Development and Testing of Responsive Feeding Counseling Cards in Ghana (OR03-07-19)

Abstract

Abstract Objectives The United Nations Children Fund (UNICEF) Community based Infant and Young Child Feeding (IYCF) counselling package currently lacks comprehensive responsive feeding curriculum, thus limiting dissemination of these messages within IYCF counselling. Thus, project objectives were to: a) develop counselling cards based on recent evidence-based responsive feeding guidelines and b) test their feasibility in Ghana. Methods Five counselling cards were developed addressing the responsive feeding topics of: enjoying eating with family; hunger/satiety cues; introducing new foods; food texture as a function of child development; soothing a child. The UNICEF image bank was used to develop counselling cards with images compatible with the UNICEF Community based IYCF counselling package. Two peri-urban focus groups (FG) were conducted with Ghanaian mothers (N = 7) and fathers (N = 6) of children < 3 years to assess the cultural appropriateness of the cards. Card revisions were made and re-tested in two rural FGs with the same target audience (N = 10 mothers; N = 4 fathers). Feasibility of including the cards as part of IYCF counselling was tested via: a) in-depth interviews with health care providers providing IYCF training and/or education (N = 14) and b) systematically observing eight educational sessions utilizing the cards with Ghanaian mothers (N = 20) and fathers (N = 18) of children < 3 years. Results FG findings led to changes to card images for each topic to ensure they were culturally and health literacy appropriate. Educational session findings strongly suggest the counselling cards provide important responsive feeding messages that are specific, clear, and feasible for mothers and fathers of children < 3 years to implement. Health care providers strongly endorsed the need for and utility of the responsive feeding counselling cards. Furthermore, they felt the cards and corresponding messages were feasible and important to integrate into the UNICEF Community based IYCF counselling package currently being used to deliver IYCF training and education in Ghana. Conclusions The counselling cards developed and tested have a strong potential to add the key responsive feeding dimension to IYCF training, education, and counselling in Ghana on a large scale. Funding Sources Yale Global Health Leadership Institute.