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Background. Alive & Thrive aims to increase exclusive breastfeeding and complementary feeding practices in Bangladesh, Ethiopia, and Vietnam. Objective. To develop and execute comprehensive communication strategies adapted to each context. Methods. We
documented how three countries followed an established iterative planning process, with research steps followed by key decisions, to develop a communication strategy in each country. Secondary analysis and formative research identified the priority practices to focus on, and locally specific
constraints to proper infant and young child feeding (IYCF). Communication strategies were then developed based on the social, cultural, economic, epidemiological, media use, and programmatic contexts of each country. Results. There were widespread gaps between recommended and actual
feeding practices, and these varied by country. Gaps were identified in household, community, and institutional levels of awareness and skills. Strategies were designed that would enable mothers in each specific setting to adopt practices. To improve priority behaviors, messaging and media
strategies addressed the most salient behavioral determinants through face-to-face communication, social mobilization, and mass media. Trials of improved practices (TIPs), concept testing, and pretesting of materials proved useful to verify the relevance and likely effectiveness of communication
messages and materials tailored for different audiences in each setting. Coordination and collaboration with multiple stakeholders from the start was important to harmonize messages and approaches, expand geographic coverage to national scale, and sustain the interventions. Conclusions.
Our experience with designing largescale communication strategies for behavior change confirms that systematic analysis and local planning cannot be omitted from the critical process of strategic design tailored to each context. Multiple communication channels matched to media habits in each
setting can reach a substantial proportion of mothers and others who influence their IYCF practices. Preliminary data suggest that exposure to mass media plays a critical role in rapidly reaching mothers, household members, community influentials, and health workers on a large scale. Combining
face-to-face interventions for mothers with social mobilization and mass media was effective in improving IYCF practices.
Established in 1978, the Food and Nutrition Bulletin (FNB) is a peer-reviewed journal published quarterly by the Nevin Scrimshaw International Nutrition Foundation. The focus of the journal is to highlight original scientific articles on nutrition research, policy analyses, and state-of-the-art summaries relating to multidisciplinary efforts to alleviate the problems of hunger and malnutrition in the developing world.
Food and Nutrition Bulletin's 2012 Impact Factor: 2.106