What we do

Country-specific approaches for infant feeding and HIV activities

The Infant & Young Child Nutrition (IYCN) Project develops and implements infant feeding and HIV activities to improve the nutritional status of mothers and children and to promote HIV-free survival for children. The project works with USAID, PEPFAR, and country partners to develop evidence-based, cost-effective programs that are customized for each country.

We design nutrition interventions to serve as a platform to ensure that HIV-exposed infants receive a complete package of child survival interventions, including immunizations, vitamin A supplementation, oral rehydration therapy with zinc, cotrimoxazole, and growth monitoring and promotion.

Our approach includes the following core elements:

Needs assessment

  • Work with each country to conduct assessments of infant and young child feeding practices and programs within the context of HIV.
  • Identify barriers and facilitators to optimal nutrition practices in order to design responsive solutions.
  • Assess gaps in the continuum of care provided to HIV-positive mothers, from antenatal care to delivery to postnatal/child services, in order to develop programs with harmonized messages and services.

Policy guidance

  • Engage a wide range of partners to achieve consensus on infant feeding and HIV policies and guidelines. We collaborate with all levels of government, health and nutrition partners, United Nations agencies, local organizations, civil society, and other groups.
  • Update and operationalize policy and technical guidance to include the World Health Organization (WHO) 2006 guidelines on HIV and infant feeding. We develop strategic plans and guidelines and roll out guidance to provinces, districts, and facilities.
  • Work collaboratively with nutrition partners to address barriers to policy and program implementation, improve coordination, and minimize overlap.

 

Enhancing guidance for health workers in Côte d’Ivoire

Orphans and vulnerable children (OVC) need special nutrition policies and programs because they are often more susceptible to growth faltering and malnutrition. To help health providers in Côte d’Ivoire meet the needs of OVC, the IYCN Project has collaborated with government and US President’s Emergency Plan for AIDS Relief partners to launch a pocket guide with enhanced nutrition guidance. The Guide for Nutritional Care and Support for OVC Affected by HIV in Côte d’Ivoire offers recommendations for health workers, social workers, and community health workers on integrating nutrition support for OVC into HIV efforts across the country. IYCN and partners will use the guide to develop training tools and conduct workshops for providers.

Capacity building and training

  • Enhance existing training curricula for health workers and community-based workers. We update prevention of mother-to-child transmission of HIV training courses to incorporate the WHO 2006 guidelines on HIV and infant feeding, and tailor WHO’s Infant Feeding Counselling: An Integrated Course (2006) to meet the needs of different countries. We also develop training modules on special topics, such as counseling HIV-positive mothers after the six-week PCR test for infants.
  • Conduct national, decentralized, and on-site workshops for health workers to improve knowledge and skills, such as conducting nutritional assessments and using good counseling techniques.
  • Train community-based workers on infant feeding in order to shift counseling and other tasks from clinical staff to lay counselors.
  • Collaborate with government and local partners to develop supportive supervision systems. We follow up after training workshops to make sure that health workers and community-based workers use new skills.
  • Establish two-way referral systems between health facilities and community-based workers.
  • Institute quality improvement approaches at health facilities, including integrating quality improvement principles into nutritional assessment and counseling services in facilities and communities.
  • Strengthen the capacity of partners who work with orphans and vulnerable children to integrate nutrition information into their programs.
  • Provide technical assistance to other organizations to ensure the effective use of food in programs for prevention of mother-to-child transmission of HIV.
  • Collaborate with different sectors of the government, including agriculture and social welfare, to improve access to infant feeding information and support for mothers.

 

Improving knowledge and skills for health workers in Zambia

Photo of Prudence Lukwesa, who took part in the IYCF course for health staff, is a nurse at the Chelston health center. In this photo, she is pictured at the Chelston clinic reviewing medical records.

Prudence Lukwesa, a nurse at the Chelston Health Centre.

Prudence Lukwesa, a nurse at the Chelston Health Center in Lusaka, Zambia, often felt unsure when HIV-positive mothers asked her questions about infant feeding. After participating in a training workshop conducted by the IYCN Project, she now feels more confident that she is offering accurate information to mothers.

“Before the IYCN training, I didn’t even know that HIV-positive mothers could breastfeed. Now I use the knowledge and skills I gained to help mothers choose the best option for feeding their babies,” said Prudence.

Behavior change communication and social mobilization

  • Design and pilot behavior change communication strategies for health facilities and community health workers with input from national stakeholders.
  • Develop and disseminate take-home brochures, community and support group discussion guides, and radio spots.
  • Create behavior change communication tools for health facilities, including counseling cards, job aids, monitoring tools, and supervision checklists.
  • Update curricula, provide training, and conduct outreach to support groups for mothers, people living with HIV/AIDS, fathers, and grandmothers.

Monitoring and evaluation

  • Advocate for indicators critical to prevention of mother-to-child transmission and HIV programs (e.g., HIV-free survival) to be included in national health management information systems.
  • Develop approaches to track the contribution of infant and young child feeding counseling to the uptake of other child survival services.
  • Train and build the capacity of national data collectors and nutrition partners to monitor and evaluate nutrition programs and indicators.

Identifying and sharing good practices

  • Continuously monitor and share lessons learned from each country in order to help a wide range of global and country partners enhance the impact of their programs.

     

 

Photos: Aurelio Ayala III; 2005 Paul J. Crystal, Courtesy of Photoshare; Kali Erickson