Evaluating the substainability of the A&T initiative in Vietnam

Evaluating the sustainability of the infant and young child feeding (IYCF) program that supported by Alive&Thrive (A&T) in Vietnam at 2 years after the program’s end through understanding the maintaining activities at the central and local levels, the scopes and determinants of sustainability, thereby analyzing the relationship between these factors and the sustainability of the program.
Alive & Thrive initiative (A&T) began in 2009 to reduce child malnutrition and mortality rates by improving infant feeding practices in 3 countries, namely Vietnam, Bangladesh and Ethiopia in 6 year period (from 2009 to 2014). There are 4 main program components: advocacy, interpersonal communication and community mobilization, mass communication, and strategic use of data. A&T in Vietnam worked in close partnership with the Ministry of Health, the National Institute of Nutrition, the Women’s Union and provincial government belong the program to implement interventions to increase breastfeeding rates and reduce stunting in malnutrition rates in Vietnam. A&T has launched an innovative social franchise model – “Mat troi be tho” Consultancy Department to provide high-quality child-rearing counseling services.

Empirical evaluations showed that the A&T program has improved the nutritional practice skills of Vietnamese mothers. The results of the final evaluation studies indicated that the A&T intervention package has significantly improved breastfeeding practices when compared to other counseling methods. Community support models and communication campaigns contributed to raising the awareness and practice of colostrum feeding and raising the rate of exclusive breastfeeding. These results showed that if the A&T program is implemented in a large and sustainable manner, it will improve the nutritional status of children in Vietnam.

This study evaluated the sustainability of the A&T initiative in Vietnam at 2 years after the end of the grant. This study is conducted by RTCCD and T.H Chan School of Public Health – Harvard University (USA) under the sponsorship of FHI360.

Objective: Evaluating the sustainability of the IYCF program (A&T) in Vietnam at 2 years after the program’s end through understanding the maintaining activities at the central and local levels, the scopes and determinants of sustainability, thereby analyzing the relationship between these factors and the sustainability of the program.

Main activities:

• Informant interviews at central and local levels with people involved in the A&T program in Vietnam, including staffs directly implementing the program at central and local levels, staffs working in the field of child nutrition and feeding policy by the Ministry of Health and the National Institute of Nutrition, NGOs working in the field of nutrition and nourishment of young children to gather opinions about the decisive factors and scope of the sustainability as well as the activities of the program are being maintained at the time of the study.
• Group discussions with health officials on training and oversight missions to gather health workers’ opinions about the determinants and scope of sustainability of the A&T program including the maintenance of project activities, training courses of infant and young child feeding practices, and quality of service delivery.
• Interview health workers working in nutrition counseling and infant feeding in order to gain knowledge about nutrition and feeding young children which health workers are provided in previous training courses, contents in terms of counseling and self-evaluating about capacity and satisfaction of their current job.
• Interview women in the last 3 months of pregnancy and mothers who have children under 2 years of age in order to gain their feeding knowledge and practices of infants, programs or activities providing and counseling infant nutrition and nurturing for mothers as well as mothers’ satisfaction with the local available counseling services.
• Observe health workers in infant nutrition and feeding counseling sessions to pregnant women in the last 3 months and/or mothers who have children under 2 years of age to assess the knowledge and counseling skills of health workers on related content.

Expected results:

• Evaluating the sustainability of the program on the scope and determinants of sustainability, including: coverage, accessibility, design compliance and operational adjustments to suit the situation.
• The study will help the A&T program and the related agency to replicate the model and have a corrective direction to promote the program to be replicated effectively.
• The study is also a pioneer, paving the way for researches on the sustainability of a implemented program. This is a lesson learned and opens up a new research direction for future research.

Some photo of the study