Embed Size (px)
Citation preview
National Communication Framework and Plan forInfant and Young Child Feeding in
Bangladesh
Institute of Public Health Nutrition (IPHN)Directorate General of Health ServicesMinistry of Health and Family Welfare
CONTENTS
Acronyms xii
Communication Framework and Plan for IYCF 1
I. Background 2
II. Rationale for the Communication Framework and Plan 4
III. Communication Approaches 5
IV. Communication Objectives 6
V. Barriers and Facilitators 9
VI. Participant Groups for Communication 12
VII. Communication Channels and Media 16
VIII. Key Messages 17
IX. Implementation Plan 25
X. Monitoring and Evaluation Indicators for IYCF Communication 40
List of Tables
Table 1. Primary, Secondary and Tertiary Participant Groups 14
Table 2. Key Messages for Four IYCF Behaviours 18
Table 3. Stakeholders for National IYCF Communication Frameworkand Plan 26
Table 4. Action Plan for Implementation of Communication Activities 29
Table 5. Monitoring and Evaluation Indicators for IYCFCommunication Activities 40
xi
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
AcronymsANC Antenatal CareARI Acute Respiratory InfectionsBCC Behaviour Change CommunicationBBF Bangladesh Breastfeeding Foundation BDHS Bangladesh Demographic and Health SurveyBGMEA Bangladesh Garment Manufacturers and Exporters
AssociationBKMEA Bangladesh Knitwear Manufacturers and Exporters
AssociationBNFE Bureau of Non-Formal Education BNNC Bangladesh National Nutrition CouncilBTMA Bangladesh Textile Mills AssociationBPA Bangladesh Pediatric AssociationBPS Bangladesh Perinatal SocietyCF Complementary FeedingCHV Community Health VolunteerCHW Community Health WorkerCNO Community Nutrition Organiser CNP Community Nutrition PromoterCSR Corporate Social ResponsibilityDC Deputy CommissionerDDCC District Development Coordination Committee DEO District Education OfficerDGFP Directorate General of Family PlanningDGHS Directorate General of Health ServicesDPEO District Primary Education OfficerEBF Exclusive Breastfeeding EI Early InitiationENC Essential Newborn Care
xii
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
FWA Family Welfare Assistant FWV Family Welfare VisitorGOB Government of BangladeshHMIS Health Management Information SystemHW Hand WashingIMCI Integrated Management of Childhood IllnessIPHN Institute of Public Health Nutrition IYCF Infant and Young Child Feeding MNH Maternal and Neonatal Health MNCH Maternal, Neonatal and Child Health MNCS Maternal, Neonatal and Child Survival MOA Ministry of AgricultureMORA Ministry of Religious AffairsMOHFW Ministry of Health and Family WelfareMOI Ministry of Information MOLGRD Ministry of Local Government and Rural DevelopmentMOPME Ministry of Primary and Mass Education MOWCA Ministry of Women and Children AffairsMOSW Ministry of Social WelfareNCTB National Curriculum and Textbook BoardNNF National Neonatology ForumOGSB Obstetric & Gynaecological Society of BangladeshPNC Post Natal CareSACMO Sub-Assistant Community Medical OfficerSBA Skilled Birth AttendantTBA Traditional Birth AttendantUP Union ParishadWHO World Health Organization
xiii
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
xiv
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
Communication Framework and Planfor IYCF The Communication Framework and Plan is a component of the NationalIYCF Strategy and its goal is to contribute to the reduction ofundernutrition and death caused by sub-optimal infant and young childfeeding practices. In Bangladesh, as in many other countries, socialcommunication plays a significant role in achieving programmeobjectives. This communication framework and plan outlines the role ofcommunication in demand creation for basic services and in theadoption of key life saving behaviours and bringing about social normschange related to IYCF. The plan sets out actions for reaching mothersand families through interpersonal and mass media channels andcreating an enabling environment for them to adopt healthy behavioursthrough social actions and supportive policies. This plan has beenprepared for 2010-2013 and will be reviewed and extended up to 2016to fit the national Health, Population and Nutrition Sector Strategy Planfor the period of 2011-2016.
In order to implement systematic multi-channel communication activities,a national communication framework and plan has been developedthrough a participatory process which involved different stakeholders.Main objective of the communication framework and plan is to createdemand for early initiation of breastfeeding, exclusive breastfeeding andquality complementary feeding for infant and young children. Thecontents of this document are based on a synthesis of past and newformative research, national and district level information and data, andfour workshops organized by IPHN from March to September 2010 thatwere attended by over 50 persons from 25 organizations.
Communication interventions are meant to be dynamic and take intoaccount the lessons learned from the field and the evolving socio-economic and programme contexts. It is a continuous process.Therefore this communication framework and plan will be adjusted toreflect what is learned during the testing and implementation phases.
1
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
I. BackgroundEpidemiological evidence indicates that the following IYCF practices willhave substantial impacts on health and nutrition indicators in Bangladesh(Lancet 2008, BDHS 2007, WHO/PAHO 2003, and National IYCFStrategy 2007):
Initiation of breastfeeding immediately (within one hour) after birthand no pre-post-lacteal foods
Exclusive breastfeeding from birth through 6 months
Timely initiation of semi-solid complementary feeding and givingrecommended amounts of solid or semi-solid foods to children from6-24 months in addition to continued breastfeeding for at least 24months
Assuring the quality of complementary foods through: adequatedensity of energy and nutrients, use of diverse types of foodsespecially animal foods, feeding fortified foods, or supplementation1
Reducing pathogens in complementary foods through handwashingwith soap before preparing and feeding children under two years
In Bangladesh, current IYCF patterns fall short of these practicesresulting in nutritional deficits and increased infections leading to growthfailure, stunting, anaemia, cognitive damage and increased neonatal,infant and child morbidity and mortality. These five sets of behaviours aretop priorities for the national IYCF communication plan. Other WHOrecommended behaviours are already widely practiced in Bangladeshaccording to the available research and do not require special focus. Forexample, initiation of breastfeeding, continuation of breastfeeding to atleast 2 years, on demand feeding and frequency of complementaryfeeding do not present a serious problem at present.
2
1 IPHN 2007: National Strategy for Anaemia Prevention and Control in Bangladesh: page 48
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
Past experience has shown that a lack of focus on a few prioritybehaviours and messages leads to limited achievement of programmeobjectives. The proposed communication framework and plan isselective and aims to address all the above mentioned behaviours. Inthe past, IYCF programmes addressed the barriers and motivations ofmothers and other family members inadequately. Insufficient coveragewith short duration programmes that did not use multiple channels ofcommunication further reduced the possibility of behaviour change on alarge scale. Currently Bangladesh offers an effective set ofcommunication channels and there are several options for reaching keyparticipant groups (target audiences). Recent formative researchconducted as a part of communication plan preparation has alsoidentified barriers and facilitators in the local context of Bangladesh. Thiscommunication framework and plan takes advantage of the newunderstanding of programme options and the availability of newtechnologies and communication channels.
The Government of Bangladesh (GOB) has taken several importantsteps to address IYCF problems. The overall goal of the National IYCFStrategy (2007) is to improve nutritional status, growth and development,health, and survival of infants and young children in Bangladesh throughoptimal IYCF practices. The specific objectives of the National Strategyare to:
Increase the national percentage of newborns who are breastfedwithin one hour of birth from 24% to 50%
Increase the national percentage of infants aged less than 6 monthswho are exclusively breastfed from 42% to 60%
Maintain the national percentage of children aged 20-23 months whoare still breastfed at 90%
Increase the percentage of children aged 6-9 months who arebreastfed and receive appropriate complementary foods to 50%
3
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
In addition to the National IYCF Strategy, the National Neonatal HealthStrategy (2009) is also supportive of IYCF. It states,
"All birth attendants and providers must know about the benefits ofbreastfeeding and should be trained on breastfeeding counselling andtechniques. They should promote initiation of breastfeeding immediatelyafter birth and no later than one hour, counsel for exclusivebreastfeeding for six months and encourage compliance to breastfeedingthrough advocacy and health education of family and mothers. Allfacilities should provide environment conducive for breastfeeding.Additional efforts to raise motivation and practice for immediate initiationand continuation of breastfeeding for mothers with caesarean sectionsshould be in place. Feeding should be as frequent as the babydemands, without any pre-lacteals (plain water, sugar water, honey etc.)"
National IMCI guidelines and protocols also contain sections related toassessing and counseling on breastfeeding and complementary feeding.
II Rationale for the CommunicationFramework and PlanThe national IYCF programme aims to create an environment to improveIYCF practices by addressing barriers regarding knowledge andpractices on infant and young child feeding. Thus a communicationframework and plan has been prepared to bring sustainable changes ingenerating demand for infant and young child feeding services andsetting the stage where individual behaviour change is supported bycommunity members, basic health and social services and effectivepolicies in several sectors. As stated earlier the plan will be extended toalign with the Health, Population and Nutrition Sector Strategy Plan for2011-2016.
