Evaluation of the Improved Feeding Practices for the First 1000 Days Project in Ghana

Abstract

Background Sub-optimal nutrition during the first 1000 days of life can impair the physical and cognitive development of children, as well as limit their health and wellbeing. The improved feeding practices for the first 1,000 days (IFP) project aimed to improve the dietary practices of women of reproductive age (pregnant and lactating) and children below ages two years in three selected districts (Kassena-Nankana West [KNW], Sekyere East[SE], and Kintampo South[KS]) in Ghana. This integrated project combined interventions on micronutrient powder (MNP) distribution, social behaviour-change communication, and nutrition-sensitive agriculture to catalyse enhanced awareness and consumption of nutrient-rich foods in selected communities. Objective This paper evaluates the IFP project based on measures associated with relevance, effectiveness, impact, and sustainability. Methods Using a mixed-methods design, data from in-depth interviews of project beneficiaries, and key community-based actors involved in the project’s implementation were triangulated with routine project monitoring data, and documentation to answer the evaluation questions. The evaluation questions and our analyses were guided by the Development Assistance Committee evaluation criteria. Interviews with key stakeholders were conducted in June 2023. Key project data were compared between baseline and endline assessments to ascertain the extent to which the project met its intended objectives and targets. Results The project demonstrated high relevance of the proposed project among the target groups; for example, nearly half the children were eating low quality, non-diverse diets (49% in KNW, 46% in KS and 35 in SE). The project enabled almost 14,000 children to be reached with MNP. While 96,000 eggs were produced, <10% was consumed at home. About 35,000 kilograms of orange-fleshed sweet potatoes (OFSP) were produced, resulting in improved access to the nutrient-rich foods produced. Nutrition messages were disseminated widely and were reported to have contributed to improved awareness of nutrition among caregivers. Data-based and reported evidence both indicated there was improved child dietary diversity between baseline and endline of the project; in KNW, 90% of children met minimum dietary diversity at endline compared to 75% at baseline. In KS and SE, the endline estimates of dietary diversity were 71% and 70%, up from 65% in both districts at baseline, respectively. Multiple strategies aiming to support project sustainability that were built into the project design were implemented. Additional sustainability strategies evolved during the project’s lifetime, including crossbreeding of project chickens with hardier local breeds, continued multiplication of OFSP vines, and transfer of Village Savings and Loans Association funds accumulated from MNP sale to Village-Based Entrepreneurs to sustain MNP supply. Conclusions IFP project delivered interventions successfully, leading to improved awareness and practices related to diets of women in reproductive age and young children, in project communities. These strategies can be extended to women and children living in similar settings to improve the diet quality of women and children.

Keywords

• Evaluation
• Diet
• Nutrition-Sensitive
• Intervention
• Children
• Women