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Group of mothers holding their children while sitting under a tree in Ghana. The two mothers in the front of the group are smiling :).
Photo Credit: Bishnu Prasad Ghimire for JSI

Evidence shows that integrating nurturing care into existing nutrition programs results in improved nutrition and early childhood development outcomes. USAID Advancing Nutrition developed the Responsive Care and Early Learning (RCEL) Addendum to help programs integrate responsive care and early learning content into existing infant and young child feeding (IYCF) counseling and provide holistic nurturing care for children from birth to age three.

Responsive Care and Early Learning Addendum Resources for Ghana

Visit the RCEL Addendum Resources for Ghana page to access and download all of the materials required for any program interested in using the RCEL Addendum in Ghana.

Package Adapted and Tested in Ghana

Between 2021–2023, USAID Advancing Nutrition supported the adaptation, implementation, and testing of the RCEL Addendum in Ghana. Counselors provided RCEL counseling to caregivers of children 0–2 years of age using existing facility- and community-based health and nutrition platforms.

Methods and Results

Using a mixed methods approach, USAID Advancing Nutrition tested the feasibility, acceptability, and effectiveness of integrating the RCEL Addendum into existing health and nutrition counseling services in Ghana. Training, supervision, and qualitative data showed that implementation of the RCEL Addendum in Ghana was both feasible and acceptable to counselors and caregivers. Study results showed improvements in responsive caregiving practices and early learning opportunities, reductions in parental stress, and opportunities for improved adult supervision. Commitment from and collaboration with the Government of Ghana and close alignment with existing health system infrastructure were critical for success. Details of the results can be found in this webinar series.

USAID Advancing Nutrition documented how we adapted the materials for the Ghanaian context through a summary brief on how we trained and supported the counselors to conduct the RCEL training and a more in-depth report. The report provides further insights into our adaptation and training processes to help guide other programs seeking to replicate this work. During adaptation, we found a need for practical guidance for covering growth and development content during counseling and streamlining workflows to ensure sufficient time for counseling during routine appointments. Learn how we co-designed this guidance with health workers in this blog!

Related Resources

USAID Advancing Nutrition has developed other resources and shared materials related to the RCEL Addendum implementation in Ghana, including a counseling brief for health workers and a webinar. The RCEL Addendum was also adapted, implemented, and tested in the Kyrgyz Republic.

For more information on our work in Ghana please visit:


Recognizing contextual challenges with counseling that often go unaddressed (e.g., limited time, heavy workloads, practical integration of nurturing care), USAID Advancing Nutrition partnered with…