either GM or men. • Ref; Aubel J, 2010

9. Engaging influential household members • There is Increasing recognition of the need to adopt a wider approach which involves other influential household actors such as grandmothers and men

10. Why Grandmothers and Fathers? • Grandmothers - Primary caregivers of women and children. • Play a leading role in decision making in the family: • Pregnancy and maternal nutrition • New born care • Breastfeeding, & complementary feeding • Home care for sick children

11. Male engagement • Involvement of men in maternal and infant young child nutrition is primarily focused on supportive roles:. • Provision of food • Resources to meet health needs of family members

12. A Family Approach? • GMs and men play critical and complementary roles in promoting the nutritional and health status of children and women. • Need for program designs that build on and strengthen the cultural roles of mothers, fathers and grandmothers.

13. Engagement of grandmothers and fathers – IYCN’s approaches • Literature review on roles and influence of grandmothers and men • Formative research on role of men and grandmothers in maternal, • infant, and young child nutrition • Evaluation of interventions to engage grandmothers and fathers. • a

14. Approaches • Integration of activities into on-going community based initiatives

15. Integration and partnerships • Training psycho-social support counselors on PMTCT and infant feeding. • Developing reporting tools for PSSCs. • Production of IEC materials for dissemination in facilities and communities.

16. Infant feeding & HIV community support • Integrating infant feeding support into on-going community-based HIV activities through training: • Community Counselors • Ambassadors of Hope • Developed training manual and participant guide on Infant Feeding and HIV. • Developed reporting tools for ongoing monitoring of activities.

17. Engaging men in infant feeding • Piloting integration of infant feeding issues into men’s groups activities • Target existing men’s groups • Developed 2-day training guide • Trained men’s groups facilitators Photo: APHIA II Western

18. Lessons Learnt • Use a family focused approach to behaviuor change for infant feeding and maternal nutrition • Grandmothers are frontline caregivers and key influencers in the family • Men are not male women

19. Lessons Learnt • View grandmothers and men as resources rather than obstacles • Engage men and grandmothers through existing structures and networks • Address community norms, not just individual behaviors

20. Resources on Grandmothers and Male Involvement • Literature review – Roles and influence t of grandmothers and men • Training manual for male group leaders • Training manual for dialogue group leaders (Grandmothers) • Formative assessment report on engagement of men and grandmothers to improve IYCN in Kenya

21. Group discussion • Question1: What are opportunities and barriers in engagement of men and grandmothers in your country and/or project?

22. Question 2 What would be the next steps for using a family approach to improve maternal, infant and young child nutrition in your program/country?

23. Thank you • Ps Visit: www:iycn.org