Learning from the Implementation of the Child Nutrition Program: A Mixed Methods Evaluation of Process
Emily DeLacey,
Cally Tann,
Tracey Smythe,
Nora Groce,
Michael Quiring,
Elizabeth Allen,
Maijargal Gombo,
Merzel Demasu-ay,
Batbayar Ochirbat,
Marko Kerac
Affiliations
Emily DeLacey
Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK
Cally Tann
Centre for Maternal, Adolescent, Reproductive & Child Health (MARCH), London School of Hygiene & Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK
Tracey Smythe
Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK
Nora Groce
UCL International Disability Research Centre, Department of Epidemiology and Healthcare, University College London, 1-19 Torrington Place, London WC1E 6BT, UK
Michael Quiring
Holt International, 250 Country Club Rd, Eugene, OR 97401, USA
Elizabeth Allen
Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK
Maijargal Gombo
Holt International Representative Office in Mongolia, Chinggis Avenue Mongol TV Tower 905, Sukhbaatar District 1st Khoroo, Ulaanbaatar 14251, Mongolia
Merzel Demasu-ay
Kaisahang Buhay Foundation, Inc., 1109 10th Ave, Quezon City 1109, Metro Manila, Philippines
Batbayar Ochirbat
Health Minister’s Office, Ministry of Health, Ulaanbaatar 15160, Mongolia
Marko Kerac
Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, University of London, Keppel Street, London WC1E 7HT, UK
Nutrition and feeding interventions are important for children’s growth and development. Holt International’s Child Nutrition Program (CNP) is a child nutrition and feeding intervention. This study aims to describe and explore the implementation of CNP in Mongolia and the Philippines using mixed methods including qualitative and quantitative data analysis. The analysis framework was guided by the WHO’s Monitoring the Building Blocks of Health Systems. Key informant interviews (KIIs) were conducted, transcribed, translated and coded. Knowledge, Attitude and Practice Surveys (KAPS) and pre-/post-tests from routine program audit data were analyzed. Analysis of nutrition (Mongolia: 95% CI: 7.5-16.6 (p = p= p = p = < 0.0001)) tests indicate improvement post-training in both countries. KAPS indicate changes in desired practices from pre-training to post-training. Thematic analysis of KIIs highlight essential components for program implementation and effectiveness, including strong leadership, buy-in, secure funding, reliable supply chains, training and adequate staffing. This evaluation of program implementation highlights successful strategies and challenges in implementing CNP to improve the health of children in Mongolia and the Philippines. Lessons learned from the implementation of CNP can inform growth of the program, scaling strategies and provide insights for similar interventions.
