Overview
The Maternal, Infant, and Young Child Community Nutrition Training
The Maternal, Infant and Young Child Community Nutrition Training Package provides basic nutrition training for Community Service Providers (CSP) and Community Resource Persons (CRP) to prepare for developing and disseminating nutrition-specific and nutrition-sensitive community videos. Specific community health workers, including the Accredited Social Health Activists (ASHAs), Anganwadi Workers (AWWs), Auxiliary Nurse Midwives (ANMs), and other community workers are also possible target audiences for this training, because they can provide support and information to mothers, fathers, and other community members about nutrition and feeding infants and young children. The training focuses on basic technical knowledge for the recommended essential nutrition actions, including maternal nutrition practices, breastfeeding, and complementary feeding practices for children from 0 up to 24 months, and hygiene. The training also helps build counselling, problem solving, and negotiation skills.
Throughout the Facilitator Guide, “maternal, infant, and young child nutrition” is usually referred to as “MIYCN” or “nutrition,” the trainers as “facilitators,” and the trainees or learners as “participants.”
Materials
The Maternal, Infant and Young Child Community Nutrition Training package includes the following:
- The Facilitator Guide, provides technical knowledge and skills related to key nutrition and hygiene practices, with a focus on preventing stunting and anaemia, especially during the first 1,000 days. The competency-based, participatory approach is based on established, adult learning principles and is intended for use training low literacy community staff and volunteers.
- The Facilitator Training Tips includes various short documents designed to support the trainers in planning and executing the training. It is intended as reference material and the training team should review and discuss it before the training.
- The Training Aids include visual graphic materials and images that can be printed and laminated (if possible) for different sessions of the training. (Graphics include pictures of women, infants, and young children, infant feeding scenes, common foods, etc.)
- The Handouts, a set of 31 take-homes present illustrations and summaries of key messages related to different maternal, infant, and young child feeding behaviours. Each one reflects specific content covered in the various training sessions. Participants can use them as reference material following the training. They can also be used to create nutrition-focused video content and discussion points during the dissemination of the videos. This facilitator’s guide assumes that each handout will be distributed individually when the content is presented during the training.
Planning the Training
Specific Learning Objectives
The learning objectives for the training are focused around (1) women’s nutrition; (2) exclusive breastfeeding from birth to 6 months; and (3) complementary feeding, with continued breastfeeding from 6 months through 2 years. Other important maternal, infant, and young child health practices affect nutrition and health: feeding of sick infants and young children; hygiene, safe water, and compound sanitation; as well as kitchen gardening and small animal promotion.
By the end of the training, participants will be able to—
- Explain why maternal nutrition is important to the health and nutrition of a baby.
- Explain why maternal, infant, and young child nutrition practices are important.
- Describe recommended feeding practices through the first two years.
- Describe how to position and attach a baby to the breast.
- Identify ways to prevent and resolve common breastfeeding difficulties.
- Describe various aspects of appropriate complementary feeding from 6–24 months of age.
- Describe practices for feeding a sick child.
- Describe basic handwashing techniques, and when and why they are important.
- Use basic behaviour change and negotiation skills to support the adoption of key practices by mothers, fathers, mothers-in-law, and other caregivers.
Target Group and Training Team
This training is intended for community health workers, including the CSPs, CRPs, ASHAs, AWWs, and other community workers who interact with mothers, fathers, and other caregivers of infants and young children.
At least three facilitators should conduct the training. Ideally, plan for no more than 20–25 participants in the training; include one facilitator for every five or six participants. When the ratio exceeds this number, it is difficult to oversee skills development and ensure competency. The facilitators should be maternal, infant, and young child experts with community-based experience and skills in facilitating the training of community workers.
Training Structure
The Facilitator Guide includes 14 sessions, divided between the two-day training, with exercises ranging from 20 minutes to 60 minutes each.
Each session includes—
- Learning objectives
- list of materials needed (Training Aids and Handouts)
- advance preparation
- time allotted
- suggested activities and methodologies, based on each learning objective with instructions for the facilitator(s)
- key information with explanation of content.
The Facilitator Guide is for facilitators to use as guidance when they prepare and execute the training; it is not intended to be given to participants. The Training Aids are only for the facilitators to use during training. The Handouts can be used during the various exercises, but are intended as take-home reference material for each participant.
