Sanghvi Tina, Jimerson Ann, Hajeebhoy Nemat, Zewale Medhanit, Nguyen Giang Huong
FHI 360, Dhaka, Bangladesh.
Food Nutr Bull. 2013 Sep;34(3 Suppl):S169-80. doi: 10.1177/15648265130343S204.
Alive & Thrive aims to increase exclusive breastfeeding and complementary feeding practices in Bangladesh, Ethiopia, and Vietnam.
To develop and execute comprehensive communication strategies adapted to each context.
We documented how three countries followed an established iterative planning process, with research steps followed by key decisions, to develop a communication strategy in each country. Secondary analysis and formative research identified the priority practices to focus on, and locally specific constraints to proper infant and young child feeding (IYCF). Communication strategies were then developed based on the social, cultural, economic, epidemiological, media use, and programmatic contexts of each country.
There were widespread gaps between recommended and actual feeding practices, and these varied by country. Gaps were identified in household, community, and institutional levels of awareness and skills. Strategies were designed that would enable mothers in each specific setting to adopt practices. To improve priority behaviors, messaging and media strategies addressed the most salient behavioral determinants through face-to-face communication, social mobilization, and mass media. Trials of improved practices (TIPs), concept testing, and pretesting of materials proved useful to verify the relevance and likely effectiveness of communication messages and materials tailored for different audiences in each setting. Coordination and collaboration with multiple stakeholders from the start was important to harmonize messages and approaches, expand geographic coverage to national scale, and sustain the interventions.
Our experience with designing large-scale communication strategies for behavior change confirms that systematic analysis and local planning cannot be omitted from the critical process of strategic design tailored to each context. Multiple communication channels matched to media habits in each setting can reach a substantial proportion of mothers and others who influence their IYCF practices. Preliminary data suggest that exposure to mass media plays a critical role in rapidly reaching mothers, household members, community influentials, and health workers on a large scale. Combining face-to-face interventions for mothers with social mobilization and mass media was effective in improving IYCF practices.
“活力与成长”项目旨在提高孟加拉国、埃塞俄比亚和越南的纯母乳喂养及辅食喂养率。
制定并实施适合各国国情的综合传播策略。
我们记录了三个国家如何遵循既定的迭代规划流程，先进行研究，再做出关键决策，以在每个国家制定传播策略。二次分析和形成性研究确定了需要关注的优先做法以及婴幼儿喂养（IYCF）方面的当地特定限制因素。然后根据每个国家的社会、文化、经济、流行病学、媒体使用和项目背景制定传播策略。
推荐的喂养做法与实际喂养做法之间存在广泛差距，且因国家而异。在家庭、社区和机构层面的认知和技能方面发现了差距。设计了相应策略，以使每个特定环境中的母亲能够采用相关做法。为改善优先行为，信息传递和媒体策略通过面对面交流、社会动员和大众媒体解决了最突出的行为决定因素。改进做法试验（TIPs）、概念测试和材料预测试被证明有助于验证针对每个环境中不同受众量身定制的传播信息和材料的相关性及可能的有效性。从一开始就与多个利益相关者进行协调与合作对于统一信息和方法、将地理覆盖范围扩大到全国规模以及维持干预措施很重要。
我们在设计大规模行为改变传播策略方面的经验证实，在为每个环境量身定制的战略设计的关键过程中，不能省略系统分析和本地规划。与每个环境中的媒体习惯相匹配的多种传播渠道可以覆盖很大比例的母亲以及其他影响其婴幼儿喂养做法的人。初步数据表明，接触大众媒体在迅速大规模地接触母亲、家庭成员、社区有影响力的人和卫生工作者方面发挥着关键作用。将针对母亲的面对面干预与社会动员和大众媒体相结合，对于改善婴幼儿喂养做法是有效的。
