Enhancing Skills for Improved Infant and Young Child Nutrition : Baby Friendly Village Approach, Takhar Province, Afghanistan

Abstract

Afghanistan has high rates of malnutrition and a high infant mortality rate of 77/1000 births. Infant and young child feeding practices are a key determinant of malnutrition in Afghanistan, and thus far, relatively little attention has been given to this issue. This report was prepared to inform the scaling up of infant and young child feeding through the Government of Afghanistan's Basic Package of Health Services. The case study outlines the Baby Friendly Village Project intervention objectives, the project's approach, monitoring and evaluation issues, findings, and lessons learned. The overall goal of the Project was to promote early and exclusive breastfeeding for children under 6 months old and to encourage families to offer age-appropriate complementary foods to children 6-24 months. Despite several monitoring and evaluation issues, the pilot has generated a number of important lessons for policymakers and program implementers in Afghanistan. The Care for Afghan Families intervention shows that for future similar projects, sufficient technical support should be provided to assist the implementing agency with the overall planning of the intervention, including conducting the needed formative studies to guide the education, communication, and social marketing messages and approaches for the various target groups. Special assistance would be needed to help with the design and implementation of an appropriate and feasible program monitoring system to track the quality and coverage of the intervention and to assess its anticipated impact. Finally, it is important to pretest the intervention strategy as well as the data collection methodology prior to full-scale implementation. Public health impact from an intervention can be achieved by ensuring its quality and sustained high population coverage over time. While many unknowns exist in a country such as Afghanistan, this report illustrates some of the lessons learned from the Care for Afghan Families pilot intervention on infant and young child feeding, Baby Friendly Village Project, and provides recommendations for future initiatives.