1. Better Behavior Change with Care Groups

2. DRC MYAP, 2008-2011 Results & Lessons Learned Indicator% Baseline (08)% Final (‘11) Children 0-5.9 months exclusively breastfed in the last 24h 28.4%75.4% Children 1-11.9 months commenced breast-feeding within two hours of birth 39.9%77.5% Children 6-23.9 months of age with 3 appropriate infant and young child feeding practices (continued breastfeeding, age-appropriate dietary diversity, age-appropriate frequency of feeding) 5.7%61.2% Children 6-23.9 months who have been supplemented with Vitamin A in the six last months 38.7%70.8% Household Dietary Diversity Score: mean number of food groups consumed in the last 24h 3.78 (CI: 3.58-3.98) 5.95 (CI: 5.15-6.70) Lessons Learned: Mother Beneficiaries have confidence and respect for Mother Leaders because they elected them as representatives and see them as role models, listen and follow their advice LQAS – sharing results with Mother Leader to identify areas of high performance so that Care Group with low performance can learn behavior change strategies Husbands support, provide encouragement, and sometimes participate in teachings

3. Burundi MYAP, 2008-2013 Results & Lessons Learned (PM2A and Care Groups) Indicator% Baseline (09)% Follow-up (‘11) Children 0-5.9 months exclusively breastfed in the last 24h 69.4%92.6% Women having at least four prenatal visits during their last pregnancy 28.9%61.4% Children 0-59 months whose growth monitoring took place at least once every two months 16%61.4% Mother/Child units who had used the CSB (Corn Soy Blend) / oil in the last 24 hours 6.1%89.9% Lesson Learned: In Burundi PM2A Care Group program Due to the requirements of PM2A projects, the number of mothers who were initially registered were limited to pregnant women in Burundi. FH now proposes to run Care Groups separate from PM2A food distribution so that pregnant women + those with children 0-23m can participate. Home visits will only be done with mothers of children 0-23m, but those with older children (24m+) will be allowed to participate in group mtgs. In Burundi, the strict initial registration criteria (pregnant women only) for this PM2A programs limited Beneficiary mothers from electing the best suited CGV. FH proposes that future prgms not have this restraint. PM2A program in Burundi required CG Promoters and/or CGVs to assist with food distribution activities, dividing their focus between behavior change and food distrib. PM2A links Care Group attendance with an extrinsic benefit – food ration – which can be problematic.

4. PM2A and Care Groups (cont.) Traditional Care Group Project Burundi PM2A Care Group Project Perceived Benefit of CG Attendance New knowledge, skillsKnowledge, skills, and (++) eligibility to receive a food ration Length of CGV and Neighbor Women Participation A CGV or Neighbor Women can participate as long as they desire, although after their child moves out of the target age range their participation is “unofficial.” (No home visits, but group attendance okay) New mothers added. A Care Group Volunteer or Mother Beneficiary could participate for 30 months maximum. No home visits, and group participation was discouraged. (But not a requirement of PM2A.) Who is Eligible to be elected as a CGV Any woman who has been a mother Only women eligible for PM2A participation (had to be either pregnant or have a very young child). (Not a PM2A requirement.) Length of time it takes CGV and Neighbor Women to receive all key messages Depends on the length of the curricula, but normally is 24 – 48 months. If women only participate for 30m, curricula may need to be shortened. Focus of Project Behavior ChangeFood Distribution / Behavior Change