To develop and assess an operational delivery system for the HF program with MNP coupled with IYCF, in order toobtain an implementation model that can be duplicated in other regions in the country.
Three steps:(1) Ex-ante evaluation: Qualitative and quantitative data were collected in 25 villages in 25 health areas (HA) in order to study and understand the systems in place in terms of procurement and distribution of supplies, community based interventions with success and failure factors, communication channels and strategies, supervision, monitoring and evaluation. The PPS (Probability Proportional to Size) method was used to select the 25 HA in 13 HD. The villages were randomly selected in HA. In each village a ?Nonprobability sampling method was used to select key informants and participants of focus group discussions.(2) Findings of the Ex-ante evaluation were used to develop key components of the program.(3) The components developed were implemented in 4 HD in order to identify and document lessons learned, challengesand bottlenecks; to perform a cost-effectiveness evaluation and to develop a model of scaling with a detailed cost estimate.
Adapted packaging and delivery by community volunteers,behavior change communication, cascade training, supervision, monitoring and evaluation are the program components developed. This helped to achieve the expected coverage (reaching 95% eligible children), 100% adherence of mothers and changes of IYCF practices.
For a successful HF program coupled with IYCF, adapted and efficient components need to be in place. HF is best introduced as part of an IYCF strategy.