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Photo of a community health work counsels a woman in her home
Photo Credit: Maxime Fossat/USAID Advancing Nutrition

Counseling is an essential service to support and improve maternal, infant, and young child nutrition and child development outcomes.

Counseling is more than education and providing information. Trained providers counsel clients through tailored and interactive discussions to strengthen their knowledge, motivation, skills and/or confidence to adopt and continue positive nutrition and other nurturing care practices. Through counseling, individuals decide for themselves what actions to take.

Clients need to have the agency, resources, time, and support to act on the counseling provided. Counseling is most effective when combined with interventions at the household, community, and societal levels that reinforce positive nutrition and nurturing behaviors and create a supportive environment for clients to act.

Unfortunately, overburdened workforces, insufficient training, lack of materials, poor remuneration/incentives, high staff turnover, and inadequate supervision/monitoring, among other barriers, can limit counselors’ ability to provide quality counseling.

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Photo of a community health worker counsels a family of four
Photo Credit: Maxime Fossat/USAID Advancing Nutrition

USAID Advancing Nutrition has conducted research and generated materials that highlight ways program designers and implementers can help create a supportive enabling environment for clients to act on counseling guidance. 

These resources—

  • Share research and guidance on how to understand and respond to social norms that impact maternal, infant, and young child diets and design more effective social and behavior change activities to support improved complementary feeding practices.
  • Share guidance to encourage more acknowledgement, support, and measurement of caregiver resources that are likely relevant to providing optimal feeding and nurturing care for young children.
  • Share guidance around how to engage family members in maternal, infant, and young child nutrition activities and create a supportive enabling environment for caregivers to act on nutrition counseling.

Counseling Brief Series: Tools and Capacity Strengthening

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Photo of community health work counsels a mother and a baby
Photo Credit: Romilla Karnati/Save the Children

Over the past five years, USAID Advancing Nutrition has undertaken several activities to support the provision of quality counseling for nutrition and other components of nurturing care, and has consolidated learnings from these activities into a two-part brief series that aims to—

  • Help address gaps in the global evidence base around how to provide quality counseling.
  • Provide insights into how to address barriers to quality counseling for nutrition and nurturing care.
  • Inform USAID Missions, implementers, and other stakeholders to more effectively design and support counseling services.

The two-part brief series shares USAID Advancing Nutrition’s experiences designing and implementing various tools and two capacity strengthening approaches—supportive supervision and mentorship to improve nutrition and nurturing care counseling.

Explore Our Work on Counseling

Tools, such as job aids, can address some of the barriers to quality counseling by helping to motivate, remind, and focus information for health workers. Evidence shows that using appropriate job aids, can help health workers successfully provide tailored counseling to clients, addressing their current needs by listening and problem solving with them, not simply educating them. Tools can also help make complex information more accessible, help counselors build trust with clients, and prioritize children for counseling.

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Photo of community health work counsels a mother and a baby

Strengthening Counseling through Improved Tools for Health Workers

This brief shares USAID Advancing Nutrition-supported tools and experiences complementing global and local efforts to reduce barriers; address skill gaps; and improve the delivery of quality nutrition, responsive care, and early learning counseling.

View the Brief ›

Featured Resources

Empathways/Sharing Histories
Activity Page published by USAID Advancing Nutrition
Breakthrough ACTION Nigeria and USAID Advancing Nutrition partnered with communities in Kebbi State to answer the question: What tools do community health workers want to help them practice compassionate counseling on nutrition? Using a human-centered design (HCD) approach, the team aimed to develop tools with community health workers (CHWs) that are easy to use and build trusted connections with caregivers and their families.

View Resource ›

Responsive Care and Early Learning (RCEL) Addendum for IYCF Counseling in Kyrgyz Republic and Ghana
Counseling Package published by USAID Advancing Nutrition
To address gaps in existing nutrition counseling packages, USAID Advancing Nutrition, together with an external technical advisory group, has developed counseling materials that can be added or integrated into existing child health, nutrition, or infant and young child feeding (IYCF) counseling packages.

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Supporting Community-Level Counseling on Common Childhood Illnesses and Nutrition-Related Behaviors in Kenya
Activity Page published by USAID Advancing Nutrition
USAID Advancing Nutrition is supporting efforts to improve child health and nutrition in Kenya. Since 2015, community health volunteers (CHVs) have been implementing the integrated community case management (iCCM) program, providing their communities with identification, treatment, and referral services for common childhood illnesses such as pneumonia, diarrhea, malaria, and malnutrition.

View Resource ›

Additional Resources

Using Digital Tools to Strengthen Nutrition Service Delivery: An Overview
Brief published by USAID Advancing Nutrition
This report helps experts in both nutrition and digital health identify and fill gaps by providing an overview of how digital tools have been used to strengthen nutrition services and highlighting key features of successful tools.