4
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
III Communication ApproachesCommunication is a systematic, planned and evidence based strategicprocess that is intrinsically linked to programme elements. It usesconsultation and participation of children, family members, communitypeople, opinion leaders and networks; recognises local contexts, andrelies on a mix of communication tools, channels and approaches topromote positive and measurable behaviour and social change. In orderto achieve desired behavioural and social change objectives the IYCFframework and plan uses a mix of three key approaches. All theapproaches complement each other, thus implementation of theseapproaches is continuous and simultaneous.
Advocacy - helps garner political support to help shape and implementpolicies and ensure adequate allocation of resources. Advocacy ensuresthat the perspectives, concerns and voices of women and men from allsegments of the population including marginalized groups, are heard andreflected in upstream policy dialogue, decision making and interventions.
Communication for Social Change - engages, motivates andempowers communities and networks to influence or reinforce socialnorms and cultural practices to create an enabling environment thatsupports long-term sustainable social change for infant and young childfeeding practices.
Behaviour Change Communication (BCC) - uses a combination ofstrategies including social marketing and participatory communication tohelp inform, influence and support individuals, families, communitygroups and opinion leaders for the adoption and sustained practice andsupport of desired IYCF behaviours.
5
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
IV. Communication Objectives The IYCF framework and plan has been prepared for 2010-2013. Thefollowing communication objectives have been identified for advocacy,communication for social change, and behaviour change related topriority topics in IYCF.
Advocacy Objectives:
By the end of 2013,
50% of government authorities (all directors and programmemanagers from DGHS and DGFP) and development partners aresensitized about National IYCF Strategy and initiate allocation ofresources for implementing relevant sections of the action plan andgive additional support for mainstreaming IYCF into health, familyplanning, education, agriculture, food security and nutrition sectorprogrammes
DGFP and DGHS add counselling and support to mothers forappropriate IYCF in job descriptions of health providers, particularlythose who provide services on ANC, PNC, ENC, FP, immunizationsand management of childhood illnesses; and HMIS indicators forappropriate IYCF are added and reviewed regularly by relevanthealth and family planning staff
Policy makers agree that government medical and nursing collegeswill be teaching about how to provide practical support to mothers
50% of monthly District Development Coordination Committee(DDCC) review meetings cover topics related to IYCF, including theimportance of maternal and child nutrition and reporting of IYCFprogress made in various sectors in programme areas
National school curriculum for classes 6-10 include the importance ofmaternal and child nutrition and appropriate IYCF
At least 20% of business corporations; and BTMA, BGMA, BKMAmembers; the national forum for CSR; consumers associations; and
6
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
chamber of commerce members are sensitized about the impact ofchildhood nutrition and IYCF on adult labour productivity and at least40% of these are promoting appropriate IYCF among their workersand communities in which they operate
Handwashing linked to complementary feeding is addressed innational hygiene promotion strategy and active plans
Reporters and gatekeepers from 50% of national media outlets (print,broadcast, radio and web) are producing increased coverage onIYCF practices and impact on child mortality, nutrition, health anddevelopment outcomes in order to remove barriers and increasesupport and resources for IYCF services among policy and decisionmakers.
Communication for Social Change Objectives:
By the end of 2013,
50% of trained health service providers (doctors, nurses, villagedoctors, pharmacists, CHWs) in programme areas support mothersto practice priority IYCF behaviours (EI, EBF, CF and hand washing)
At least 30% of religious leaders in programme areas coming incontact with pragnent women or their family members promotepriority IYCF practices during their regular and special prayers andceremonies
25% of communities in programme areas have more than onecommunity leader e.g. teachers, elites, union parishad members,woman leaders and others, who promote emphasis behaviours ofIYCF among all family members
25% of communities in programme areas have adolescent groupsactively promoting priority IYCF practices
At least 50% of existing community groups and associations inprogramme areas support emphasis IYCF behaviours
At least 3 soap manufacturers agree to include handwashing linkedto complementary feeding messages in their advertising campaigns
7
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
Behaviour Change Objectives:
By the end of 2013,
Mothers who initiated breastfeeding immediately (within one hour) ofbirth increased from 43% to 65%2
At least 65% of birth attendants (SBA, TBA, family members)reached through the IYCF initiative put infant to mother's breastimmediately (within one hour) of birth
Mothers exclusively breastfeeding their infants 0-6 months of ageincreased from 43% to 60%
An additional 10% mothers and caregivers over baseline feed animalfoods to children 6-24 months of age
50% of mothers and caregivers in programme areas feed age-appropriate quantity of diversified solid or semi-solid family food (atleast 4 food groups) at least once daily to 6-24 month old children
10% of additional mothers and caregivers wash their handsthoroughly with soap before food preparation and feeding of children6-24 months of age
50% family members and birth attendants prevent giving pre andpost lacteals within first 3 days after birth and continue exclusivebreastfeeding
At least 50% family planning workers are promoting LAM as acontraception method
8
2 BDHS 2007. However, the Multiple Indicator Cluster Survey 2009 indicates 50% early initiation rate
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
V. Barriers and FacilitatorsThe IYCF communication famework and plan focuses on four themeswith the greatest public health impact according to studies and surveysin Bangladesh and the region:
1) Timely initiation of breastfeeding immediately after birth and no pre-post lacteal foods
2) Exclusive breastfeeding through 6 months of age
3) Age-appropriate complementary feeding (quantity, quality,diversified foods and responsive feeding) for 6-24 month oldchildren
4) Handwashing thoroughly with soap linked to complementaryfeeding for 6-24 month old children (before preparing and feedingcomplementary foods)
Factors that facilitate the adoption of emphasis behaviours form the mainfocus of the communication plan. The following facilitating factors wereidentified through qualitative research methods such as observations,focus groups, in-depth interviews, semi-structured interviews and Trialsof Improved Practices (TIPs). This has helped to narrow down the focusof the plan on certain groups of individuals and effective channels ofcommunication for reaching them. It helped to formulate effectivemessages and strategies.
1) Timely initiation of breastfeeding immediately after birth and nopre-post lacteal foods
Key factors to facilitate adoption of behaviours:
- Mothers and family members learn about the importanceduring pregnancy or earlier
- At delivery, mothers receive support and help to place thenewborn on the breast for immediate breastfeeding
9
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
- Elder female family members support timely initiation ofbreastfeeding and no pre-post lacteal foods
- Reduction in unnecessary C-sections, and appropriate support,if C-section is essential
- Decisions made by family about timely initiation and no pre-lacteals during pregnancy
Main barriers: Poor understanding about adequacy of colostrum,danger of pre-post-lacteals and no skilled support given to mothers onposition, attachment, expression of breast milk and feeding of smallnewborns.
Exclusive breastfeeding through six months of age
Key factors to facilitate adoption of behaviours:
- Mothers' and family members' confidence in the sufficiency ofher milk for six months
- Mother knows how to assess if milk supply is sufficient and notinterpret infant's crying as a cue that BF is not sufficient(learning to take cues from infant correctly)
- Mother knows correct position and attachment skills so infantcan withdraw as much milk as s/he needs
- Mother knows how to prevent a decline in milk supply, how toincrease milk supply and how to manually express breastmilk
- Family members are supportive and husband does not bringbreastmilk substitutes
- Mother and family members know the dangers of breastmilksubstitutes (e.g. powdered milk) and use of bottle, nipples andpacifiers
- Health workers and 'village doctors' reassure, support and buildconfidence in mother's ability to EBF for six months; anddoctors do not recommend breastmilk substitutes
10
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
Main barriers: Perception of insufficient milk supply, lack of skills andstrategies to increase and maintain supply for six months, inadequatesupport from family and doctors/health workers.
Age-appropriate complementary feeding (quantity, quality, diversifiedfoods and responsive feeding) from 6-24 months
Key factors to facilitate adoption of behaviours:
- Mother's confidence that she can motivate her child to eat therequired amounts (e.g. responsive feeding, supervised self-feeding and learning to act on child's cues for ‘readiness to eat’)
- Mothers’ and family members' knowledge of quantities (volumeand consistency) of food required for normal development andgrowth
- Family members support and encourage mother to spend timeto feed child appropriately in sickness/when healthy
- Health workers (including 'village doctors') encourage mothersto feed young children appropriately
- Benefits that are of interest for mothers are reinforcedfrequently: 'develops child's brain' and 'protection fromillnesses', 'child likes to eat this way' and 'likes these foods';'convenient to feed child using family foods'
- Animal food encouraged by service providers and brought byhusband.
Main barriers: Perception of poor appetite among caregivers of children6-24 months, inadequate knowledge on amounts/consistency/diversity/use of animal foods, little support given to mothers for skills andstrategies to increase child's interest and ability to consume needed CF.
11
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
4) Hand washing thoroughly with soap before preparing foods andfeeding children 6-24 months
Key factors to facilitate adoption of behaviours:
- Availability of soap and water
- Supportive family members
- Role models
- Local leaders encourage this behavior
Main barriers: Inadequate understanding of dangers of contaminatedCF, few role models.
