ArticleCurrent developments in nutrition2020
Process Evaluation of a Large-Scale Community-Based Nutrition Program in Malawi.
Article in Current developments in nutrition, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 10 citations in OpenAlex.
- Conducting process evaluations of WASH interventions: a scoping review of design approaches and indicators in low- and middle-income countries.Implementation science communications · 2026Article
- Why are policies to combat undernutrition not effective in Mozambique?Nature communications · 2026Article
- Behaviour change interventions improve maternal and child nutrition in sub-Saharan Africa: A systematic review.PLOS global public health · 2023Article
- Beneficiary and Local Stakeholder Participation in Community-Based Nutrition Interventions.Current developments in nutrition · 2022Article
- Adaptive Implementation of a Community Nutrition and Asset Transfer Program during the COVID-19 Pandemic in Rural Bangladesh.Current developments in nutrition · 2022Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGlobal attention to the study of nutrition program implementation has been inadequate yet is critical for effective delivery and impact at scale.
objectivesThe objective of this mixed-methods process evaluation study was to measure the recruitment, fidelity, and reach of a large-scale, community-based nutrition program in Malawi.
methodsThe nutrition program delivered a small-quantity lipid-based nutrient supplement (SQ-LNS) and social and behavior change communication (SBCC) to improve infant and young child feeding (IYCF) and water, sanitation, and hygiene (WASH) practices in households with children aged 6-23 mo. Program monitoring and evaluation data were used to measure program recruitment, reach, and fidelity. Structured direct observations and knowledge questionnaires with program volunteers measured quality aspects of program fidelity. The number of times activities were done correctly was used to tabulate proportions used to represent program functioning.
resultsHalf (49.5%) of eligible children redeemed program benefits by 8 mo of age during the first 4 y of program implementation. Implementation of training activities for SBCC cadres exceeded program targets (100.6%), but the completion of certain modules (breastfeeding and complementary feeding) was lower (22.9% and 18.6%, respectively). Knowledge of IYCF, WASH, and SQ-LNS messages by volunteers was >85% for most messages, except ability to list the 6 food groups (35.7%). Structured direct observations of SQ-LNS distributions indicated high fidelity to program design, whereas those of household-level counseling sessions revealed lack of age-appropriate messaging. Program reach showed participation in monthly distribution sessions of 81.0%, group counseling of 93.3%, and individual-level counseling of 36.9%.
conclusionsThis community-based nutrition program was implemented with high fidelity and quality, with specific interventions requiring further attention. The documentation of implementation contributes to our understanding about how program impacts were achieved.
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