nutrition-related behaviors and is an attempt at reducing redundancies and focusing efforts to stimulate lasting and effective change. This prioritization in no way suggests that SPRING will not be involved in activities around the promotion of the entire package of recommended nutrition and hygiene behaviors, simply that SPRING will focus efforts around the priority behaviors as strategically aligned with our program activities, organizational advantage and to complement other organizational efforts. Specifically, SPRING will continue to train on and promote the entire ENHA package of practices but will place additional emphasis and design activities focusing on the prioritized behaviors to achieve better nutrition in the first 1,000 days. Priority Behaviors Through the process outlined above, SPRING has prioritized the following four key behaviors categorized in Table 2: Table 2: Priority Behavior Matrix Behavior Primary Audience Secondary Audience Determinants of Behavior Optimal Nutrition for PLW • Consuming one handful of extra food •Consuming diverse & animal source foods •Taking adequate Rest PLW Husbands, frontline workers Knowledge, access to quality, diverse and ASF foods, food taboos, family power structure (food distribution), perceptions of nutritious foods Optimal complementary feeding starting at 6 months with continued breastfeeding to 2 years of age and beyond •Frequency, Quality, Quantity, and Consistency of appropriate complementary food •Consuming diverse & animal source foods •Continued Breastfeeding Mothers and caregivers of children under 2 years Husbands, frontline workers Knowledge; access to quality, diverse and animal source foods; food taboos; family power structure (food distribution); attraction to processed and sweet foods; influence of commercially marketed foods; cultural norms/tradition; perceived milk insufficiencies, perceptions of nutritious foods, time constraints of mothers for preparing food Handwashing •Washing hands at critical times (after defecation, before cooking, before eating, and before feeding) Mothers and caregivers of children under 2 years of age All other household members, frontline workers Knowledge, self-efficacy (belief in one's own ability – having the knowledge and skills), access to clean and running water, perceived risk of not washing hands, perceived severity of consequences of not washing hands, time constraints/convenience, unwillingness to adopt new technology Homestead Food •Production Consumption of diverse and animal source foods PLW Husband, Access to resources and production inputs (land, seeds), knowledge & skills, perceived consequences, time investment, natural disasters/conditions, empowerment, social praise, family happiness
extra serving of staple food (285kcal) a day. serving of staple food (285kcal). Optimal complementary feeding starting at 6 months with continued breastfeeding to 2 years of age and beyond Increase in the % of children 6-23 months who receive the minimum acceptable diet on WHO recommendations). The indicator is calculated from the following two fractions: Breastfed children 6–23 months of age who had at the minimum dietary diversity and the minimum meal frequency during the previous day. Percentage of children 6-23 months receiving a minimum acceptable diet (Indicator 15) Increase in the % of children 6-23 months who continue to be breastfed. Proportion of children 6–23 months of age who continue to be breastfed. SPRING Household Register Increase in the % of children starting complementary feeding after 6 months of age. Proportion of infants 6–9 months of age who receive solid, semi-solid or soft foods. SPRING Household Register Increase in the % of children exclusively breastfeeding at 0-6 months. Proportion of infants exclusively breastfeeding 0-6 months of age. Prevalence of exclusive breastfeeding children under 6 months (Indicator 14 ) Hygiene – Handwashing To increase practice on hand washing at critical times Percentage of respondents who have installed Tippy Taps next to the kitchen and the latrine both (self-reported and observations) Percent of households in upazilas with “tippy taps” installed near toilet, and next to kitchen (Indicator 1) Increase in the % of mothers and caregivers that wash their hands with soap during critical times Percentage of respondents who know and act on and can observe washing area) critical moments for hand washing with focus on the following two actions (aggregated and disaggregated): - after defecation (self and child) - before handling food (raw, cooked, processed) SPRING Household Register Homestead Food Production Increase diversified food consumption Percentage of households in SPRING-supported upazilas that have household gardens that produce at least 4 fruits or vegetables. Percentage of households growing at least four types of vegetables through HFP (Indicator 4d) reported
Increase animal source food consumption Percentage of households in SPRING-supported upazilas that to poultry or fish, by type of plants/animals Percentage of beneficiaries (PLW) consuming ASF (Indicator 4e) Enhance the adoption of advanced agricultural techniques to increase homestead food production Number of farmers and others who have applied new technologies or management practices as a result of USG assistance (Indicator 9) SBCC activities Promote ENHA to the policy level and mainstream with other ministries SPRING Policy Tracking Sheet and PTS Make a supportive environment to change behavior Percentage of supportive supervision visits made to FFS beneficiaries, CCs, Agriculture Officers (Indicator 2a) Percentage of observations of ENA/EHA messages being provided by health care workers and FFS facilitators through supportive supervision visits deemed to be of an acceptable quality (Indicator 11) SPRING Household Register Increase the capacity of HW for counseling mothers Number and percentage of trained health workers who report providing ENA/EHA services or messages (Indicator 7a ) Number of pregnant women and women with children <2 years reached with nutritional/hygiene messages through the health system (Indicator 7d) Percentage of observations of ENA/EHA messages being provided by health care workers and FFS facilitators through supportive supervision deemed to be of an acceptable quality (Indicator 11 ) Materials and messages Increase knowledge through message dissemination by using different media Percentage of pregnant women and women with children <2 years reached with nutritional and hygiene messages (Indicator 7b ) Social Change Themes SPRING is currently finalizing the analysis of formative research conducted in early 2013, by The Manoff Group, around intra-household decision-making and men’s market purchasing decisions. Preliminary findings indicate that men’s behaviors at the household level are important determinants of the four