VI. Participant Groups forCommunicationParticipant groups (audiences) analysis is an important component fordesigning the communication plan. Primary participant group is the directbeneficiary in this communication. Secondary and tertiary participantgroups play the direct and the indirect role as influencers for primaryparticipant groups. Many times programmes design and implementinterventions for the primary participant groups and less emphasis isgiven on the secondary and tertiary groups. Communication activities,therefore, need to focus on the behaviours of those who need to practicethe desired behaviours e.g. mothers, but also those who directly andindirectly influence mothers/caregivers and others or enable them topractice the desired behaviours. Current thinking calls for activeparticipation also by secondary and tertiary participant groups rather thantreating them as passive audiences or recipients of information.
The main categories of participant groups (audiences) for IYCF are:
- Primary participant groups are usually pregnant women,mothers and caregivers of children <2 years of age.
12
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
Other care providers such as skilled birth attendants, who needto place the newborn on the mother’s breast immediately afterbirth, can also be primary participant groups.
- Secondary participant groups are usually husbands and olderfemale family members and service providers.
- Tertiary participant groups are community leaders andmanagers or those who can mobilize or allocate resources andare involved in making policies on various sectors. Thesesectors are health, education, food security and agriculture,livelihoods and poverty reduction, local government, genderequity and advancement of women, religious and educationalinstitutions, medical associations. Others are also included,e.g. who can influence primary or secondary participant groupsor who can remove barriers and create an enablingenvironment.
The following table describes the primary, secondary and tertiaryparticipant groups for each of the IYCF key behaviours.
13
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
14
Key
Beh
avio
ur
Tim
ely
initi
atio
n of
bre
astfe
edin
g im
med
iate
ly(w
ithin
one
ho
ur) a
fter b
irth
and
no p
re-p
ost
lact
eal f
oods
Excl
usiv
ebr
east
feed
ing
thro
ugh
6 m
onth
s of
age
Prim
ary
Part
icip
ant G
roup
s
Preg
nant
wom
en
Lact
atin
g m
othe
rs
Mot
hers
of 0
-6
mon
th o
ld in
fant
s
Seco
ndar
yPa
rtic
ipan
t Gro
ups
Skille
d bi
rth a
ttend
ants
Elde
r wom
en in
fam
ily
Elde
r wom
en in
fam
ilyH
usba
nds
Skille
d bi
rth a
ttend
ants
C
HW
sVi
llage
doc
tors
Hom
eopa
ths
Tert
iary
Par
ticip
ant G
roup
s
Empl
oyer
s of
wom
en, m
ater
nal a
nd
neon
atal
hea
lth e
xper
ts, g
over
nmen
t au
thor
ities
(nat
iona
l/dis
trict
/upa
zila
/ co
mm
unity
leve
ls),
loca
l ele
cted
bo
dies
, rel
igio
us le
ader
s, p
rivat
e do
ctor
s an
d pr
ofes
sion
al
asso
ciat
ions
, NG
Os
prov
idin
g m
ater
nal a
nd n
ewbo
rn h
ealth
car
e se
rvic
es
Seco
ndar
y le
vel h
ealth
car
e pr
ovid
ers,
go
vern
men
t aut
horit
ies,
pha
rmac
ists
, re
ligio
us le
ader
s, ro
le m
odel
s, e
lites
, in
fant
food
com
pani
es (t
o co
mpl
y w
ith
the
BMS
mar
ketin
g co
de),
NG
Os
prov
idin
g m
ater
nal a
nd n
ewbo
rn
heal
th c
are
serv
ices
, nat
iona
l and
di
stric
t dec
isio
n m
aker
s, lo
cal e
lect
ed
bodi
es, i
nflu
entia
ls, l
ocal
and
nat
iona
l m
edia
Tabl
e 1.
Prim
ary,
Sec
onda
ry a
nd T
ertia
ry P
artic
ipan
t Gro
ups
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
15
Key
Beh
avio
ur
Age-
appr
opria
teC
F (q
uant
ity,
qual
ity,
dive
rsifi
ed fo
ods
and
resp
onsi
ve
feed
ing)
from
6-
24 m
onth
s
Han
d w
ashi
ng
thor
ough
ly w
ith
soap
bef
ore
prep
arin
g an
d fe
edin
gco
mpl
emen
tary
food
s
Prim
ary
Parti
cipa
nt G
roup
s
Mot
hers
and
car
e gi
vers
of c
hild
ren
6-24
mon
ths
old
Mot
hers
and
car
e gi
vers
of c
hild
ren
6-24
mon
ths
old
Seco
ndar
yPa
rtic
ipan
t Gro
ups
Fath
ers
of c
hild
ren
Elde
r wom
en in
fam
ilySk
illed
birth
atte
ndan
ts
CH
Ws
Villa
ge d
octo
rs
Fath
ers
of c
hild
ren
Elde
r wom
en in
fam
ilySk
illed
birth
atte
ndan
ts
CH
Ws
Villa
ge d
octo
rs
Tert
iary
Par
ticip
ant G
roup
s
Seco
ndar
y le
vel h
ealth
car
e pr
ovid
ers,
go
vern
men
t aut
horit
ies,
pha
rmac
ists,
re
ligio
us le
ader
s, ro
le m
odel
s, e
lites,
in
fant
food
com
pani
es (t
o co
mpl
y wi
th th
e BM
S m
arke
ting
code
), NG
Os
prov
idin
g in
fant
and
new
born
hea
lth s
ervic
es,
natio
nal a
nd d
istric
t dec
ision
mak
ers,
lo
cal e
lect
ed b
odie
s, a
dole
scen
ts,
influ
entia
ls, lo
cal a
nd n
atio
nal m
edia
Seco
ndar
y le
vel h
ealth
car
e pr
ovid
ers,
go
vern
men
t aut
horit
ies,
pha
rmac
ists,
re
ligio
us le
ader
s, ro
le m
odel
s, e
lites,
in
fant
food
com
pani
es (t
o co
mpl
y wi
th th
e BM
S m
arke
ting
code
), NG
Os
prov
idin
g in
fant
and
new
born
hea
lth s
ervic
es,
natio
nal a
nd d
istric
t dec
ision
mak
ers,
lo
cal e
lect
ed b
odie
s, a
dole
scen
ts,
influ
entia
ls, lo
cal a
nd n
atio
nal m
edia
Tabl
e 1.
Prim
ary,
Sec
onda
ry a
nd T
ertia
ry P
artic
ipan
t Gro
ups
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
VII. Communication Channels andMediaMedia and channels of communication were identified through nationalsurveys and in-depth formative research. For mothers, direct andfrequent interpersonal communication will be conducted through trainedcommunity health volunteers (CHVs) and health workers or CHWsincluding 'village doctors' and skilled birth attendants. Simple practicalsolutions to address critical IYCF problems will be emphasized, e.g.position and attachment, how to express breastmilk, what and how muchto mix and feed of complementary foods in a responsive manner. Alsoincluded are how to assess and prevent insufficient milk and how toassess appetite problems and prevent poor appetite in children of 6-24months. CHVs and CHWs require not only practical hands-on trainingbut ongoing support and motivation through a 'PerformanceImprovement Cycle' that includes supportive supervision, monthlymeetings and reviews to discuss field difficulties, incentives/rewards/recognition, and accountability through monitoring data anddiscussion/feedback of monitoring results. The tools for generating goodperformance for IYCF support in communities on a sustained basis arebeing field tested.
Secondary and tertiary participant groups and women in urban areas canbe reached on a larger scale through electronic media. TV, in particular,has been found to penetrate almost all regions of Bangladesh. TV spotswill be aired e.g. through BTV, at prime time, drama serials and films andparticularly during major sports events and national holidays. 'Meena'films/spots/storybooks through BTV and other private channels, schools,mobile film units will have wide coverage. Journalist trainings andfellowships, news editor and director engagement, earned mediaoutreach, media champions, and TV debates will be used to target theopinion shapers - in order to create a supportive environment for IYCF.Other channels include tea stall sessions, courtyard meetings,community events such as Friday prayers, 'melas'/fairs; schoolmanagement committee meetings and adolescent group activities; adult
16
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
non-formal education learning centers; high school curriculum. Mobilephone 'hot lines' will be used for counselling and problem-solving (e.g.Grameenphone).
Special events and forums for medical professionals and medical/nursingcollege curricula have been identified as key for a sustainable strategy.Billboards, wall paintings, tin boards, digital boards, interactive theaters,mobile vans, film shows, school-based events etc. have also beenrecommended but in a selected and targeted way due to their limitedcoverage. As the communication campaign gets underway, the planinvolves monitoring and assessment of the effectiveness of eachchannel, reviewing results, and making adjustments as necessary.Throughout the implementation period, the media plan will be shaped formaximum reach and impact.
VIII. Key Messages Message development workshops with stakeholders and findings offormative research form the basis of key messages in this section(Table-2). Stakeholders worked together and agreed to use thesemessages in the interest of a harmonized national communication plan.
