Example 3: Maternal and Child Health and Nutrition (MCHN) Programs: Exclusive Breastfeeding (EBF) Priority Group or Influencing Bridges To Groups Activities Behavior Determinants Activities Mothers only Priority Group: Burundian 1. Increase the 1. Record/write stories about mothers Perceived action- give breast mothers with children 0–6 months perception that with children with good health/weight efficacy: of age who milk to their exclusively who EBF and believe in EBF. Play the Mothers don’t children from breastfeeding a child recording/read the testimonials on EBF Live in rural setting know the birth to 6 will help prevent during pre and postnatal consultations, Majority are illiterate relationship months of age malnutrition. home visits and growth monitoring and Go to church on Sunday between EBF promotion sessions. 2. Increase the morning and perception that 2. In household meetings, use growth malnutrition Are busy with daily household religious leaders charts to show the difference between chores Perceived divine approve of EBF and several children growing well who are will: Want to be perceived as good that their religious exclusively breastfeeding and contrast mothers and wives tradition is them to other children who are Mothers supportive of EBF. underweight who are not EBF. After 3 months, they think they question 3. Increase the 3. Create and give pastors/priests/imams do not have enough milk to whether their breastfeed perception that sermon guides on EBF and train them religious their in their use. Exclusively breastfeed until 4 leaders/ mothers 4. During home visits to pregnant women months, but give other foods at traditions approve of EBF. and new mothers, instruct Care Group that time support this 4. Decrease the Volunteers (CGVs) to include behavior Majority are in partial action perception that a mothers-in-law when teaching about stage Perceived social EBF. child will be hungry Influencing Group: norms: or lacking in 5. Explain to mothers (via CGVs and Mothers-in-law Mothers believe nutrition if they are home visits) that children cry for many that their exclusively reasons, and crying does not always mothers, breastfed. mean the child is hungry. Use growth mothers-in-law charts to show mothers that many do not approve children who cry a lot (identify cases of EBF ahead of time) are still growing well and therefore are not lacking adequate Perceived negative nutrition. Teach mothers a consequences: process for comforting a crying Mothers believe
Example 3: Maternal and Child Health and Nutrition (MCHN) Programs: Exclusive Breastfeeding (EBF) Behavior Priority Group or Influencing Groups Determinants Bridges To Activities Activities Mothers only give breast milk to their children from birth to 6 months of age Priority Group: Burundian mothers with children 0–6 months of age who Live in rural setting Majority are illiterate Go to church on Sunday morning Are busy with daily household chores Want to be perceived as good mothers and wives After 3 months, they think they do not have enough milk to breastfeed Exclusively breastfeed until 4 months, but give other foods at that time Majority are in partial action stage Influencing Group: Mothers-in-law Perceived action- efficacy: Mothers don’t know the relationship between EBF and malnutrition Perceived divine will: Mothers question whether their religious leaders/ traditions support this behavior Perceived social norms: Mothers believe that their mothers, mothers-in-law do not approve of EBF Perceived negative consequences: Mothers believe 1. Increase the perception that exclusively breastfeeding a child will help prevent malnutrition. 2. Increase the perception that religious leaders approve of EBF and that their religious tradition is supportive of EBF. 3. Increase the perception that their mothers approve of EBF. 4. Decrease the perception that a child will be hungry or lacking in nutrition if they are exclusively breastfed. 1. Record/write stories about mothers with children with good health/weight who EBF and believe in EBF. Play the recording/read the testimonials on EBF during pre and postnatal consultations, home visits and growth monitoring and promotion sessions. 2. In household meetings, use growth charts to show the difference between several children growing well who are exclusively breastfeeding and contrast them to other children who are underweight who are not EBF. 3. Create and give pastors/priests/imams sermon guides on EBF and train them in their use. 4. During home visits to pregnant women and new mothers, instruct Care Group Volunteers (CGVs) to include mothers-in-law when teaching about EBF. 5. Explain to mothers (via CGVs and home visits) that children cry for many reasons, and crying does not always mean the child is hungry. Use growth charts to show mothers that many children who cry a lot (identify cases ahead of time) are still growing well and therefore are not lacking adequate nutrition. Teach mothers a process for comforting a crying
advanced_workshop_on_designing_for_behavior_change.docx