title: Assessing Program Coverage of Two Approaches to Distributing a Complementary Feeding Supplement to Infants and Young Children in Ghana.
abstract: The work reported here assesses the coverage achieved by two sales-based approaches to distributing a complementary food supplement (KOKO Plus™) to infants and young children in Ghana. Delivery Model 1 was conducted in the Northern Region of Ghana and used a mixture of health extension workers (delivering behavior change communications and demand creation activities at primary healthcare centers and in the community) and petty traders recruited from among beneficiaries of a local microfinance initiative (responsible for the sale of the complementary food supplement at market stalls and house to house). Delivery Model 2 was conducted in the Eastern Region of Ghana and used a market-based approach, with the product being sold through micro-retail routes (i.e., small shops and roadside stalls) in three districts supported by behavior change communications and demand creation activities led by a local social marketing company. Both delivery models were implemented sub-nationally as 1-year pilot programs, with the aim of informing the design of a scaled-up program. A series of cross-sectional coverage surveys was implemented in each program area. Results from these surveys show that Delivery Model 1 was successful in achieving and sustaining high (i.e., 86%) effective coverage (i.e., the child had been given the product at least once in the previous 7 days) during implementation. Effective coverage fell to 62% within 3 months of the behavior change communications and demand creation activities stopping. Delivery Model 2 was successful in raising awareness of the product (i.e., 90% message coverage), but effective coverage was low (i.e., 9.4%). Future programming efforts should use the health extension / microfinance / petty trader approach in rural settings and consider adapting this approach for use in urban and peri-urban settings. Ongoing behavior change communications and demand creation activities is likely to be essential to the continued success of such programming.
authors.affiliation: Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland.
authors.forename: Grant J
authors.initials: GJ
authors.lastname: Aaron
authors.affiliation: International Nutrition Foundation (INF), Boston, Massachusetts, United States of America.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Strutt
authors.affiliation: University of Ghana (UG), Accra, Ghana.
authors.forename: Nathaniel Amoh
authors.initials: NA
authors.lastname: Boateng
authors.affiliation: Valid International, Oxford, England, United Kingdom.
authors.forename: Ernest
authors.initials: E
authors.lastname: Guevarra
authors.affiliation: Valid International, Oxford, England, United Kingdom.
authors.forename: Katja
authors.initials: K
authors.lastname: Siling
authors.affiliation: Valid International, Oxford, England, United Kingdom.
authors.forename: Alison
authors.initials: A
authors.lastname: Norris
authors.affiliation: International Nutrition Foundation (INF), Boston, Massachusetts, United States of America.|Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America.
authors.forename: Shibani
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: CARE International in Ghana, Accra, Ghana.
authors.forename: Mercy
authors.initials: M
authors.lastname: Nyamikeh
authors.affiliation: CARE International in Ghana, Accra, Ghana.
authors.forename: Antoine
authors.initials: A
authors.lastname: Attiogbe
authors.affiliation: Exp Social Marketing, Accra, Ghana.
authors.forename: Richard
authors.initials: R
authors.lastname: Burns
authors.affiliation: Ghana Health Services, Accra, Ghana.
authors.forename: Esi
authors.initials: E
authors.lastname: Foriwa
authors.affiliation: Ajinomoto Co., Inc, Tokyo, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Toride
authors.affiliation: Ajinomoto Co., Inc, Tokyo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitamura
authors.affiliation: University of Ghana (UG), Accra, Ghana.
authors.forename: Kwaku
authors.initials: K
authors.lastname: Tano-Debrah
authors.affiliation: University of Ghana (UG), Accra, Ghana.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sarpong
authors.affiliation: Brixton Health, Llawryglyn, Wales, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Myatt
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D008962:Models, Theoretical; D010865:Pilot Projects; D015397:Program Evaluation; D012306:Risk; D011795:Surveys and Questionnaires