17
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
18
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 1
: Ti
mel
y in
itiat
ion
of b
reas
tfeed
ing
imm
edia
tely
afte
r birt
h (w
ithin
one
hou
r) an
d no
pre
-pos
tla
ctea
l foo
ds
Act
ion
Why
?W
ho?
Preg
nant
wom
en a
nd
lact
atin
gm
othe
rs
Oth
er fa
mily
m
embe
rs
Elde
r wom
en in
fam
ily
Skille
d bi
rth
atte
ndan
ts
M
othe
r’s m
ilk is
the
only
food
for t
he b
aby
An
y ot
her p
rodu
ct w
ill in
crea
se c
hanc
es o
f dea
th
and
diar
rhoe
a
The
soon
er y
ou p
ut th
e ba
by to
bre
ast t
he s
oone
r m
othe
r’s m
ilk w
ill flo
w
M
othe
r’s m
ilk is
the
only
food
for t
he b
aby
Any o
ther
pro
duct
will i
ncre
ase
chan
ces o
f dea
th a
nd
diarrh
oea
Th
e so
oner
you
put
the
baby
to b
reas
t the
soo
ner
mot
her’s
milk
will
flow
Re
mem
ber m
othe
r’s m
ilk is
the
only
food
for t
he b
aby
Ea
rly in
itiat
ion
can
save
the
baby
’s lif
e
Prog
ram
me
will
achi
eve
resu
lts in
redu
cing
ne
onat
al a
nd c
hild
mor
talit
y
Put y
our b
aby
to b
reas
t im
med
iate
ly a
fter b
irth
Hel
p to
put
the
baby
to th
e m
othe
r’s b
reas
t im
med
iate
ly a
fter
birth
Hel
p to
put
the
baby
to th
e m
othe
r’s b
reas
t im
med
iate
ly a
fter
birth
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
19
Who
?A
ctio
nW
hy?
Teac
hers
, Im
ams
M
othe
r’s m
ilk s
aves
a c
hild
’s lif
e
Hel
ps th
e ba
by to
be
inte
lligen
t
Mot
hers
’ milk
pro
tect
s th
e ba
by fr
om d
isea
sesd
Tell t
he m
othe
r, fa
ther
, gra
nd
pare
nts
to p
ut p
lace
the
baby
to
mot
her’s
bre
ast i
mm
edia
tely
afte
r bi
rthD
octo
r, nu
rse
and
med
ical
pr
ofes
sion
als
and
heal
th a
nd
fam
ily p
lann
ing
offic
ials
Yo
ur a
dvic
e an
d su
ppor
t can
sav
e a
child
’s lif
e
Prog
ram
me
will
achi
eve
resu
lts in
redu
cing
ne
onat
al a
nd c
hild
mor
talit
y
Hel
p th
e m
othe
r who
just
del
iver
ed
to p
ut th
e ba
by to
the
mot
her’s
br
east
In a
ll AN
C s
essi
ons,
ens
ure
early
in
itiat
ion
mes
sage
s ar
e gi
ven
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 1
: Ti
mel
y in
itiat
ion
of b
reas
tfeed
ing
imm
edia
tely
afte
r birt
h (w
ithin
one
hou
r) an
d no
pre
-pos
tla
ctea
l foo
ds
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
20
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 2
: Ex
clus
ive
brea
stfe
edin
g th
roug
h 6
mon
ths
of a
geW
ho?
Act
ion
Why
?M
othe
rs o
f 0- 6
m
onth
old
in
fant
s
Hus
band
s
Elde
r wom
en in
fa
mily
Serv
ice
prov
ider
s
N
early
all
mot
hers
can
bre
astfe
ed fo
r 6 m
onth
s.
Excl
usiv
e br
east
feed
ing
help
s th
e ch
ild’s
phys
ical
gr
owth
and
men
tal d
evel
opm
ent,
and
also
pr
even
ts d
iarrh
oea,
AR
I and
man
y ot
her i
llnes
ses
To
pre
vent
dia
rrhoe
a, A
RI
The
mor
e th
e ba
by s
ucks
, mor
e m
ilk w
ill be
pro
duce
d
Bo
ndin
g b
etw
een
mot
her a
nd c
hild
will
be s
trong
To
ens
ure
baby
is g
ettin
g pl
enty
of m
ilk
To e
nsur
e pr
otec
tion
of b
aby
and
plen
ty o
f milk
for
brai
n de
velo
pmen
t
So m
othe
rs c
an b
reas
tfeed
exc
lusi
vely
for 6
m
onth
s
Brea
stfe
ed e
xclu
sive
ly fo
r 6
mon
ths
(180
day
s), d
o no
t giv
e ev
en a
dro
p of
wat
er
Till
6 m
onth
s m
othe
rs’ m
ilk h
as
enou
gh w
ater
to s
atis
fy th
e th
irst
even
dur
ing
hot w
eath
er
Brea
stfe
ed fr
eque
ntly
whe
neve
r th
e ch
ild d
eman
ds a
t lea
st 8
-10
times
a d
ay
Prac
tice
prop
er a
ttach
men
t and
po
sitio
n
Supp
ort m
othe
rs to
spe
nd ti
me
and
EBF
for 6
mon
ths,
sha
re
hous
ehol
d ch
ores
Build
con
fiden
ce a
nd s
kills
in
mot
hers
Enco
urag
e hu
sban
ds a
nd m
othe
r in
law
s to
sup
port
mot
hers
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
21
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 2
: Ex
clus
ive
brea
stfe
edin
g th
roug
h 6
mon
ths
of a
geW
ho?
Act
ion
Why
?Vi
llage
doc
tors
Phar
mac
ists
Med
ical
prac
titio
ners
Nur
ses
Polic
y m
aker
s fro
m h
ealth
and
ot
her s
ecto
rs
For t
he b
enef
it of
you
r com
mun
ity’s
child
ren
To
avo
id b
reak
ing
the
law,
and
to a
void
tarn
ishi
ng
your
imag
e
Th
e ch
ildre
n of
the
natio
n w
ill be
hea
lthy
To
mai
ntai
n yo
ur e
thic
al s
tand
ards
, avo
id p
enal
ties
for v
iola
ting
the
Cod
e, a
nd p
reve
nt ta
rnis
hing
you
r im
age
C
hild
sur
viva
l goa
ls w
ill be
ach
ieve
d an
d th
e co
untry
’s ec
onom
y w
ill be
hel
ped
Supp
ort m
othe
rs in
EBF
for 6
m
onth
s by
bui
ldin
g co
nfid
ence
Do
not p
resc
ribe
or re
com
men
d BM
S or
oth
er fo
ods
befo
re 6
m
onth
s
Prov
ide
appr
opria
te s
uppo
rt w
hen
a br
east
feed
ing
mot
her n
eeds
he
lp
Do
not a
ccep
t gift
s an
d in
cent
ives
fro
m B
MS
com
pani
es, f
ollo
w o
ther
pr
ovis
ions
of n
atio
nal C
ode
of
mar
ketin
g fo
r BM
S
Giv
e pr
iorit
y to
IYC
F pr
ogra
mm
es
and
indi
cato
rs a
nd is
sue
Gov
ernm
ent O
rder
and
Circ
ular
s (e
.g. a
ll he
alth
wor
kers
com
ing
in
cont
act w
ith m
othe
rs) t
o su
ppor
t m
othe
rs
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
22
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 3
: A
ge-a
ppro
pria
te C
F (q
uant
ity, q
ualit
y, d
iver
sifie
d fo
ods
and
resp
onsi
ve fe
edin
g)fro
m 6
-24
mon
ths
Who
?A
ctio
nW
hy?
Mot
hers
and
ca
regi
vers
Fath
ers
of
child
ren
Eld
er w
omen
in
fam
ily
Hea
lth, f
amily
pl
anni
ng a
nd
nutri
tion
wor
kers
�Fo
r phy
sica
l gro
wth
and
men
tal d
evel
opm
ent
�Fa
mily
food
is im
med
iate
ly a
vaila
ble,
nou
rishi
ng
and
chea
p
�Li
quid
food
s fil
l up
stom
ach
only,
giv
e th
ick
solid
fo
ods
�C
hild
will
gro
w w
ell,
play
and
sle
ep w
ell.
