title: Using formative research to design a context-specific behaviour change strategy to improve infant and young child feeding practices and nutrition in Nepal.
abstract: Global recommendations on strategies to improve infant feeding, care and nutrition are clear; however, there is limited literature that explains methods for tailoring these recommendations to the local context where programmes are implemented. This paper aims to: (1) highlight the individual, cultural and environmental factors revealed by formative research to affect infant and young child feeding and care practices in Baitadi district of Far Western Nepal; and (2) outline how both quantitative and qualitative research methods were used to design a context-specific behaviour change strategy to improve child nutrition. Quantitative data on 750 children aged 12-23 months and their families were collected via surveys administered to mothers. The participants were selected using a multistage cluster sampling technique. The survey asked about knowledge, attitude and behaviours relating to infant and young child feeding. Qualitative data on breastfeeding and complementary feeding beliefs and practices were also collected from a separate sample via focus group discussions with mothers, and key informant interviews with mothers-in-law and husbands. Key findings revealed gaps in knowledge among many informants resulting in suboptimal infant and young child feeding practices - particularly with relation to duration of exclusive breastfeeding and dietary diversity of complementary foods. The findings from this research were then incorporated into a context-specific nutrition behaviour change communication strategy.
authors.affiliation: Helen Keller International Headquarters, New York, New York, USA.
authors.forename: Lindsey M
authors.initials: LM
authors.lastname: Locks
authors.affiliation: Helen Keller International, Kathmandu, Nepal.
authors.forename: Pooja R
authors.initials: PR
authors.lastname: Pandey
authors.affiliation: Helen Keller International, Asia Pacific Regional Office, Phnom Penh, Cambodia.
authors.forename: Akoto K
authors.initials: AK
authors.lastname: Osei
authors.affiliation: Helen Keller International, Kathmandu, Nepal.
authors.forename: David S
authors.initials: DS
authors.lastname: Spiro
authors.affiliation: Helen Keller International, Kathmandu, Nepal.
authors.forename: Debendra P
authors.initials: DP
authors.lastname: Adhikari
authors.affiliation: Helen Keller International, Asia Pacific Regional Office, Phnom Penh, Cambodia.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Haselow
authors.affiliation: Helen Keller International Headquarters, New York, New York, USA.
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Quinn
authors.affiliation: Helen Keller International Headquarters, New York, New York, USA.
authors.forename: Jennifer N
authors.initials: JN
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding; D016000:Cluster Analysis; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005247:Feeding Behavior; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D044342:Malnutrition / Q000178:diet therapy*; D008895:Milk, Human; D009035:Mothers; D009390:Nepal; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: Nepal; barrier analysis; behaviour change communication; infant and young child feeding; nutrition
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