Baker Jean, Sanghvi Tina, Hajeebhoy Nemat, Martin Luann, Lapping Karin
Alive & Thrive, FHI 360, 1825 Connecticut Ave. NW, Washington, DC 20009, USA.
Food Nutr Bull. 2013 Sep;34(3 Suppl):S146-55. doi: 10.1177/15648265130343S202.
Global interest in scaling up nutrition outcomes has focused attention on the need for more effective programs to improve infant and young child feeding (IYCF). However there are few examples in the literature of comprehensive programs that have been systematically designed.
To describe an evidence-based approach for designing large-scale yet tailored IYCF programs in varied country settings.
Behavior change principles, epidemiological data, situational analysis, stakeholder consultations, formative research, and feasibility studies informed the design of IYCF programs delivered at scale in Bangladesh, Ethiopia, and Vietnam.
Impact, scale, and sustainability objectives guided the choice of partners, service delivery platforms, and advocacy, systems strengthening, and communication strategies for reaching mothers and decision makers. All programs focused on the critical first 2 years of life, followed global World Health Organization and UNICEF guidelines for IYCF, and applied a common theory of change. Formative research, stakeholder consultations, trials of improved practices, and assessments of media habits were most useful for making program decisions. Opinion leader research, monitoring of the policy environment, and stakeholder analysis were key elements in the design of advocacy strategies. All programs found that setting measurable and explicit targets, strengthening systems to provide support for mothers, multichannel communication, and advocacy for opinion leaders were vital components in the design.
A systematic, evidence-based collaborative approach can facilitate the design of comprehensive IYCF programs. Programs should also embed design flexibility to enable changes as new challenges and opportunities arise.
全球对扩大营养成果的关注将注意力集中在需要更有效的项目来改善婴幼儿喂养（IYCF）上。然而，文献中很少有系统设计的综合项目实例。
描述一种基于证据的方法，用于在不同国家背景下设计大规模且量身定制的婴幼儿喂养项目。
行为改变原则、流行病学数据、情境分析、利益相关者咨询、形成性研究和可行性研究为在孟加拉国、埃塞俄比亚和越南大规模实施的婴幼儿喂养项目设计提供了依据。
影响、规模和可持续性目标指导了合作伙伴的选择、服务提供平台以及针对母亲和决策者的宣传、系统强化和沟通策略。所有项目都聚焦于生命最初关键的两年，遵循世界卫生组织和联合国儿童基金会关于婴幼儿喂养的全球指南，并应用了共同的变革理论。形成性研究、利益相关者咨询、改进实践的试验以及媒体习惯评估对做出项目决策最为有用。意见领袖研究、政策环境监测和利益相关者分析是宣传策略设计的关键要素。所有项目都发现，设定可衡量且明确的目标、加强为母亲提供支持的系统、多渠道沟通以及对意见领袖的宣传是设计中的重要组成部分。
一种系统的、基于证据的协作方法可以促进综合婴幼儿喂养项目的设计。项目还应具备设计灵活性，以便在出现新的挑战和机遇时能够做出改变。
