Scaling up an Integrated Strategy for Attention to Nutrition (EsIAN) to Prevent Stunting, Micronutrient Deficiency and Obesity in Mexico

Bonvecchio, Anabelle; Guerra, Armando Garcia; Neufeld, Lynnette M.; Rivera, Juan Á.; González, Wendy; Théodore, Florence; Lozada, Ana Lilia

doi:10.9734/ejnfs/2015/21335

Cited by 2 publications

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“…For example, they were unclear on the definition of exclusive breastfeeding and recommendation of age-appropriate complementary foods. Physicians and nurses did not conduct nutrition assessment of infants and young children described in their institutional procedures, focused on assessing weight (and not height) of children, and relied on single measurements instead of growth trajectory with respect to both weight and height to conduct the nutritional assessment (22). We also found that receptivity and interest among working at all levels to improve the quality of service delivery demonstrated a willingness to participate in training activities.…”

Section: Resultsmentioning

confidence: 99%

An Iterative Process for Training Design and Implementation Increased Health Workers’ Knowledge for Taking Nutrition Behavior Change to Scale

González

Bonvecchio

García‐Guerra

et al. 2019

The Journal of Nutrition

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BackgroundThe shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services.ObjectiveThe objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context.MethodsThe design and implementation of training followed a 5-phase process: situation analysis, formative research, large-scale feasibility study, redesign and scale up, and evaluation. We conducted document reviews, surveys, and focus groups during the first phases to inform and refine the training, as well as a pre- and posttraining telephone survey to evaluate change in knowledge.ResultsThe initial phases of the design provided a clear understanding of the opportunities and challenges for promoting infant and young child feeding, as well as health workers’ routines and practices, which informed training design. The feasibility study allowed tailoring and refinement of training. The vertical coherence and coordination between the federal and state levels during redesign and scale up facilitated compliance with training timeline and process. Evaluation results showed significant improvement in knowledge posttraining of up to 19 percentage points.ConclusionsThe EsIAN training component for health providers was developed using a systematic approach to consolidate and generate relevant evidence, following an iterative process to test, learn, and improve both design and implementation. This process allowed for flexibility to take advantage of new opportunities and respond to findings from iterations. Garnering and ensuring political support allowed for continuity and sustainability of actions.

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Section: Resultsmentioning

confidence: 99%

An Iterative Process for Training Design and Implementation Increased Health Workers’ Knowledge for Taking Nutrition Behavior Change to Scale

González

Bonvecchio

García‐Guerra

et al. 2019

The Journal of Nutrition

Self Cite

View full text Add to dashboard Cite

show abstract

“…Multiple studies have demonstrated that the most effective treatment is a home-visiting and integrative intervention. The nutritional intervention improves weight gain, child development scores, breastfeeding ( 8 ), and complementary feeding practices ( 9 ), children's growth, health, and survival ( 10 ). Our findings showed that after adjusting for the DID impact, integrated intervention increased children's weight, height, and development scores by 0.31 (0.25–0.37), 0.41 (0.13–0.68), and −0.40 (−0.59-(−0.21)), respectively.…”

Section: Dear Editor-in-chiefmentioning

confidence: 99%