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woman wearing a child on her back
Photo Credit: MCSP/USAID

In Nampula Province, Mozambique’s largest and most densely populated province, USAID Advancing Nutrition partnered with the Government of Mozambique and Transform Nutrition (TN), led by Ajuda de Desenvolvimento de Povo para Povo, to improve nutrition and early childhood development (ECD) outcomes. The partners built on the Ministry of Health's momentum around ECD and the strong foundation other partners helped establish. The baseline study USAID Advancing Nutrition conducted confirmed pervasive undernutrition among children 0–23 months and that a high proportion of children in this age group are at risk for developmental delays.

Leveraging TN and USAID Advancing Nutrition's platforms and expertise, the partners collaborated to integrate responsive care and early learning (RCEL) and monitoring for child development into TN’s community-based activities, including support for the widely used multi-sectoral nutrition intervention package (Pacote de Intervenções de Nutrição (PIN)) for community-based services. The initiative also helped create an enabling environment for these services by engaging policymakers, government technicians, and other stakeholders at the provincial and national levels in multi-sectoral coordination to ensure the sustainability of these efforts. Trained volunteers delivered the content to caregivers through community-based nutrition groups and home visits. Using a mixed methods study, USAID Advancing Nutrition examined the implementation experience, feasibility and acceptability of the integrated program, and impact of the integrated program on children’s development. Findings from qualitative data showed integration was feasible and acceptable; however, researchers only observed limited increases in caregiver engagement in early learning activities and no effects on child development (full study results are detailed in a forthcoming manuscript anticipated in mid-2024). Based on study results, researchers recommended similar programs–

  • provide additional training and supervision for community health workers and volunteers
  • create more tailored materials and trainings that meet the needs of these frontline workers
  • place a greater emphasis on ECD monitoring.

To complement this contribution to the evidence base, USAID Advancing Nutrition developed a series of videos (with translation in Portuguese) modeling and explaining responsive care and demonstrating high-quality counseling. The videos also fill a gap in job aids and can be used during RCEL training with health workers and volunteers and/or for self-learning programs. These videos can also be found by visiting Global Health Media’s website.

To find out more about this work, check out the associated webinar and this poster from the International Congress of Nutrition Conference 2022!

For more information on our work in Mozambique please visit: 

Access more videos from the Responsive Care and Early Learning Video series.
View all videos in the nurturing care series from Global Health Media.


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…