By: Daniel Takea
UNICEF & MoH, led by the Tech RRT SBC Advisor, conducted an IYCF-focused Barrier Analysis Training and Assessment in eight Internally Displaced Person (IDP) camps in Erbil and Dohuk governorate of Kurdistan Region in Iraq this past December 2016 –January 2017. Click below to access the full report.
The Barrier Analysis assessment was conducted to:
- Identify the most important context-specific determinants of key IYCF behaviors among Mothers/caretakers in Erbil and Dohuk, IDP camps;
- Design a tailored and appropriate communication and behavior change strategy and a set of key behavior change activities;
- Build capacity of key partners in Barrier Analysis methodology.
The behaviors studied were: early initiation of breastfeeding within an hour of birth, exclusive breastfeeding for the first 6 months of life, meal frequency within children 6-23 months and meal diversity for children 9-23 months. The four most commonly found determinants for these behaviors were self-efficacy (what makes it difficult), social norms (who approves), positive consequences (what are the advantages), and negative consequences (what are the disadvantages). The assessment interviewed 45 “Doers” (people who already practice the behavior) and 45 “Non-doers” (people who do not practice the behavior) and compared the responses.
Based on the findings of the assessment, the following recommendations were made and specific activities were proposed for each recommendation (available in the report):
- Support Mothers with C-section or complications to breastfeed as soon as possible within health facility, followed by trained community social worker via home visits.
- Work with Government of Iraq and Camp management to implement the International Code for Marketing of Breast Milk Substitutes.
- Establish referral process from Mother-to-Mother Support Groups (MtMSGs) and Peer Groups to help identify mothers with breastfeeding difficulties due to breast problems and stress.
- Integrate breastfeeding support messages with wider public health and other sector (WASH, Health, Protection, Food Security, Education) activities.
- Conduct a market survey to look at what foods are available and which are low cost.
- Involve other family members in learning about appropriate feeding techniques.
- Through MtMSGs mobilize/encourage older mothers to teach younger mothers about feeding techniques and cooking meals.
- Advocate to camp management to allow and assist mothers to access a greater variety of foods from nearby markets in order to feed children better (i.e. from at least 4 food groups out of 7).
- Advocate with food security and livelihood cluster on food voucher for targeted household with children 6-23 months to make foods more affordable.
The assessment served as a good example of how to develop evidence based informative SBC activities to improve the overall performance of program activities and services. If you have any specific questions, please contact the Tech-RRT team at www.techrrt.org