Chi
ld w
ill
be s
afe
from
illn
ess,
and
chi
ld’s
bra
in w
ill d
evel
op
�Yo
ur c
hild
will
be
inte
llige
nt a
nd c
hild
will
like
it
�To
sup
port
mot
hers
and
rem
ind
them
how
to fe
ed
enou
gh o
f goo
d fo
od to
chi
ld
Sta
rt se
mi-s
olid
(not
liqu
id)
mas
hed
fam
ily fo
ods
twic
e a
day
afte
r 6 m
onth
s
Car
eful
ly s
elec
t app
ropr
iate
fam
ily
food
. No
need
of s
peci
al c
ooki
ng/
food
s
A ch
ild s
houl
d ea
t WH
O
reco
mm
ende
d am
ount
s of
CF
a da
y in
add
ition
to b
reas
tfeed
ing
Feed
one
pie
ce o
f mea
t or f
ish
or
egg
at le
ast o
nce
ever
y da
y
Sho
w m
othe
rs h
ow to
giv
e ag
e-ap
prop
riate
CF
(qua
ntity
and
ty
pes
of fo
ods)
and
how
to
impr
ove
appe
tite
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
23
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 3
: A
ge-a
ppro
pria
te C
F (q
uant
ity, q
ualit
y, d
iver
sifie
d fo
ods
and
resp
onsi
ve fe
edin
g)fro
m 6
-24
mon
ths
Who
?A
ctio
nW
hy?
Com
mun
ityhe
alth
wor
kers
(g
over
nmen
tan
d no
n-
gove
rnm
ent)
DP
EO
s
DE
Os
Rel
igio
usle
ader
sC
omm
unity
lead
ers
�To
fulfi
ll yo
ur jo
b re
spon
sibi
lity,
get
re
war
ds/re
cogn
ition
, res
pect
from
com
mun
ity.
�To
sup
port
mot
hers
for h
ealth
y ch
ildre
n
�
To b
enef
it co
mm
unity
with
hea
lthy
and
inte
llige
nt
child
ren,
to g
et e
xtra
resp
ect f
rom
the
com
mun
ity,
and
to g
et m
ore
inte
llige
nt c
hild
ren
in s
choo
l
�
To s
prea
d re
ligio
us m
essa
ges
abou
t BF
for 2
ye
ars
�
To d
emon
stra
te c
omm
itmen
t to
the
com
mun
ity b
y re
ligio
us le
ader
s an
d ot
her c
omm
unity
lead
ers
Iden
tify
6-24
mon
th c
hild
ren,
pr
ovid
e tim
ely
coun
selin
g/
dem
onst
ratio
n at
6, 9
, 12,
18
mon
th to
feed
app
ropr
iate
CF
Enc
oura
ge te
ache
rs to
talk
with
pa
rent
s ab
out i
mpo
rtanc
e of
CF
and
feed
ing
prac
tices
for b
rain
de
velo
pmen
t of c
hild
Pro
mot
e IY
CF
mes
sage
s du
ring
regu
lar a
nd s
peci
al p
raye
rs a
nd
cero
mon
ies,
and
mee
tings
with
th
e co
mm
unity
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
24
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 3
: A
ge-a
ppro
pria
te C
F (q
uant
ity, q
ualit
y, d
iver
sifie
d fo
ods
and
resp
onsi
ve fe
edin
g)fro
m 6
-24
mon
ths
Who
?A
ctio
nW
hy?
Bus
ines
spe
rson
s an
d C
EO
s
�
To e
nsur
e cu
rren
t and
futu
re p
rodu
ctiv
ity in
the
labo
ur fo
rce
�
Com
pani
es w
ill n
eed
to s
pend
less
mon
ey o
n he
alth
car
e an
d w
orke
rs w
ill b
e ha
ppie
r and
less
ab
sent
Pro
mot
e an
d pr
ovid
e su
ppor
t for
ap
prop
riate
CF
amon
g yo
ur
wor
kers
’ chi
ldre
n
Sec
. MO
H&
FW
Oth
er o
ffici
als
�
For b
enef
its o
f hea
lth a
nd a
dult
labo
ur p
rodu
ctiv
ity�
Age
-app
ropr
iate
CF
is c
ruci
al fo
r the
phy
sica
l gr
owth
and
men
tal d
evel
opm
ent o
f the
chi
ld
Req
uest
the
corp
orat
e se
ctor
to
star
t or e
nhan
ce C
SR
act
iviti
es o
n ap
prop
riate
CF
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
25
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 4
: Han
d w
ashi
ng th
orou
ghly
with
soa
p be
fore
pre
parin
g an
d fe
edin
g co
mpl
emen
tary
food
s
Who
?A
ctio
nW
hy?
Mot
hers
,ca
regi
vers
,fa
mily
mem
bers
Rel
igio
usle
ader
s,co
mm
unity
lead
ers
Uni
on P
aris
had
mem
bers
�
To k
eep
child
’s fo
od s
afe
from
illn
ess,
and
pre
vent
un
der-
nutri
tion
and
prot
ect b
rain
dev
elop
men
t
�
To p
rote
ct y
our c
hild
from
dia
rrho
ea a
nd d
ysen
tery
�
Bec
ause
you
r acc
epta
nce
will
incr
ease
in s
ocie
ty
for p
rote
ctin
g th
e m
ost v
ulne
rabl
e m
embe
rs
(you
ng c
hild
ren)
of t
he c
omm
unity
�
To im
prov
e co
mm
unity
hea
lth
�Be
caus
e m
ale
mem
bers
gat
her t
oget
her a
nd li
sten
to
you
and
they
can
sup
port
mot
hers
to k
eep
child
ren
safe
from
illn
ess
�
To d
emon
stra
te y
our c
omm
itmen
t to
the
com
mun
ity
Bef
ore
prep
arin
g fo
od a
nd b
efor
e fe
edin
g in
fant
s an
d yo
ung
child
ren
was
h bo
th h
ands
with
so
ap a
nd w
ater
Whe
n yo
ur c
hild
lear
ns to
eat
on
its o
wn
was
h hi
s/he
r han
ds w
ith
soap
and
wat
er
Dis
cuss
the
impo
rtanc
e of
ha
ndw
ashi
ng b
efor
e pr
epar
ing
and
feed
ing
child
ren
unde
r 2 in
re
gula
r wee
kly
pray
ers;
mee
tings
Dis
cuss
the
impo
rtanc
e of
ha
ndw
ashi
ng b
efor
e pr
epar
ing
and
feed
ing
child
ren
in d
iffer
ent
publ
ic a
war
enes
s pr
ogra
mm
es
Incl
ude
the
impo
rtanc
e of
ha
ndw
ashi
ng in
you
r mon
thly
m
eetin
g ag
enda
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
26
Tabl
e 2.
Key
Mes
sage
s fo
r Fou
r IYC
F B
ehav
iour
s
Key
Beh
avio
ur 4
: Han
d w
ashi
ng th
orou
ghly
with
soa
p be
fore
pre
parin
g an
d fe
edin
g co
mpl
emen
tary
food
s
Who
?A
ctio
nW
hy?
Loca
lG
over
nmen
tR
ural
Dev
elop
men
tM
inis
try
�
You
can
incr
ease
the
invo
lvem
ent o
f man
y co
mm
unity
lead
ers
to p
rote
ct y
oung
chi
ldre
n fro
m
illne
ss/m
alnu
tritio
n
�
To re
min
d m
embe
rs th
eir r
espo
nsib
ility
tow
ards
th
eir c
omm
uniti
es b
y en
cour
agin
g ha
ndw
ashi
ng
befo
re fe
edin
g yo
ung
child
ren
�
So
that
uni
on p
aris
hads
will
be
activ
e an
d ac
tiviti
es
will
mov
e fo
rwar
d to
pro
tect
you
ng c
hild
ren
from
ill
ness
and
mal
nutri
tion
�
To p
rote
ct c
hild
hea
lth a
nd n
utrit
ion
for t
he fu
ture
de
velo
pmen
t of t
he lo
cal c
omm
uniti
es
Issu
e G
over
nmen
t Ord
er a
nd
Circ
ular
s to
incl
ude
hand
was
hing
is
sue
in th
e m
onth
ly w
orkp
lan
of
Uni
on P
aris
had
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
IX. Implementation PlanInstitute of Public Health Nutrition of Directorate General of HealthServices, Ministry of Health and Family Welfare is the main coordinatingbody for the implementation of national IYCF strategy and itscommunication plan. The communication framework and plan isdesigned to be implemented in collaboration with partners in thegovernment, development organizations, NGOs and private sector. Thelist of stakeholders is presented in Table 3 below.
The implementation is planned as a concerted effort of variousstakeholders. Government will work together with donors, developmentpartners and other key entities to ensure a harmonized and unifiedimplementation approach. This will be done through ensuring allocationof resources, using a common logo and branding of the campaign.
The IYCF communication plan will be implemented in phases to cover allthe 64 districts. GOB with support of the several partner agencies isimplementing some components of IYCF communication interventions aspart of their maternal, neonatal and child health and nutritionprogrammes. Table 4 indicates the action plan with targets and timelineof activities.
