Title |
Exploring barriers and enablers for scaling up a community-based grain bank intervention for improved infant and young child feeding in Ethiopia: A qualitative process evaluation |
Author |
Sako, Binta Leerlooijer, Joanne N. Lelisa, Azeb Hailemariam, Abebe Brouwer, Inge D. |
Publication Year |
2018 |
Series Name |
Maternal and Child Nutrition |
Series Number |
14(2) |
Publisher |
Wiley |
Language |
English |
Record Type |
Journal article |
Abstract |
Child malnutrition remains high in Ethiopia, and inadequate complementary feeding is a contributing factor. In this context, a community‐based intervention was designed to provide locally made complementary food for children 6–23 months, using a bartering system, in four Ethiopian regions. After a pilot phase, the intervention was scaled up from 8 to 180 localities. We conducted a process evaluation to determine enablers and barriers for the scaling up of this intervention. Eight study sites were selected to perform 52 key informant interviews and 31 focus group discussions with purposely selected informants. For analysis, we used a framework describing six elements of successful scaling up: socio‐political context, attributes of the intervention, attributes of the implementers, appropriate delivery strategy, the adopting community, and use of research to inform the scale‐up process. A strong political will, alignment of the intervention with national priorities, and integration with the health care system were instrumental in the scaling up. The participatory approach in decision‐making reinforced ownership at community level, and training about complementary feeding motivated mothers and women's groups to participate. However, the management of the complex intervention, limited human resources, and lack of incentives for female volunteers proved challenging. In the bartering model, the barter rate was accepted, but the bartering was hindered by unavailability of cereals and limited financial and material resources to contribute, threatening the project's sustainability. Scaling up strategies for nutrition interventions require sufficient time, thorough planning, and assessment of the community's capacity to contribute human, financial, and material resources. |
Source Publication |
Maternal and Child Nutrition 14(2): e12551 |
ISSN |
1740-8695 |
DOI/WEB/URL |
https://doi.org/10.1111/mcn.12551 |
DOI Number |
10.1111/mcn.12551 |
Full citation |
Sako, Binta; Leerlooijer, Joanne N.; Lelisa, Azeb; Hailemariam, Abebe; Brouwer, Inge D.; et al. 2018. Exploring barriers and enablers for scaling up a community-based grain bank intervention for improved infant and young child feeding in Ethiopia: A qualitative process evaluation. Maternal and Child Nutrition 14(2): e12551. https://doi.org/10.1111/mcn.12551 |
IFPRI Descriptors |
CRP4 IFPRI3 ISI |
IFPRI Division |
A4NH |
Peer Reviewed - PR or Non-PR |
PR |
Subject - country location |
ETHIOPIA EAST AFRICA AFRICA SOUTH OF SAHARA AFRICA |
Subject - keywords |
community organizations infant feeding child feeding qualitative analysis malnutrition child nutrition health care systems complementary feeding infants children |
Subject - author supplied keywords |
nutritional interventions; process evaluation; scaling‐up |
Times cited-- Google Scholar |
https://scholar.google.com/scholar?hl=en&as_sdt=0%2C9&q=Exploring+barriers+and+enablers+for+scaling+up+a+community%E2%80%90based+grain+bank+intervention+for+improved+infant+and+young+child+feeding+in+Ethiopia%3A+A+qualitative+process+evaluation&btnG= |
IFPRI Publication Ranking |
A |
CGIAR Research Program Name |
CGIAR Research Program on Agriculture for Nutrition and Health (A4NH) |
Creative Commons CC License |
CC-BY-4.0 |
Funding |
http://dx.doi.org/10.13039/501100008627 Global Affairs Canada; http://dx.doi.org/10.13039/100006641 UNICEF |
Access Rights |
Open Access |
Language ISO639 |
eng |
Record Type CG Core |
Journal Article |