Program Impact Pathway Analysis of a Social Franchise Model Shows Potential to Improve Infant and Young Child Feeding Practices in Vietnam

被引:50
作者
Nguyen, Phuong H. [1 ]
Menon, Purnima [2 ]
Keithly, Sarah C. [3 ]
Kim, Sunny S. [4 ]
Hajeebhoy, Nemat [5 ]
Tran, Lan M. [5 ]
Ruel, Marie T. [4 ]
Rawat, Rahul [4 ]
机构
[1] IFPRI, Hanoi, Vietnam
[2] IFPRI, New Delhi, India
[3] Inst Social & Med Studies, Hanoi, Vietnam
[4] IFPRI, Washington, DC USA
[5] FHI 360, Hanoi, Vietnam
关键词
COMMUNE HEALTH STATIONS; LARGE-SCALE PROGRAMS; REPRODUCTIVE HEALTH; CLIENT SATISFACTION; IMPLEMENTATION; SERVICES; NUTRITION; PERCEPTIONS; BEHAVIOR; MYANMAR;
D O I
10.3945/jn.114.194464
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
By mapping the mechanisms through which interventions are expected to achieve impact, program impact pathway (PIP) analysis lays out the theoretical causal links between program activities, outcomes, and impacts. This study examines the pathways through which the Alive & Thrive (A&T) social franchise model is intended to improve infant and young child feeding (IYCF) practices in Vietnam. Mixed methods were used, including qualitative interviews with franchise management board members (n = 12), surveys with health providers (n = 120), counseling observations (n = 160), and household surveys (n = 2045). Six PIP components were assessed: 1) franchise management, 2) training and IYCF knowledge of health providers, 3) service delivery, 4) program exposure and utilization, 5) maternal behavioral determinants (knowledge, beliefs, and intentions) toward optimal IYCF practices, and 6) IYCF practices. Data were collected from A&T-intensive areas (A & T-I; mass media + social franchise) and A&T-nonintensive areas (A & T-NI; mass media only) by using a cluster-randomized controlled trial design. Data from 2013 were compared with baseline where similar measures were available. Results indicate that mechanisms are in place for effective management of the franchise system, despite challenges to routine monitoring. A&T training was associated with increased capacity of providers, resulting in higher-quality IYCF counseling (greater technical knowledge and communication skills during counseling) in A&T-I areas. Franchise utilization increased from 10% in 2012 to 45% in 2013 but fell below the expected frequency of 915 contacts per mother-child dyad. Improvements in breastfeeding knowledge, beliefs, intentions, and practices were greater among mothers in A&T-I areas than among those in A&T-NI areas. In conclusion, there are many positive changes along the impact pathway of the franchise services, but challenges in utilization and demand creation should be addressed to achieve the full intended impact.
引用
收藏
页码:1627 / 1636
页数:10
相关论文
共 40 条
[1]  
Agha S., 2003, A Quasi-Experimental Study to Assess the Performance of a Reproductive Health Franchise in Nepal
[2]   Changes in perceptions of quality of, and access to, services among clients of a fractional franchise network in Nepal [J].
Agha, Sohail ;
Gage, Anastasia ;
Balal, Asma .
JOURNAL OF BIOSOCIAL SCIENCE, 2007, 39 (03) :341-354
[3]   The impact of a reproductive health franchise on client satisfaction in rural Nepal [J].
Agha, Sohail ;
Karim, Ali Mehryar ;
Balal, Asma ;
Sosler, Steve .
HEALTH POLICY AND PLANNING, 2007, 22 (05) :320-328
[4]   Impacts of a government social franchise model on perceptions of service quality and client satisfaction at commune health stations in Vietnam [J].
Anh Ngo ;
Ha Phan ;
Van Pham ;
Thang Trinh ;
Khoa Truong .
JOURNAL OF DEVELOPMENT EFFECTIVENESS, 2009, 1 (04) :413-429
[5]  
[Anonymous], 2009, STAT STAT SOFTW REL
[6]  
[Anonymous], IMPL SCI INF RES
[7]  
[Anonymous], 2010, ALIVE THRIVE BASELIN
[8]  
[Anonymous], 2012, CLIN SOCIAL FRANCHIS
[9]  
[Anonymous], 2003, 57 PSI RES DIV
[10]  
[Anonymous], FORM RES INF YOUNG C