1 McGill University, Ste Anne de Bellevue, Canada; 2 Instituto de Investigación Nutricional, Lima Perú; 3 University of Ghana, Ghana.
Worldwide, infant and young child nutrition education is provided primarily through growth monitoring and promotion (GMP) clinics. Once children no longer participate in GMP, usual around 2 y of age, families may have little or no access to nutrition information. We report on interventions that expanded nutrition education from GMP silos into other areas of the health system as well as into non-health sectors as integrated and sustainable models for improving nutrition in rural communities. In rural Peru, most nutritionists and nurses are 1-y-contracted professionals (serumistas). We identified health service technicians who are typically permanent staff as the personnel to sustain nutrition education IYC programs and implement them with cultural sensitivity. National-level changes in health sector job descriptions and improvement of institutional dynamics among staff are needed to implement this reorganization of nutrition education responsibilities in rural Peru. Health services in Ghana are more limited than in Peru; most rural communities have access only to a nurse in an open-air monthly clinic that provides GMP, vaccinations, and other preventive care. However, staff from other ministries and the private sector regularly visit rural communities. Our interventions harmonize nutrition education messages across four sectors (health, agriculture, education, and banking) to provide communities with consistent and frequent IYC messages. As an example, inclusion of animal source foods in young children’s diets is supported through training of nurses who counsel mothers in GMP, agriculture extension workers who support poultry raising and egg production for home consumption and sale, education staff who oversee nutrition curriculum and school feeding programs, and microcredit staff who provide brief educational talks to mothers in their weekly repayment meetings. Nutrition education must be a cross-sector effort that integrates complementary activities to improve the health, development, and well-being of children.