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'Boden Food Plate': Novel Interactive Web-based Method for the Assessment of Dietary Intake

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Published on: September 18, 2018

Process Evaluation of a Large-Scale Community-Based Nutrition Program in Malawi.

Julie C Ruel-Bergeron¹, Kristen M Hurley¹, Audrey Buckland¹

¹Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.

Current Developments in Nutrition

|April 8, 2020

Summary

This study evaluated a community nutrition program in Malawi, finding high implementation fidelity and quality. Key interventions like small-quantity lipid-based nutrient supplements (SQ-LNS) and social and behavior change communication (SBCC) showed success, though some areas need improvement.

Keywords:

Malawi community-based nutrition nutrition program implementation process evaluation program fidelity program reach program recruitment small-quantity lipid based nutrient supplement

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Area of Science:

Public Health Nutrition
Global Health
Implementation Science

Background:

Inadequate global focus on nutrition program implementation hinders large-scale impact.
Effective delivery and scalability of nutrition interventions require robust evaluation.

Purpose of the Study:

To conduct a mixed-methods process evaluation of a large-scale, community-based nutrition program in Malawi.
To measure recruitment, fidelity, and reach of the nutrition program.
To assess the quality of program delivery and identify areas for improvement.

Main Methods:

Utilized program monitoring and evaluation data for recruitment, reach, and fidelity assessment.
Employed structured direct observations and knowledge questionnaires with program volunteers to evaluate fidelity.
Quantified program functioning through the proportion of correctly implemented activities.

Main Results:

Nearly half (49.5%) of eligible children received benefits by 8 months.
Training for social and behavior change communication (SBCC) cadres exceeded targets (100.6%), but module completion varied.
High fidelity observed in small-quantity lipid-based nutrient supplement (SQ-LNS) distribution; counseling sessions showed inconsistencies in age-appropriate messaging.

Conclusions:

The community-based nutrition program demonstrated high implementation fidelity and quality.
Specific interventions, such as age-appropriate counseling, require further attention and refinement.
Documenting implementation processes enhances understanding of program impact achievement.