The SUNFLOWER Creative Concept: Promoting Increased Iron Intake during the First 1000 Days through Social and Behavior Communication in Integrated Nutrition Programming in Tanzania and Ethiopia

Abstract

Objectives: Our objective was to design and implement evidence-based social and behavior change communication (SBCC) interventions to increase iron intake by women and children during the first 1000 days of maternal, infant and young child nutrition (MIYCN) through agriculture, health and nutrition programs in Tanzania and Ethiopia. Methods: We developed evidence-based behavioral profiles of pregnant and lactating women, their husbands, and grandmothers of children under five in smallholder farming communities in the two countries. Creative concept testing and pretesting helped focus the development of messages and materials to promote behaviors that increase iron intake in a way that is appealing and makes sense in the context of people's daily lives. All materials underwent technical content reviews by experts from national government and civil society organizations working in nutrition, agriculture, maternal health, and SBCC. Results: The creative design process led to the development of the agriculture-friendly "SUNFLOWER" concept that divides the first 1000 days of maternal and child nutrition into four stages: SEED (pregnancy), SPROUT (birth to 6 months), BUD (6-12 months), FLOWER (12-24 months). Each stage includes behaviors that increase uptake of MIYCN services, improve demand for and adherence to IFA supplements, and increase access to and consumption of iron-rich foods. A set of multi-media SBCC materials were developed for each "SUNFLOWER" stage and will be used by health and agriculture extension workers to reach over one million families in both countries. Conclusions: The SUNFLOWER concept facilitates behavior change communication about increased iron intake during the first 1000 days in an appealing way that makes sense to farming audiences.