Use of Monitoring Data to Improve Implementation of a Home Fortification Program in Bihar, India

AbstractThis paper describes the use of program ‐monitoring data to track program performance and inform activities. Monitoring data were collected as part of an effectiveness trial of multiple micronutrient powders (MNPs) for children 6‐18 months in Bihar, India. Communities (n=70; reaching over 10,000 children) were randomized to receive ei ther counselling on infant and young child feeding or both counselling and MNPs. Government frontline health workers (FLWs), implemented and monitored program activities with support from CARE, India and university partners. Monitoring data were collected over the duration of the entire program to a ssess program impact pathways using various checklists, which captured information about: (i) attendance and training of FLWs at health sub‐centre meetings, (ii) distribution of MNPs, (iii) receipt and use of MNPs at the household level, and (iv) midline mixed methods survey.At the beginning of the program, 72% of households reported receiving and 53% reported currently consuming MNPs. These numbers fell to 40% and 43% at midline, respectively. The main barrier to use by household was a lack of MNPs, due in part to infrequent FLW distribution. However, FLWs rarely reported MNP shortages at Aanganwadi Centres. Side effects also emerged as a barrier and were addressed through revised recommendations for MNP use. Qualitative data indicated high community acceptance of MNPs and a good understanding of the program by FLWs. The use of real ...
Source: Maternal and Child Nutrition - Category: Nutrition Authors: Tags: ORIGINAL ARTICLE Source Type: research