title: Learning from the design and implementation of large-scale programs to improve infant and young child feeding.
abstract: BACKGROUND
  Improving and sustaining infant and young child feeding (IYCF) practices requires multiple interventions reaching diverse target groups over a sustained period of time. These interventions, together with improved maternal nutrition, are the cornerstones for realizing a lifetime of benefitsfrom investing in nutrition during the 1000 day period.
  
  
  OBJECTIVE
  Summarize major lessons from Alive & Thrive's work to improve IYCF in three diverse settings--Bangladesh, Ethiopia, and Vietnam.
  
  
  METHODS
  Draw lessons from reports, studies, surveys, routine monitoring, and discussions on the drivers of successful design and implementation of lYCF strategies.
  
  
  RESULTS
  Teaming up with carefully selected implementing partners with strong commitment is a critical first step. As programs move to implementation at scale, strategic systems strengthening is needed to avoid operational bottlenecks. Performance of adequate IYCF counseling takes more than training; it requires rational task allocation, substantial follow up, and recognition of frontline workers. Investing in community demand for IYCF services should be prioritized, specifically through social mobilization and relevant media for multiple audiences. Design of behavior change communication and its implementation must be flexible and responsive to shifts in society's use of media and other social changes. Private sector creative agencies and media companies are well equipped to market IYCF. Scaling up core IYCF interventions and maintaining quality are facilitated by national-level coordinating and information exchange mechanisms using evidence on quality and coverage.
  
  
  CONCLUSIONS
  It is possible to deliver quality IYCF interventions at scale, while creating new knowledge, tools, and approaches that can be adapted by others
authors.affiliation: Jean Baker, Alive & Thrive, FHI 360, 1825 Connecticut Ave., Washington, DC 20007, USA. jbaker@fhi360.org
authors.forename: Jean
authors.initials: J
authors.lastname: Baker
authors.forename: Tina
authors.initials: T
authors.lastname: Sanghvi
authors.forename: Nemat
authors.initials: N
authors.lastname: Hajeebhoy
authors.forename: Teweldebrhan Hailu
authors.initials: TH
authors.lastname: Abrha
mesh_terms: D001459:Bangladesh; D001942:Breast Feeding; D002662:Child Health Services / Q000379:methods*; D002664:Child Nutritional Physiological Phenomena; D002675:Child, Preschool; D003906:Developing Countries; D005002:Ethiopia; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D039382:Maternal Nutritional Physiological Phenomena; D009752:Nutritional Status; D015397:Program Evaluation / Q000379:methods*; D014744:Vietnam