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Feeding and Disability Resource Bank
Resource Collection published by USAID Advancing Nutrition
The Feeding and Disability Resource Bank is a repository of materials that help nutrition and disability program managers, government leaders, and donor agency staff design and implement effective nutrition programs for children with disabilities.

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Measuring Caregiver Resources Toolkit
Resource Collection published by USAID Advancing Nutrition
This toolkit presents a set of measures of Caregiver Resources relevant to the care of young children, and in particular, nutrition outcomes to help program and research teams understand whether their programs successfully influence these Caregiver Resources.

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Behavioral Barriers to Feeding Young Children During and After Illness
Guide published by USAID Advancing Nutrition and Breakthrough ACTION
The perspectives, experiences, and challenges shared by caregivers, health workers, and others in South Kivu in the Democratic Republic of the Congo (DRC) describe the behavioral factors that stand in the way of optimal complementary feeding during and after illness.

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Behavioral Solutions for Child Feeding During and After Illness
Guide published by USAID Advancing Nutrition and Breakthrough ACTION
This resource outlines solutions that support families so they can continue feeding their young children during periods of illness and feed children more in the two weeks following illness.

View Resource ›

Health workers need a solid foundation of technical knowledge and interpersonal skills—including problem solving, empathy, communication, and listening—to provide quality counseling and improve nutrition and child development outcomes. Counselors need continued support throughout their careers to provide quality counseling. Post-training supportive supervision and mentoring are effective approaches to reinforce and strengthen a counselor’s knowledge and skills and play an important role in improving provider and supervisor relationships, motivation, and ultimately service delivery. 

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Photo of a demonstration of supportive supervision

Strengthening Counseling Capacity through Supportive Supervision and Mentorship

Learn more about USAID Advancing Nutrition’s experiences supporting health workers’ provide nutrition and responsive care and early learning counseling through supportive supervision and mentorship activities.

View the Brief ›

Featured Resources

Breastfeeding Counseling Mentorship in Kenya
Activity Page published by USAID Advancing Nutrition
USAID Advancing Nutrition is developing and testing a model mentorship program to improve the quality of breastfeeding counseling provided by health workers in Kenya.

View Activity Page ›

Supportive Supervision Brings Better Health Services to the Kyrgyz Republic
Success Story published by SPRING
The SPRING project helped health facilities in the Krygyz Republic develop internal supportive supervision systems in which health workers participated in clinical trainings to strengthen their IYCF and anemia counseling skills. USAID Advancing Nutrition has advanced SPRING’s work by continuing supportive supervision to improve nutrition counseling performance across Kyrgyz Republic oblasts.

View Resource ›

Additional Resources

Qualitative Study on Skills and Capacity Barriers in Turkana County, Kenya: Study Report
Technical Report published by USAID Advancing Nutrition
USAID Advancing Nutrition conducted this formative research to understand the counseling community health volunteers provide related to the prevention of pneumonia and malnutrition.

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Growth Monitoring and Promotion in Northern Ghana: A Case Study Narrative
Case Study published by USAID Advancing Nutrition
This country narrative highlights findings, challenges, good practices, and innovations from northern Ghana related to routine growth monitoring and promotion. 

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Growth Monitoring and Promotion in Three Districts of Nepal: A Case Study Narrative
Case Study published by USAID Advancing Nutrition
This country narrative highlights findings, challenges, and good practices from three districts of Nepal related to routine growth monitoring and promotion. 

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Learning from Health System Actors and Caregiver Experiences in Ghana and Nepal to Strengthen Growth Monitoring and Promotion
Journal Article published by PLOS One and USAID Advancing Nutrition
The objective of this study was to describe implementation of growth monitoring and promotion (growth monitoring, growth promotion, data use, and implementation challenges) in two countries, Ghana and Nepal, to identify key actions to strengthen GMP programs.

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Implementing Two National Responsibilities of the Revised UNICEF/WHO Baby-Friendly Hospital Initiative: A Two-Country Case Study
Journal Article published by Maternal & Child Nutrition and USAID Advancing Nutrition
This research article includes qualitative case studies to institutionalize the Ten Steps to Successful Breastfeeding in the Kyrgyz Republic and Malawi.

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Strengthening Nutrition Competencies for Nurses: A Tool for Updating Pre-Service Training
Toolkit published by USAID Advancing Nutrition
This tool can be used to help review and improve the nutrition content in existing pre-service training curricula for health workers who provide frontline nutrition services.

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Community Health Worker Competency List for Nutrition Social and Behavioral Change
Guidance published by USAID Advancing Nutrition
This resource identifies 38 competencies that are important for community health workers to demonstrate in order to carry out high-quality social and behavior change activities for improved nutrition.

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Frontline Nutrition Service Delivery: A Comparison of Packages for Policymakers and Program Managers
Technical Report published by USAID Advancing Nutrition
This report presents several generic nutrition program packages for frontline health and nutrition service delivery and clarifies what each can and cannot address. 

View Resource ›