27
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
28
Tim
ely
initi
atio
n of
br
east
feed
ing
imm
edia
tely
(with
in
one
hour
) afte
r birt
h an
d no
pre
-pos
t la
ctea
l foo
ds
Excl
usiv
e br
east
feed
ing
thro
ugh
6 m
onth
s of
ag
e
Age
-app
ropr
iate
CF
(qua
ntity
, qua
lity,
di
vers
ified
food
s an
d re
spon
sive
feed
ing)
fr
om 6
-24
mon
ths
Han
d w
ashi
ng
thor
ough
ly w
ith s
oap
befo
re p
repa
ring
and
feed
ing
com
plem
enta
ry
food
s
MO
HFW
-DG
FP, D
GH
S,
IPH
N, N
NP,
BN
NC
, BB
F
MO
I
MO
RA
MO
SW
MO
E-N
CTB
BPA
NN
F
Don
ors
and
deve
lopm
ent
partn
ers
: WH
O, U
NIC
EF
A&T,
USA
ID, G
TZ, D
FID
, C
IDA,
JIC
A, W
FP, F
AO
MO
HFW
-DG
FP, D
GH
S,
IPH
N, N
NP,
BN
NC
, BB
F
MO
I
MO
RA
MO
LGR
D
MO
SW
Min
istry
of H
ome
Affa
irs
MO
E-N
CTB
Don
ors
and
deve
lopm
ent
partn
ers
: WH
O, U
NIC
EF,
A
&T,
US
AID
, GTZ
, DFI
D,
CID
A, J
ICA
, WFP
, FA
O
MO
HFW
-DG
FP, D
GH
S,
IPH
N, N
NP,
BN
NC
MO
I
MO
RA
DG
-AE
MO
PM
E, D
G-D
PE
,D
G-B
NFE
MO
SW
MO
E-N
CTB
Don
ors
and
deve
lopm
ent
partn
ers
: WH
O, U
NIC
EF,
A
&T,
US
AID
, GTZ
, DFI
D,
CID
A, J
ICA
, WFP
, FA
O
MO
HFW
-DG
FP, D
GH
S,
IPH
N, N
NP,
BN
NC
Min
istry
of A
gric
ultu
re
MO
I
MO
RA
MO
LGR
D
MO
SW
MO
WC
A
Don
ors
and
deve
lopm
ent
partn
ers
: WH
O, U
NIC
EF,
A&T,
USA
ID, G
TZ, D
FID
, C
IDA,
JIC
A, W
FP, F
AO
Tabl
e 3.
Sta
keho
lder
s fo
r Nat
iona
l IYC
F C
omm
unic
atio
n Fr
amew
ork
and
Plan
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
29
Tim
ely
initi
atio
n of
br
east
feed
ing
imm
edia
tely
(with
in
one
hour
) afte
r birt
h an
d no
pre
-pos
t la
ctea
l foo
ds
Excl
usiv
e br
east
feed
ing
thro
ugh
6 m
onth
s of
ag
e
Age
-app
ropr
iate
CF
(qua
ntity
, qua
lity,
di
vers
ified
food
s an
d re
spon
sive
feed
ing)
fr
om 6
-24
mon
ths
Han
d w
ashi
ng
thor
ough
ly w
ith s
oap
befo
re p
repa
ring
and
feed
ing
com
plem
enta
ry
food
s
Med
ia P
artn
ers,
New
spap
ers,
BTV
, pr
ivat
e TV
and
Rad
io
Cha
nnel
s
All
NG
Os
wor
king
in
rela
ted
field
BP
S
OG
SB
All
Bab
y Fo
rmul
a M
aker
s
Med
ia P
artn
ers,
New
spap
ers,
BTV
, pr
ivat
e TV
and
Rad
io
Cha
nnel
s
Wom
en le
ader
s (M
P,
UC
,UP
-C)
DG
-TV,
Bet
ar
Ans
ar-V
DP
Shi
shu
Aca
dem
y
Med
ia P
artn
ers,
New
spap
ers,
BTV
, priv
ate
TV a
nd R
adio
Cha
nnel
s
Priv
ate
sect
or, s
oap
man
ufac
ture
rs
Isla
mic
Fou
ndat
ion
Pub
lic P
rivat
e P
artn
ersh
ip
NG
Os
& IN
GO
s: B
RA
C,
SC
F-U
SA
, SC
F-U
K,
Pla
n B
angl
ades
h, C
AR
E
Ban
glad
esh,
Con
cern
W
orld
wid
e an
d ot
hers
Tabl
e 3.
Sta
keho
lder
s fo
r Nat
iona
l IYC
F C
omm
unic
atio
n Fr
amew
ork
and
Plan
Med
ia P
artn
ers,
N
ewsp
aper
s, B
TV,
priv
ate
TV a
nd R
adio
C
hann
els
Em
ploy
ers,
Gar
men
ts
and
othe
rs
NN
F
BP
S
OG
SB
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
30
Tim
ely
initi
atio
n of
br
east
feed
ing
imm
edia
tely
(with
in
one
hour
) afte
r birt
h an
d no
pre
-pos
t la
ctea
l foo
ds
Excl
usiv
e br
east
feed
ing
thro
ugh
6 m
onth
s of
ag
e
Age
-app
ropr
iate
CF
(qua
ntity
, qua
lity,
di
vers
ified
food
s an
d re
spon
sive
feed
ing)
fr
om 6
-24
mon
ths
Han
d w
ashi
ng
thor
ough
ly w
ith s
oap
befo
re p
repa
ring
and
feed
ing
com
plem
enta
ry
food
s
BTR
C a
nd a
ll ot
her T
elco
an
d N
okia
NG
Os
& IN
GO
s: B
RA
C,
SC
F-U
SA
, SC
F-U
K,
Pla
n B
angl
ades
h, C
AR
E
Ban
glad
esh,
Con
cern
W
orld
wid
e an
d ot
hers
BPA
NG
Os
& IN
GO
s: B
RA
C,
SC
F-U
SA
, SC
F-U
K,
Pla
n B
angl
ades
h, C
AR
E
Ban
glad
esh,
Con
cern
W
orld
wid
e an
d ot
hers
All
Bab
y Fo
rmul
a M
aker
s
Gra
mee
npho
ne, t
elec
om
com
pani
es
BPA
NG
Os
& IN
GO
s: B
RA
C,
SC
F-U
SA
, SC
F-U
K,
Pla
n B
angl
ades
h, C
AR
E
Ban
glad
esh,
Con
cern
W
orld
wid
e an
d ot
hers
Priv
ate
sect
or, f
ood
com
pani
es a
nd te
leco
me
NG
Os
& IN
GO
s: B
RA
C,
SC
F-U
SA
, SC
F-U
K,
Pla
n B
angl
ades
h, C
AR
E
Ban
glad
esh,
Con
cern
W
orld
wid
e an
d ot
hers
Tabl
e 3.
Sta
keho
lder
s fo
r Nat
iona
l IYC
F C
omm
unic
atio
n Fr
amew
ork
and
Plan
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
31
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
Rev
iew
exi
stin
g tra
inin
g an
d ot
her m
ater
ials
and
in
corp
orat
e va
rious
IY
CF
rela
ted
com
mun
icat
ion
cont
ent
for d
iffer
ent p
artic
ipan
t gr
oups
Trai
ning
and
orie
ntat
ion
of g
over
nmen
t, N
GO
, pr
ivat
e co
mm
unity
w
orke
rs, s
ervi
ce
prov
ider
s an
d sk
illed
bi
rth a
ttend
ants
on
incl
udin
g co
unse
ling
hom
e vi
sits
, cou
rtyar
d se
ssio
nsO
rient
atio
n of
vill
age
doct
ors
and
phar
mac
ists
BF
(EI,
EB
F),
CF,
HW
CF
BF
(EI,
EB
F),
CF,
HW
CF
BF
(EI,
EB
F),
CF,
HW
CF
DG
HS
, IP
HN
, U
NIC
EF,
DG
FP,
NN
P, B
BF,
S
CF-
US
A,
US
AID
, BR
AC
, A
&T,
oth
er
NG
Os
IPH
N, U
NIC
EF,
N
IPO
RT,
BH
E,
IEM
, NN
P, B
BF,
S
CF-
US
A,
BR
AC
, A&
T,
US
AID
IPH
N, U
NIC
EF,
IE
M, B
HE
, B
RA
C, A
&T
11. 2. 3.
23
41
23
4X
XX
XX
X
XX
XX
XX
XX
XX
XX
XX
X
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
40 dist
ricts
40 dist
ricts
40 dist
ricts
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
32
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
Orie
ntat
ion
of re
ligio
us
lead
ers
for
diss
emin
atio
n of
IYC
F m
essa
ges
durin
g re
ligio
us o
ccas
ions
and
w
eekl
y pr
ayer
sH
ealth
and
fam
ily
plan
ning
pro
gram
mes
im
plem
ent c
ouns
elin
g (w
ith d
emon
stra
tion)
am
ong
preg
nant
w
omen
and
mot
hers
an
d fa
mili
es th
roug
h ho
me
visi
tsTV
spo
ts a
t prim
e tim
e an
d m
obile
film
sho
ws
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
40 d
istric
ts
40 d
istric
ts
3 at
leas
t ai
red
natio
nally
14. 5. 6.
