Abstract
OBJECTIVE: To evaluate the impact of a counselling programme to strengthen the health and nutrition behaviours of caregivers of children under 2 and the sustainability of that impact through reduced intervention intensity one year later. DESIGN: The programme trained community- and facility-based health staff to provide nutrition counselling. We conducted an impact evaluation with a modified stepped-wedge design using difference-in-differences analysis to compare indicator changes in an intervention group to a comparison group (midterm survey) and then a full intervention group to a light intervention group (final survey). SETTING: Batken and Jalal-Abad oblasts, the Kyrgyz Republic, 2020-2023. PARTICIPANTS: Caregivers of children under 2 provided 6253 responses in three telephone surveys. RESULTS: We observed statistically significant differences between the intervention and comparison groups at midterm for the percentage of children consuming vitamin A-rich foods; an increase in the intervention group (58-62 %) and a decrease in the comparison group (61-57 %). We observed similar results with exclusive breastfeeding (51-55 % in the intervention group and 48-40 % in the comparison group). There were also positive differences in other health and nutrition indicators. With the final survey results, in general, we observed statistically significant differences indicating a bigger change in full intervention areas compared to light intervention areas. We observed small negative changes in many indicators in light intervention areas. CONCLUSIONS: This evaluation highlights the importance of continued support for local interventions, particularly counselling programmes, to foster optimal nutrition behaviours.