Training Methodology
The goal of the Maternal, Infant, and Young Child Community Nutrition Training is to prepare participants to improve the nutrition and child care–related behaviour of mothers, fathers, mothers-in-law, and other caregivers in their own households and communities. The competency-based participatory training approach used in the Facilitator Guide reflects key principles of behaviour change communication, with a focus on promoting small doable actions. The approach recognises the widely acknowledged theory that adults learn best by reflecting on their own personal experiences (see the Facilitator Training Tips).
Adult learning principles include—
- use of motivational techniques
- use of the experiential learning cycle
- problem-centered approach to training
- mastery and performance of one set of skills and knowledge at a time
- reconciliation of new learning with the reality of current, strongly held beliefs and practices.
Training Location and Set Up
Select a training site with the local participating organization and community leaders. Wherever possible, it should be convenient to both the participants and facilitators. It should be clean, comfortable, have good lighting, and enough space to allow participants to sit comfortably in a large circle and to break into smaller groups for various activities. To create a comfortable training space, floor mats spread on the floor are highly recommended; arrange chairs around the edges of the training space for anyone who is not comfortable sitting on the floor. Set up a table for Training Aids in one corner of the room. Ensure that wall space or stands for flipchart paper are available for exercises; or to display session notes, graphics, and other training information.
Prior to beginning the training, trainers should review all training materials, Handouts, and lesson plans carefully, including information in “Key Information” under each session objective. Additionally, trainers can prepare flipcharts in advance and, using large envelopes or folders, separate materials by session and activity. This will make transitions between activities faster and easier. For an overview of materials and preparation requirements, see the sections “Materials” and “Advance preparation” that begin each session. See examples and templates of flipcharts in the “Key Information” for each session objective.
Venue Requirements and Training Room Set Up:
The facilitators and participants will sit in a circle on mats, on the floor (without tables).
Have the following available and ready:
- comfortable space for 30 people, with ventilation and natural light
- local mats to cover the floor
- one table in front of the room for Training Aids
- wall space for hanging flipchart material
- two–four easels or flipchart stands
- one or two white boards or chalkboards, if possible
- generator/power backup, if possible and necessary
- drinking water for facilitators and participants
- washroom facilities.
Arrangements
Ensure the following are prepared:
- lunch for participants and trainers for each day
- tea/biscuits twice a day (approximately 11:00 am and 3:00 pm)
- travel and/or accommodations (as needed).
Materials Needed for the Training
- Facilitator’s Guide: one per facilitator
- Training Aids: one complete set
- set of Handouts: one per facilitator and one per participant
- attendance sheet for each day
- camera, photographer, videographer, as needed
- name card materials: (e.g., hard paper, punch, safety pins)
- rubber ball or ball of bunched up paper
- coloured index cards of various sizes (or stiff coloured paper)
- flipchart paper, flipchart stands: two–four
- pico projector
- Tippy Tap video and speakers
- markers: black, blue, green, and a few red
- masking tape or sticky putty, glue stick, stapler, staples, scissors
- writing pads/notebooks and pens for participants
- large envelopes/folders for individual session preparation materials
- white board marker, if applicable
- printouts of case studies: two copies each
- dolls (life-size); or bath towels and rubber bands: 1 for every breakout group
- four clear glasses (identical size) for water demonstration
- one pitcher to fill with water for demonstration
- set of local bowls and utensils/spoons
- local cups (examples, including one 250 mL)
- different types of locally available foods, if possible
- a bucket and cup or tippy tap and basin for demonstrating handwashing
- one bar of soap
- training certificate (if required).
Post-Training Follow Up
The desired outcome of the Maternal, Infant and Young Child Community Nutrition Training is the application of the new knowledge and skills. Participants’ new knowledge can be measured immediately through the pre/post-assessments built into the training. Post-training follow up will allow program managers to determine what skills have been acquired, the need for reinforcement of specific participant’s knowledge and skills, and the need for additional on-the-job training or other refresher training.
On-going follow up through a formalized system of supervision and mentoring would allow programme managers to monitor community worker’s retention or loss of knowledge and skills, over time; to focus on ongoing problem-solving to meet the needs of individual community workers; and to determine the need for on-the-job training or other refresher training. When it is not possible to supervise individual community workers, peer discussion groups and peer mentoring for a group of community workers may be useful.