IYCN worked with the FMOH, other relevant government ministries, UNICEF, WHO, and the many partners implementing OVC and HIV/AIDS programs in Nigeria with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) to improve the nutritional status of children less than two years of age and their mothers. The project placed special emphasis on increasing the chance that children born to HIV-positivemothers live healthy lives free from HIV. Efforts focused on improving the enabling environment for nutrition programs by reviewing and updating policy guidelines and training manuals and building the capacity of health workers.
From 2009 to 2011, the US Agency for International Development’s (USAID) Infant & Young Child Nutrition (IYCN) Project supported the government of Nigeria’s efforts to reduce maternal and child undernutrition and improve the HIV-free survival of infants and young children. IYCN provided technical assistance to the Federal Ministry of Health (FMOH), the Federal Ministry of Women’s Affairs and Social Development, and other partners to review, update, and disseminate nutrition policies and guidelines, train health care workers in the Federal Capital Territory (FCT) and its surrounding area councils, and enhance behavior change interventions targeting HIV-positive mothers and HIV-exposed children.
The project also supported a quality improvement approach to strengthen nutrition assessment, counseling, and support (NACS) services at prevention of mother-to-child transmission of HIV and orphans and vulnerable children service sites in the FCT. As a result of IYCN’s role in Nigeria, the country adopted the World Health Organization’s (WHO) most recent recommendations on infant feeding within the context of HIV, and updated national guidelines were distributed to nutrition stakeholders across the country.
STUDY DESIGNThe study consisted of an assessment using qualitative methodology. Within the focal area of FCT, four Area Councils were selected. First, the Area Councils were divided into urban/rural groups. Within each group, the “lucky dip” technique was used to pick two Area Councils. Within each selected Area Council, two urban and two rural communities were selected. Data collection was done at the health facility level. Health workers at the health facilities served as contact persons and mobilizers for respondents. In-depth interviews (IDIs) were conducted with key individuals in each of the communities, including traditional leaders, opinion leaders, community health workers, and community health volunteers. Focus group discussions (FGDs) were held amongst primary caregivers (mothers) of children under six months of age, primary caregivers of children between 6 and 24 months, grandmothers of under-24-month-olds, and fathers with children under 24 months of age.DATA COLLECTIONData collection instruments were developed for the target groups of the study. The instruments were pre-tested, on the basis of which some moderations were made. A methodology workshop was held to train the field officers and assistants a day before field work began. The training took place in the IYCN office in Asokoro, Abuja. During the training sessions, field assistants were taken through each instrument, and possible interpretations debated and agreed upon. Role-play sessions were also conducted. The workshop was facilitated by Dr Afolabi in conjunction with the principal investigator, Dr R. A. Okunola. Data were later collected at the different sites in FCT, coordinated by the principal consultant. Health officials of Area Councils to be visited were informed some days before the arrival of the study team, and necessary mobilizations were done. On arrival, courtesy calls were made to the traditional head and permission formally obtained for entrance into the community. Afterwards, the team proceeded to the health facility, where the various interviews and discussion sessions took place. Each FGD session was facilitated by a moderator and a note-taker while the sessions were tape-recorded. The collected data were transcribed and translated into English for the purpose of analysis.
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