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Nutrition Education and Behavior Change Communication: How Much is 'Enough' to Achieve Measurable Results for Nutrition in Social Protection Programs?

This post was written by Andrea L. Spray and originally appeared on the Secure Nutrition blog.

Nutrition education and behavior change communication (BCC) improve infant and young child nutrition.[1] In combination with cash, nutrition education may influence caregivers’ preferences towards more nutrient-rich foods, intra-household allocation of food to benefit pregnant and lactating women and children, and other practices related to child feeding, caregiving, sanitation and hygiene, and use of health services.[2] Although the overall results to date regarding the effectiveness of transfers (cash and in kind) to improve nutrition are mixed, the global evidence base is growing and effective incorporation of complementary nutrition messaging within social protection programs has been associated with improved nutrition outcomes.[3],[4],[5] 

Preliminary findings recently reported by IFPRI in Bangladesh indicate that stunting decreased only when transfers were combined with intensive BCC, which underscores the importance of designing effective interventions within transfer programs to change the household practices that drive nutrition status.[6] However, research conducted thus far has not adequately evaluated the impact pathways from social protection to improved nutrition outcomes.[7]                   

As a result, when nutrition-sensitive social protection programs fail to achieve improvements in nutrition, it is all too easy to say “the program did not work”, rather than “the nutrition education and BCC component was insufficient.” The relative importance of key factors of nutrition education and BCC (e.g. the intensity of the engagement, qualifications of the promoter, format of the delivery platform) are not well enough understood. Yet, in a recently published compendium of case studies of global nutrition-sensitive social protection programs, the vast majority included a nutrition education and BCC component.[8]

For these programs, somewhere along the path from design to implementation, decisions are made about what nutrition messages to promote, how they will be conveyed, by whom, how often, and what tools will be provided to support this work. Hopefully, but not always, these decisions are rooted in formative research and a clear understanding of their respective merits. These decisions have major implications for program delivery, cost, and impact, yet their relative effectiveness within the scope of at-scale nutrition-sensitive social protection programming... Read more on Secure Nutrition.