Malnutrition among pregnant women and young children is a major public health concern in Bangladesh — 5.5 million children under 5 years of age are chronically malnourished. To improve the dietary practices of mothers and reduce undernutrition among children under 2 years of age, the SHIKHA project scaled up maternal nutrition and infant and young child feeding interventions in southern Bangladesh.

FHI 360 implemented this three-year, community-centered project in partnership with BRAC; the Centre for Injury Prevention and Research, Bangladesh; and Asiatic Marketing and Communication Limited. The project was funded by the U.S. Agency for International Development under the Feed the Future initiative. The name SHIKHA was inspired by the Bangla term, “shisukekhawano,” which means infant and young child feeding.

To accomplish their goal of changing feeding practice behaviors, the SHIKHA team managed several project components.

Home visits. SHIKHA established a home-visit schedule of five visits per pregnant woman and 12 visits per child under 2. Government frontline workers provided the mothers of the children with infant and young child feeding counseling, coaching, demonstrations, problem-solving lessons and referrals. Pregnant women also received counseling on the importance of a diverse diet as described on the Food Plate, a plastic plate with images of nutritious food types and proportions that was developed by the SHIKHA team and endorsed by the Bangladesh government for this project and other nutrition efforts.

• Result: SHIKHA enrolled 468,351 pregnant women and 1,005,946 children under 2 during these home visits.
• Result: The project produced 18,500 copies of the Food Plate and distributed them to staff and frontline workers.

Health forums. Frontline workers organized and delivered health forums in village courtyards, where mothers of children under 2 discussed child health and feeding practices, diverse diets during pregnancy and hygiene.

• Result: The health forums reached a total of 711,393 pregnant women, adolescents and mothers of children under 2.

Social mobilization sessions. Field workers organized group meetings at the community level for influential members of society, fathers and other community members to raise awareness of maternal and child nutrition, maternal diet, infant and young child feeding, and hygiene. Workers also sought the commitment of influential community members to take action in support of these issues.

• Result: The project provided 40,378 influential members of society with information and orientation to support the project’s messages in their communities.

Mass media and special events. The SHIKHA team conducted mass media outreach in villages where electronic media is not available (known as media-dark areas). These were special communication events to make community members, including mothers of children under 2, more aware of four high-impact behaviors: early initiation of breastfeeding, exclusive breastfeeding, complementary feeding and handwashing.

• Result: SHIKHA conducted 7,520 mass media shows in 2,400 media-dark villages, reaching 1,190,353 participants.

By the end of the project, the SHIKHA team demonstrated that comprehensive behavior change communication is essential to improving nutrition outcomes and that infant and young child feeding interventions are feasible and can produce positive results. Going forward, local governments in Bangladesh will review data regularly and use the Food Plate model and the frontline workers training to continue progress beyond the project’s end.

Read the final report for more details.

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Photo credit: FHI 360