Improving Complementary Feeding Practices: A Review of Evidence from South Asia

This report is the second in a series of evidence reviews prepared by the Vistaar project team in 2008 to assist the national government in making evidence-based decisions regarding maternal, newborn, and child health and nutrition (MNCHN) interventions. Led by IntraHealth and funded by the United States Agency for International Development (USAID), Vistaar is a 6-year (2006-2012) MNCHN project that takes its name from the Hindi word for 'expansion' or 'flowering'. This document outlines the review on interventions for improving complementary feeding practices in the community, summarises the selected interventions, and shares the recommendations and evidence gaps identified by a technical expert group after analysis of the interventions.

Specifically, the project team short-listed 13 interventions carried out as part of Vistaar. These interventions applied multiple approaches, the most common of which was community-based behaviour change communication (BCC) through household-level counselling and education. Some interventions included capacity building of community-level health care providers, and a few applied a "positive deviance" approach (promoting positive feeding practices which are identified and accepted locally). Table 1 on page 2 provides more information on the 13 interventions.

Studying the quality of data and results available, the experts concluded that further application and review of several models showing some successes would be useful; they recommended more study and documentation of the governmental programme's efforts to improve complementary feeding. They also felt that the positive deviance approach had potential and should be further applied and evaluated.

Looking at the process of evidence review itself, the document indicates that this "a useful approach to build consensus among technical experts and program leaders, inform program planning, and assist with decision making. The Vistaar Project experience shows that this process is most valuable when:

• It is conducted in an open, inclusive and participatory manner
• The focus is on learning lessons, not identifying the best model
• The audience is clear, and the evidence is reviewed from their perspective (i.e., in this case, the evidence was reviewed for application in Government programming)"