Action - Infant and Young Child Nutrition Project - Infant feeding in the context of HIV - Infants and young children|Pregnant/lactating women with HIV/AIDS (PLWHA)

Programme: Infant and Young Child Nutrition Project

Programme description

From 2007 to 2010, the US Agency for International Development’s Infant & Young Child Nutrition (IYCN) Project supported Lesotho’s Ministry of Health and Social Welfare (MOHSW) to improve the nutrition of mothers and their children younger than two years of age, with a focus on those affected by HIV. The project strengthened national nutrition and prevention of mother-to-child transmission of HIV (PMTCT) policies and programs and conducted supportive activities at health facilities and within communities. As a result of the project, there is now a strengthened referral system, which allows community health workers to refer mothers and children to providers at facilities and providers to refer their patients back to community health workers for followup. Building the capacity of a wide range of community workers resulted in supportive networks for improved feeding practices in many communities, including among village chiefs, traditional healers, and men’s groups.

Programme type




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End date:

Target group: 
Infants and young children
Pregnant/lactating women with HIV/AIDS
Primary health care center
Implementation details : 

Enhanced national nutrition guidelines

IYCN helped to set a countrywide standard for improved feeding practices by supporting the revision of Lesotho’s National Infant and Young Child Feeding Policy and incorporating the World Health Organization’s guidelines on HIV and infant feeding into national PMTCT guidelines. In February 2010, IYCN assisted the MOHSW with presenting the infant and young child feeding guidelines to the Minister of Health.

Facilitated multisectoral collaboration
To effectively reach communities with information about optimal feeding practices, the project fostered collaboration among three government ministries to develop joint training and supervision activities. A cascade-style approach to training community workers enabled IYCN to reach more caregivers with nutrition support. For example, IYCN supported the MOHSW to train 29 trainers at the Ministry of Agriculture, who then conducted “step-down trainings” with 496 home economists and other workers. IYCN also trained trainers at the Ministry of Education, who then trained early childhood care and development teachers. Both sets of trainees gave health talks at local clinics. The home economists showed mothers how to prepare food for their children and the teachers led discussions about good nutrition. Additionally, IYCN collaborated with each ministry to train 246 traditional healers in villages and 30 mentor mothers from mothers2mothers about how to counsel HIV-positive mothers on infant feeding.

Increased community support
Over the life of the project, IYCN supported the training of nearly 750 community health workers to counsel mothers on infant and young child feeding. Trained community health workers increased community support for optimal infant feeding practices and improved social norms, individual attitudes, and infant feeding behaviors. Through household visits, community health workers reached pregnant women and breastfeeding mothers two to four times each month. Community health workers also helped health workers create breastfeeding Masoabicommittees in some villages, which included traditional healers, grandmothers, and priests. By sensitizing village chiefs, traditional healers, community councils, grandmothers, and men’s groups, community health workers broadened support for infant and young child nutrition, which led to more public discussions about the issue. The project informally integrated traditional healers into the referral system, through which they referred mothers to community health workers.

By performing supervisory visits with 270 health providers trained by the project, IYCN monitored the two-way referral system between facilities and community health workers. Project staff also monitored community activities initiated through the project, such as growth monitoring and promotion, health talks, the creation of keyhole gardens, and cooking demonstrations. Health workers reported significant improvement in community-based growth monitoring and promotion sessions and said they were better able to detect and refer children who were growth-faltering, while keyhole gardens became a user-friendly, inexpensive, local source of vegetables.

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Outcome reported by social determinants: 
Vulnerable groups


Revision log

Tue, 03/11/2014 - 17:28engesveenkEdited by william_nkoom.published
Wed, 03/27/2013 - 16:14bloessnermEdited by william_nkoom.published
Sun, 01/13/2013 - 22:03william_nkoomEdited by william_nkoom.published