23
41
23
4
XX
XX
XX
X
XX
XX
XX
XX
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
IPH
N, U
NIC
EF,
IE
M, B
RA
C,
A&
T
IPH
N, U
NIC
EF,
IE
M, B
HE
, NN
P,
BB
F, S
CF-
US
A,
BR
AC
, A&
T,
Pla
nB
angl
ades
h,U
SA
ID, a
nd
othe
r NG
Os
IPH
N, A
&T,
MO
I, U
SA
ID
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
33
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
Rad
io s
pots
for n
atio
nal
and
Com
mun
ity R
adio
Visu
al re
min
der I
EC
m
ater
ials
or j
ob a
ids
for
heal
th p
rovi
ders
and
co
mm
unity
wor
kers
Mee
na p
rodu
ctio
n an
d vi
ewin
g of
ani
mat
ed
film
s
Tea
stal
l vie
win
g of
TV
Cs
and
docu
men
tarie
s in
DV
D
play
ers,
foru
ms
for
mot
her,
fath
er, m
othe
r in
law
and
com
mun
ity
peop
le
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
3 at
leas
t ai
red
natio
nally
As n
eede
d
3 ai
red
natio
nally
40 d
istric
ts
17. 8. 9. 10
.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
X
A&
T, U
NIC
EF,
M
OI
IPH
N, U
NIC
EF,
A
&T,
US
AID
, N
GO
s
UN
ICE
F, A
&T
and
DM
C
IPH
N, U
NIC
EF,
IE
M, B
HE
, NN
P,
BR
AC
, A&
T,
NG
Os
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
34
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
At le
ast 8
ep
isode
san
nual
ly
At le
ast 2
As n
eede
d
IPH
N, M
OI,
Plan
Ban
glad
esh,
US
AID
IPH
N, U
NIC
EF,
DM
C, P
IB, A
&T
CM
ES
, BR
AC
, A
&T,
oth
er
NG
Os
111
.
12.
13.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
X
XX
XX
X
XX
XX
XX
X
Tele
visi
on p
rogr
amm
e on
ce a
wee
k ta
rget
ed
tow
ards
ado
lesc
ents
an
d yo
ung
mot
hers
and
fa
mili
es
Laun
ch o
f co
mm
unic
atio
nca
mpa
ign
for p
ublic
an
d pr
ivat
e se
ctor
, pr
ess
brie
fing
of
Jour
nalis
ts, s
ucce
ss
stor
ies
diss
emin
ated
an
d re
peat
ed
Bui
ld c
apac
ity o
f ad
oles
cent
net
wor
ks fo
r so
cial
act
ion
initi
ativ
e
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
35
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
Sch
ool/c
olle
ge d
ebat
es
and
quiz
pro
gram
mes
Adv
ocac
y m
eetin
g in
7
divi
sion
s w
ith d
iffer
ent
sect
ors
of G
OB
, NG
O,
priv
ate
sect
or a
nd lo
cal
Mem
bers
of P
arlia
men
t an
d in
fluen
tials
Inte
ract
ive
dram
a se
rials
on
radi
o an
d TV
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
At le
ast 5
pe
r yea
r
Annu
ally
in
7 Di
visio
ns
13 episo
des
114
.
15.
16.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
XIP
HN
, UN
ICE
F,
IEM
, BH
E,
Sec
onda
ryE
duca
tion,
SC
F-U
SA
,U
SA
ID, B
RA
C,
A&
T, o
ther
N
GO
s
IPH
N, U
NIC
EF,
A
&T,
BR
AC
, ot
her
impl
emen
ting
partn
ers
IPH
N, U
NIC
EF,
M
OI
XX
XX
XX
XX
XX
XX
X
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
36
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
BF (E
I, EB
F),
CF,
HW
CF
BF (E
I, EB
F),
CF,
HW
CF
BF (E
I, EB
F),
CF,
HW
CF
As need
ed
2 pe
r yea
r
At le
ast 3
pe
r yea
r
IPH
N, U
NIC
EF,
A
&T
and
othe
rs
IPH
N, U
NIC
EF,
A
&T,
oth
er
impl
emen
ting
partn
ers
IPH
N, U
NIC
EF,
A
&T,
oth
er
impl
emen
ting
partn
ers
117
.
18.
19.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
XX
XX
X
XX
XX
XX
XX
Dev
elop
and
pro
duce
co
mm
unic
atio
ngu
idel
ines
, mod
ules
an
d m
ater
ials
, as
requ
ired
Nat
iona
l con
sulta
tions
fo
r tec
hnic
al, p
olic
y an
d pr
ogra
mm
e up
date
s
Adv
ocac
y m
eetin
gs
with
GO
B, d
onor
s,
partn
ers
and
othe
r in
fluen
tial g
roup
s su
ch
as p
arlia
men
taria
ns,
med
ia p
erso
nnel
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
37
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
IYC
F tra
inin
g an
d m
edia
en
gage
men
t pro
gram
me
for n
atio
nal h
ealth
and
ot
her j
ourn
alis
ts, e
dito
rs
and
new
s di
rect
ors
and
upda
tes
Arti
cles
pub
lishe
d in
m
ost w
ell c
ircul
ated
na
tiona
l and
regi
onal
da
ilies
Adv
ocac
y an
alys
is
(Pro
files
) act
iviti
es/
even
ts a
nd m
ater
ials
in
colla
bora
tion
with
m
edia
e.g
. Wor
ld
Bre
astfe
edin
g W
eek,
H
andw
ashi
ng W
eek
and
othe
r eve
nts
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
IPH
N, U
NIC
EF,
A
&T
and
US
AID
IPH
N, A
&T
IPH
N, A
&T,
U
NIC
EF,
US
AID
(F
AN
TA 2
), ot
her
impl
emen
ting
partn
ers
120
.
21.
22.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
4 wor
ksho
ps
per y
ear
At le
ast
8 pe
r yea
r
At le
ast 4
ac
tiviti
esan
d 2
mat
eria
lspe
r yea
r
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
XX
X
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
38
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
Incl
usio
n of
IYC
F co
nten
t in
non-
form
al
and
form
al s
choo
l ed
ucat
ion
curr
icul
um
and
orie
ntat
ion
of
faci
litat
ors
Wor
ksho
p fo
r M
essa
ges
and
mat
eria
ls d
evel
opm
ent,
revi
ew a
nd u
pdat
ing
Wor
ksho
ps a
nd fo
llow
up
for p
re-s
ervi
ce
train
ing
in m
edic
al a
nd
nurs
ing
colle
ges
Orie
ntat
ion
of u
nion
/ up
azila
par
isha
ds/lo
cal
lead
ers
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
BF (E
I, EB
F),
CF, H
WCF
2 se
ts o
f m
ater
ials
At l
east
1
per y
ear
At l
east
2 To
T
per y
ear
In 4
0 fo
cus
dist
ricts
IPH
N, N
CTB
, B
NFE
, A&
T,
UN
ICE
F,
IPH
N, U
NIC
EF,
A
&T
IPH
N,
Con
tinuo
usM
edic
alEd
ucat
ion
BPA,
N
NF,
OG
SB, A
&T
IPH
N, U
NIC
EF,
N
GO
s, M
in.
Loca
l Gov
t.,
BR
AC
, A&
T
123
.
24.
25.
26.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
XX
XX
X
XX
XX
XX
X
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
39
SN
Act
iviti
es
Key
Ta
rget
s R
espo
nsib
ilitie
s 20
10
2011
20
12 2
013
beha
viou
rs
Form
ativ
e re
sear
ch,
test
ing,
mon
itorin
g,
lear
ning
and
ev
alua
tion:
bas
elin
e su
rvey
s, m
onito
ring
and
qual
ity
asse
ssm
ents
, ana
lysi
s an
d re
view
/revi
sion
, qu
alita
tive
stud
ies
Rev
iew
of
com
mun
icat
ion
fram
ewor
k an
d pl
an
Mon
itorin
g, le
arni
ng
and
eval
uatio
n:
base
line
surv
eys,
m
onito
ring
and
qual
ity
asse
ssm
ents
, ana
lysi
s an
d re
view
/revi
sion
BF (E
I, EB
F),
CF,
HW
CF
BF (E
I, EB
F),
CF,
HW
CF
BF (E
I, EB
F),
CF,
HW
CF
In a
t lea
st
10 f
ocus
di
stric
ts
In fo
cus
dist
ricts
IPH
N, U
NIC
EF,
A
&T,
IFP
RI,
othe
r NG
Os
IPH
N, A
&T,
U
NIC
EF
IPH
N, A
&T,
U
NIC
EF,
NG
Os
127
.
28.
29.
23
41
23
4
Tabl
e 4.
Act
ion
Plan
for I
mpl
emen
tatio
n of
Com
mun
icat
ion
Act
iviti
es
XX
XX
XX
XX
XX
XX
XX
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
X. Monitoring and EvaluationIndicators for IYCF Communication The achievement of this communication plan will depend on thefollowing processes that will be carefully monitored:
effective planning and timely implementation of activities;
use of a common, harmonized set of messages and approaches byvarious stakeholders covering all parts of the country for a sustainedperiod of time;
development and production of appropriate communication materialsfor different participant groups and channels;
use of mass media and IPC materials through multiple channels toachieve adequate intensity and saturation with key messages; and
an effective monitoring and evaluation plan and use of results forcontinuous fine-tuning of the strategy until changes in behaviour aredocumented.
