Strengthening Maternal, Infant And Young Child Feeding Training And Education Delivery In Ghana

Objective: To document the maternal, infant and young child feeding (MIYCF) training and education system within Ghana and identify key factors influencing MIYCF training and education delivery by health care providers. Design: A qualitative study that utilized in-depth interviews. Setting: The study was conducted within the Central Region of Ghana. Participants: Fourteen health care providers that served as MIYCF trainers or educators were included in this study. Analysis: Interviews were conducted in English, audio recorded, and then transcribed. A grounded theory approach was used to create a conceptual model of the themes that emerged from the interview. Half of the interviews were coded independently by three investigators, consensus was reached, and a final codebook developed. The remaining interviews were coded by the lead author. Dedoose was used to code and analyze all interviews with the final codebook. Results: Three domains emerged from the analysis: MIYCF training, MIYCF education, and implementation of a responsive feeding curriculum. MIYCF training was described to be disseminated to staff both formally and informally, using standardized curriculums when funding was available. Participants requested more training for staff both formally and informally. MIYCF education to caregivers was delivered on an individual and group basis with the UNICEF Community-based IYCF counseling cards and complemented with other materials including child health booklets, flip-charts from other nutrition projects, or props such as food items or dolls. Providers identified several barriers and facilitators to MIYCF training and education at both the caregiver- and provider-level including lack of access to resources, limited staff, lack of finances for transportation, and lack of social support. The potential addition of a new responsive feeding curriculum into this MIYCF system was well received, and participants suggested providing training for all staff, distributing enough training and educational materials for each facility, and holding trainings that do not unduly burden the staff as far as time or transportation. Conclusions and Implications: Strengthening MIYCF training and education in Ghana involves providing more training to all staff, improving MIYCF curriculum and education materials for both health care staff and caregivers, and implementing national level policies to standardize MIYCF training guidelines. A responsive feeding curriculum is desired and has the potential to help improve malnutrition in Ghana. Keywords: Maternal Infant and Young Child Feeding, Health Care Provider Training, Qualitative Research, Responsive Feeding, Counseling, Social and Behavioral Science