Improving complementary feeding practices through peer counselling in Bangladesh: moving successfully from project to program mode

Sub-optimal feeding practices contribute towards malnutrition in young infants and children. Building upon successfully improving breastfeeding practices through peer counselling in Bangladesh, starting from 1995, this project tested if complementary feeding practices could be improved by similar means. Global and national infant and young child feeding counselling materials were adapted and simplified. Twelve community-based female peer counsellors in selected areas of Dhaka and Chattogram were trained over 2 weeks in 2009. They provided home-based counselling to mothers in the last trimester of pregnancy, after birth, and monthly for 1 year. Infants’ minimum dietary diversity (intake of four or more food groups) increased from 70% at 7 months to 85.6% at 12 months, and the minimum adequate diet from 61.7% to 70.9%. After the project ended in 2011, peer counselling services continued in program mode until 2017 with further improvement in the complementary feeding indicators, the minimum adequate diet rising to 89.1%. Despite several challenges, peer counsellors were satisfied, as they were respected by mothers and their families who tried to follow their suggestions. Further research is required to understand how to sustain such counselling programs.