The monitoring and evaluation plan for communication should be part ofthe total M&E plan for the IYCF programme. Government, stakeholdersand partners will jointly monitor the implementation of the IYCFprogramme. The IYCF programme will build the capacity of communities,service providers and project managers at all levels to collect,synthesize, analyze and use data for making decisions about how toimprove the impact on behaviours through better reach/coverage,greater intensity, more channels, better comprehension, andtiming/targeting of the communication activities. Reports on theprocesses and outputs will be routinely discussed at national and districtlevels. A series of studies may be undertaken on various aspects of theplan including a post line study on KAP of IYCF to be conducted at theend of the campaign.
The monitoring and evaluation framework presented in Table 5 will befurther developed and finalised through a workshop.
40
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
41
Table 5. Monitoring and Evaluation Indicators for IYCF CommunicationActivities
By the end of 2013,
Mothers initiated breastfeedingimmediately (within 1 hour) ofbirth increased from 50% to 65%
At least 65% of birth attendants(SBA/TBA/midwife/familymember) reached through IYCFinitiative in programme areas putnewborns to mothers' breastimmediately (within 1 hour) ofbirth and no pre-post lactealfoods
At least 50% of service providersinvolved in ANC/PNC/FP/IMCI/ENC/EPI in programme areaspromote putting newborns tomothers' breast immediately(within 1 hour) of birth and nopre-post lacteal foods
Optional:
At least 30% of religious leaderscoming in contact with pregnantwomen or their families activelypromote early initiation of BF andno pre-lacteals in programmeareas during their regular andspecial prayers and ceremonies
At least 50% of family planningworkers promoting LAM as acontraceptive method inprogramme areas
Key Behaviour 1 - Timely initiation of breastfeeding immediately afterbirth and no pre-post lacteal foods
% of newborns who were put tothe breast within 1 hour of birth
% of birth attendants (SBA/TBA/midwife/family member) putnewborns to mothers' breastwithin 1 hour of birth
% of service providers involvedin ANC/PNC/FP/IMCI/ENC/EPIput newborns to mothers' breastwithin 1 hour of birth and notgiving pre-lacteal foods
Optional:
% of religious leaders, coming incontact with pregnant women ortheir families who activelypromote early initiation and nopre-lacteals
% of family planning workerswho promote LAM as acontraceptive method
Communication Objectives Monitoring & Evaluation Indicators
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
42
By the end of 2013,
Mothers exclusively breastfeedingtheir infants 0-6 months of ageincreased from 43% to 60% inprogramme areas
At least 50% of communitieshave trained CHWs orvolunteers support mothers toexclusively breastfeed for 6months (including position,attachment, how to expressbreastmilk and how to assessand maintain milk supply, anddangers of BMS) in programmeareas
Optional:
At least 25% of communitieshave more than one communityleader or adolescent sensitizedand promotes exclusivebreastfeeding for 6 months anddiscourages BMS among familymembers in programme areas
Key Behaviour 2 - Exclusive breastfeeding through six months of age
% of mothers who areexclusively breastfeeding theirinfants 0-6 months of age
% of communities with trainedCHWs or volunteers who supportmothers to exclusivelybreastfeed for 6 months(including position, attachment,how to express breastmilk andhow to assess and maintain milksupply, and dangers of BMS)
Optional:
% of communities with morethan one community leader oradolescent who promotesexclusive breastfeeding for 6months and discourages BMSamong family members
Communication Objectives Monitoring & Evaluation Indicators
Table 5. Monitoring and Evaluation Indicators for IYCF CommunicationActivities
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
43
Table 5. Monitoring and Evaluation Indicators for IYCF CommunicationActivities
By the end of 2013,
At least 50% of mothers andcaregivers of 6-24 months of ageare consuming age-appropriatequantity of diversified (at least 4food groups) semi-solid or solidfamily foods in programme areas
At least 50% of communitieshave trained CHWs orvolunteers who support mothersto feed age-appropriate quantityof diversified (at least 4 foodgroups) semi-solid or solid familyfoods to children 6-24 months ofage in programme areas
An additional 10% of mothersand caregivers of 6-24 months ofage feed animal foods at leastonce daily in programme areas
Optional:
At least 50% of service providerssupport mothers to feed ageappropriate quantity of diversified(at least 4 food groups) semi-solid or solid family foods tochildren 6-24 months of age inprogramme areas
At least 50% of communities havemore than one community groupsor leaders or adolescents who aresensitized and promote feeding ofage-appropriate quantity ofdiversified (at least 4 food groups)semi-solid or solid family foods tochildren 6-24 months of age inprogramme areas
Key Behaviour 3 - Age appropriate complementary feeding (quantity,quality, diversified foods and responsive feeding) for children 6-24 months
% of children 6-24 months ofage who are consuming age-appropriate quantity of diversified(at least 4 food groups) semi-solid or solid family foods
% of communities that havetrained CHWs or volunteers whosupport mothers to feed age-appropriate quantity of diversified(at least 4 food groups) semi-solid or solid family foods tochildren 6-24 months of age
% of children 6-24 months ofage who are consuming animalfoods at least once daily
Optional:% of service providers whosupport mothers to feed age-appropriate quantity of diversified(at least 4 food groups) semi-solid or solid family foods tochildren 6-24 months of age
% of communities that havemore than one community leaderor adolescent promoting feedingof age-appropriate quantity ofdiversified (at least 4 foodgroups) semi-solid or solid familyfoods to children 6-24 months ofage
Communication Objective Monitoring & Evaluation Indicators
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
44
By the end of 2013,
An additional 10% of mothersand caregivers wash their handsthoroughly with soap before foodpreparation and feeding ofchildren 6-24 months of age inprogramme areas
Handwashing linked tocomplementary feedingaddressed in national hygienepromotion strategy and actionplans
Optional:
An additional 10% of householdsprocure and make handwashingmaterials (soap and water)available to mothers andcaregivers who prepare food andfeed children 6-24 months of agein programme areas
At least 3 soap manufacturersinclude handwashing linked tofeeding of young children inadvertising messages for soap
Key Behaviour 4 - Handwashing thoroughly with soap before preparingcomplementary foods and feeding complementary food
% of mothers and caregiverswho wash their hands thoroughlywith soap before foodpreparation and feeding ofchildren 6-24 months of age
Whether handwashing linked tocomplementary feeding isaddressed in national hygienepromotion strategy and actionplans
Optional:
% of households that procureand make handwashingmaterials (soap and water)available to mothers andcaregivers who prepare food andfeed children 6-24 months of age
Number of soap manufacturersthat include handwashing linkedto feeding of young children inadvertising messages for soap
Communication Objective Monitoring & Evaluation Indicators
Table 5. Monitoring and Evaluation Indicators for IYCF CommunicationActivities
Co
mm
un
ica
tio
n F
ram
ew
ork
an
d P
lan
fo
r In
fan
t a
nd
Yo
un
g C
hil
d F
ee
din
g
45
1. Professor Dr. Shah Monir Hossain, Director General of HealthServices
2. Professor Dr. M.Q.K. Talukder3. Professor Dr.T.A. Chowdhury4. Professor Dr. Syeda Afroza5. Directorate General of Family Planning6. Directorate General of Health Services7. Institute of Public Health Nutrition, DGHS8. Bureau of Health Education, DGHS9. National Nutrition Program, MOHFW10. Dhaka Shishu Hospital11. Bangladesh Breastfeeding Foundation 12. Dhaka Dental College & Hospital13. Directorate of Primary Education, MOPME14. Bureau of Non Formal Education, MOPME15. National Curriculum and Text Book Board, MOE16. Bangladesh Betar17. Bangladesh Television18. UNICEF19. United States Agency for International Development (USAID)20. Alive and Thrive21. BRAC22. AED/FANTA23. CARE Bangladesh24. Concern Worldwide25. Centre for Woman and Children Health 26. Helen Keller International27. International Centre for Diarrhoeal Disease Research, Bangladesh28. Plan Bangladesh29. Save the Children-USA30. Action Contre la Faim31. ASIATIC JWT32. Dhanshiri Communication
Name of individual participants and oganisations contributed indevelopment of Communication Framework and Plan for Infant andYoung Child Feeding (2010 - 2013)
N
Developed and Published by : Institute of Public Health Nutrition (IPHN) Directorate General of Health Services Ministry of Health and Family Welfare, Bangladesh
Supported by: UNICEF and Alive & Thrive, Bangladesh
October 2010
For more information contact:Director, IPHN &Line Director, MicronutrientsDirectorate General of Health ServicesMinistry of Health and Family WelfareTelephone : (88-02) 8821361e-mail: [email protected]
Photo Credit : UNICEF/Shehzad Noorani
