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Photos of Mid-Process Assessment of the Community Infant and Young Child Feeding Package in Nigeria

Nigeria’s Federal Ministry of Health (FMOH), with support from two USAID-funded global nutrition projects (IYCN and SPRING), has made a significant investment in the adaptation of the Community Infant and Young Child Feeding (C-IYCF) Counseling Package to the Nigerian context. In spite of the global interest in the package, little is known about its impact on maternal, infant, and young child nutrition behaviors in the countries where it has been adapted. In 2014, after consultations with both SPRING and UNICEF, the FMOH agreed to conduct an evaluation of the package in one intervention site (Kajuru LGA) and one comparison site (Kauru LGA) in Kaduna State.

SPRING traveled to Kajuru LGA, Kaduna State, to conduct a mid-process assessment of the implementation of the C-IYCF counseling package in Nigeria.

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Mothers and caregivers in Idon ward, Kajuru LGA attend a C-IYCF support group, which began with the nurse who works in the nearby healthcare center leading the group in a song about the benefits of exclusive breastfeeding. During the meeting, the Community Volunteer discussed the importance of initiating breastfeeding immediately after birth and breastfeeding exclusively for six months.
Mrs. Agatha Timothy, a C-IYCF Community Volunteer for Idon ward in Kajuru LGA shows her copy of the C-IYCF Counseling Cards. She has really enjoyed serving her community and has received support from the village chief, who lends his home for support group meetings.
Mr. Adams George Ango (Kajuru LGA Nutrition Focal Person), Sascha Lamstein (SPRING Co-Principal Investigator), Mrs. Agatha Timothy (C-IYCF Community Volunteer for Idon ward), Dr. Florence Oni (UNICEF/Kaduna Nutrition Specialist), and Rafael Perez-Escamilla (SPRING consultant, Principal Investigator).
Mrs. Maryam Adams, a C-IYCF Community Volunteer in Kasuwan Magani ward in Kajuru LGA, discusses the introduction of complementary foods to children at 6 months of age.
While men may not sit down to participate in C-IYCF support groups in Muslim communities like Kasuwan Magani ward, Kajuru LGA, men and children often congregate nearby to observe. Here Mr. Auwal Mohammed, the Chairman of the Kasuwan Magani Ward Development Committee, observes the support group. He too was trained in the C-IYCF Counseling Package and helped to train C-IYCF Community Volunteers. He has been an avid supporter of the program.
C-IYCF support group member in Kasuwan Magani ward, Kajuru LGA, Kaduna State.
In order to track the number of new and repeat participants as well as the types of participants (pregnant women, mothers with children under two, men, grandmothers), Community Volunteers complete a simple register at the end of each support group meeting.
C-IYCF support group meetings, like this one in Kasuwan Magani ward, Kajuru LGA, draws the participation of newly married women, pregnant women, mothers of young children, and grandmothers.
Young girls from the community listen in to an interview with a newly married woman who has regularly participated in support groups since the C-IYCF Counseling Package was initiated in Kajura LGA in July 2015.
Each month, Community Volunteers like these in the Primary Healthcare Center in Kasuwan Magani ward, meet with a health facility worker, LGA monitor, and/or State Ministry of Health Nutrition Officer to submit monitoring forms, review one or two C-IYCF counseling cards, discuss challenges, and share successes. During this support group, the local drama troupe, who had been trained by UNICEF Communication for Development team, performed three skits.
Community Volunteers (CVs) from Kajuru ward in Kajuru LGA, including these men from Ruga Ardo Suleiman Community, a Fulani settlement, attend a monthly review meeting. During this meeting CVs shared stories of women struggling to deliver the placenta after birth and successfully doing so after the CVs encouraged the mother to breastfeed immediately. Several CVs also mentioned different endeavors of support groups to encourage new practices, save money, and even make money.
A young mother and her child participate in a C-IYCF support group in Kasuwan Magani ward, Kajuru LGA. She listens as the Community Volunteer discusses the importance of and ways to continue breastfeeding even when a mother works.
Like the C-IYCF Community Volunteers visited, children studying in a madrasa in Kasuwan Magani ward were motivated by the presence of the Evaluation Team.
Women in Idon ward mill rice and millet, removing husks. This is sometimes eaten as whole grains in form of rice and stew, jollof rice, or grinded into flour for the production of molded foods such as tuwon shinkafa and tuwon gero. Other times, the grains are soaked and grinded to make different types of gruels or drinks. This is often referred to as Kunu or Koko n Hausa.
A Primary Healthcare Center in Maro ward, Kajuru LGA, Nigeria. The facility was closed when we arrived, but we were able to tour the inside, which is where Community Volunteers from this ward were trained. We found C-IYCF counseling cards on the health workers desk - evidence that health workers, like Community Volunteers, are using the cards and promoting optimal IYCF practices such as dietary diversity.
Young children accompanied their mothers while they listened to Mrs. Maryam Adams, a C-IYCF Community Volunteer in Kasuwan Magani ward in Kajuru LGA, discuss complementary feeding. C-IYCF Community Volunteers were observed to ask support group participants to explain the illustrations to ensure that they understood the messages.
Children, including adolescent girls who may marry soon in communities like this one, listen in to the C-IYCF support group in Kasuwan Magani ward, Kajuru LGA. According to the 2013 Nigeria Demographic and Health Survey (NDHS), in Kaduna State, among women 20-49 years old, the median age at first marriage was 17.5 years. Nearly half (47.7%) of women 20-49 years old were first married at 18 years of age.
SPRING’s Study Coordinator, Ms. Susan Adeyemi, interviews Mrs. Jamila Garba, a C-IYCF Community Volunteer in Kasuwan Magani ward in Kajuru LGA.
Dr. Rafael Pérez-Escamilla, SPRING consultant and Principal Investigator of the Evaluation of C-IYCF in Kaduna State, interviews a grandmother who has been participating in support group meetings for several months. Dr. Pérez-Escamilla was assisted by Mr. Ango, Kajuru LGA Nutrition Focal Person.