Social analysis and action for an infant and young child feeding program in Nicaragua

Background: According to national statistics, the north-central departments of Matagalpa and Jinotega are home to some of the highest rates of chronic child malnutrition in Nicaragua (26% and 33% respectively). CARE's Ventana de Oportunidad program (Ventana) is currently operating in these two departments to promote, protect and support optimal infant and young child feeding (IYCF) and related maternal nutrition (rMN). As part of its programmatic research, Ventana utilized social analysis and action processes to examine the relationship between poverty, power and maternal and infant malnutrition.

Methodology: Social analysis of the behaviors, practices and beliefs around IYCF and rMN was conducted with diverse community members in four municipalities in Nicaragua via a sequence of tools including market analysis, pile sorting and problem tree mapping. Through this process the Ventana team assessed the availability, access, and utilization of local foods for women, infants and young children and garnered explanations regarding decision-making, food choices and feeding practices.

Results: These methodologies confirmed 1) a lack of utilization of available foods due to tradition, culture or income limitations; 2) early introduction of solids to infants under 6 months old; 3) an inadequate post-partum diet devoid of protein and essential vitamins and minerals; and 4) culturally acceptable actions for behavior change.

Discussion: A sequence of social analysis tools leads to a deeper understanding of issues underlying high levels of maternal and infant malnutrition, as with Matagalpa and Jinotega, and to defining avenues for community action to improve current maternal, child, household and community feeding practices.