Improving Children's Diet: Approach and Progress

We highlight key findings from a recent comprehensive review of social and behavior change communication (SBCC) interventions to improve complementary feeding in low-middle-income countries and discuss 4 large-scale programs as illustrative case studies. Improving dietary diversity was the most commonly targeted practice, and interpersonal communication was the most commonly used platform for the 64 interventions included in the comprehensive review. The number of behavior change techniques used by any one intervention ranged from 2 to 13 (median 6); all provided instruction on how to perform the target behavior(s), followed by the use of a "credible" source to provide the SBCC (n = 46), demonstration of the behavior (n = 35) and providing information about health consequences of the behavior (n = 35). The key factors that contributed to the success of the large-scale programs applying SBCC alone, or in combination with point-of-use fortification or nutrition-sensitive agriculture, included the formation of alliances with key stakeholders, availability of funds, technical support from multiple donors, well-defined theory of change, and streamlined processes for monitoring and implementation. Major limitations included a lack of detailed information on (a) intervention design, (b) behavioral theories or frameworks, (c) implementation processes including adaptations to context, and (d) cost and feasibility.