DCHA Planning Framework

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USAID Office of Food for Peace ME WorkshopAug
20-23/Aug 27-30, 2007
Infant and Young Child Feeding (IYCF) Indicator
Background

Megan Deitchler, FANTA Alison Tumilowicz, FANTA
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Learning Objectives

• Participants will be familiar with the basis for
  developing the Infant and Young Child Feeding
  Indicator
• Participants will be able to adapt the
  questionnaire, tabulate data and interpret the
  results of the following indicators
• Infant and Young Child Feeding
• Exclusive Breastfeeding
• Womens Consumption of Iron-rich Foods
• Womens Consumption of Vitamin A-rich Foods
• Womens Consumption of Calcium-rich Foods
• Womens Consumption of Iron Supplements

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Growth Faltering by Age
Source Shrimpton et al. 2001
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Developing Guiding Principles (GPs) for IYCF
Practices

• A WHO/PAHO led process, with inter-agency
  involvement by leading experts, academicians in
  the field of infant and young child feeding
  nutrition
• Series of expert consultation meetings on the
  topic, taking place over a number of years
• Comprehensive review of available scientific
  evidence for best practices to date

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WHO/PAHO Issue Technical Guidance for IYCF
Practices

• Guiding Principles for Complementary Feeding of
  the Breastfed Child, (2003)
• Guiding Principles for Feeding Non-breastfed
  Children 6-24 Months of Age (2005)

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WHO/PAHO Issue Technical Guidance for IYCF
Practices
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Timeline of Process for Development of IYCF
Indicators
Fall (Sept) 2006
Spring (Jan-June) 2006
2005
2003
2002
2001
WHO Global Consultation Mtng on CF
WHO Global Strategy on IYCF Guiding Principles
for CF of the BF Child Measuring CF Practices
(Ruel et al, WHO funded)
Guiding Principles for Feeding the non BF child A
Guide for Monitoring Evaluating Child Health
Programs (MEASURE) KPC Module 2 Update I
finalized
WHO/PAHO Informal Mtng on Indicators of IYCF
Developing Composite Indicators of IYCF
Ethiopia (Arimond et al, FANTA funded) and Latin
America (Ruel et al)
Update of DHS Nutrition Section Qaire and Tab
Plan finalized KPC Module 2 Update II Finalized
IYCF Update (DHS funded)
Validating indicators using existing data
(WHO/FANTA funded)
WHO Global Consultation Mtng to develop indicators
FANTA / MEASURE DHS lead process to Update
Nutrition Section of the Demographic Health
Survey
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Updating the DHS Questionnaire and Tabulation Plan

• An ORC Macro led process, with inter-agency
  involvement by leading experts, academicians in
  the field of infant and young child feeding
  nutrition
• Inputs from FANTA, IFPRI, Linkages, MOST, UNICEF,
  PAHO, UC Davis, and others
• Series of expert consultation meetings on the
  topic, taking place 2003-2006

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ORC Macro Finalizes Updated DHS Questionnaire and
Tabulation Plan

• Updated questionnaire reflects expert
  recommendation for collecting data on 24h dietary
  recall, and assessment of exclusive breastfeeding
• IYCF indicators and tabulation plan
  operationalize components of WHO guiding
  principles for breastfed and non breastfed
  children, 6-23 m

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What New Indicators for ICYF were Developed from
the GPs?
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What NEW Indicators for IYCF were Developed from
the GPs?
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Frequency of Feeding GPs and Indicator
Development
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Frequency of Feeding GPs and Indicator
Development
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Frequency of Feeding Indicator, 6-23 m

• Indicator of children 6-23 m who ate solid or
  semi-solid foods at least the minimum number of
  times in the 24 hours preceding the survey,
  according to age and BF status
• Note Indicator can also be disaggregated by age,
  or BF status, assuming sufficient sample sizes

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What New Indicators for IYCF were Developed from
the GPs?
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The 8 Food Groups for Assessment of Dietary
Diversity

• Milk other than breastmilk, cheese or yogurt,
  infant formula
• Foods made from grains, roots, and tubers,
  including porridge, fortified baby food from
  grains
• Vitamin A rich fruits and vegetables (and red
  palm oil)
• Other fruits and vegetables
• Eggs
• Meat, poultry, fish, shellfish (and organ meats)
• Legumes and nuts
• Foods made with oil, fat, butter

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Dietary Quality GPs and Indicator Development
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Dietary Quality GPs and Indicator Development
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Dietary Diversity Indicator, 6-23 m

• Indicator of children 6-23 m who received
  minimum dietary (food group) diversity in 24
  hours preceding the survey, according to BF
  status
• Note Indicator can also be disaggregated by age,
  or BF status, assuming sufficient sample sizes

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The IYCF Indicator, 6-23 m

• What is it?
• Measures 3 IYCF practices among children 6-23
  m to assess the proportion of children fed with 3
  minimum age appropriate practices.
• Why have it?
• Way to assess (ME), communicate and advocate,
  appropriateness of feeding practices received by
  children 6-23 m

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The IYCF Indicator, 6-23 m

• Consists of
• Continued breastfeeding or feeding of milk or
  milk products
• Fed (solid/semi-solid foods) minimum number of
  times per day according to age and breastfeeding
  status
• Fed the minimum number of food groups per day
  according to breastfeeding status

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The 3 Components of the IYCF Indicator, 6-23 m
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The 3 Components of the IYCF Indicator, 6-23 m
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Results from the IYCF Update, ORC Macro,
September 2006
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DHS Country ResultsComponent 1 of IYCF Indicator
Source IYCF Update. ORC Macro. Washington DC,
September 2006.
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DHS Country Results Component 2 of IYCF
Indicator
Source IYCF Update. ORC Macro. Washington DC,
September 2006.
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DHS Country Results for Component 3 of IYCF
Indicator
Source IYCF Update. ORC Macro. Washington DC,
September 2006.
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DHS Country Results for theIYCF Indicator
Source IYCF Update. ORC Macro. Washington DC,
September 2006.
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Summarizing IYCF Indicator Why?

• ASSESSMENT by managers of overall progress in
  improving complementary feeding practices
• COMMUNICATION with non-nutritionists, who may not
  want details of various practices
• ADVOCACY with donors, who may only want to see a
  few indicators