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FIELD ACTION REPORT
Open Access

Lessons Learned From Integrating Infant and Young Child Feeding Counseling and Iron-Folic Acid Distribution Into Routine Immunization Services in Ethiopia

Natasha Kanagat, Adriana Almiñana, Belayneh Dagnew, Lisa Oot, Amare Bayeh, Daniel Girma, Tewodros Alemayehu, Getu Molla Tarekegn, Yohannes Lakew Tefera, Meseret Zelalem Tadesse, Hiwot Darsene Dimd and Zenaw Adam
Global Health: Science and Practice October 2022, 10(5):e2200166; https://doi.org/10.9745/GHSP-D-22-00166
Natasha Kanagat
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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  • For correspondence: natasha_kanagat@jsi.com
Adriana Almiñana
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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Belayneh Dagnew
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Lisa Oot
aJSI Research & Training Institute, Inc., Arlington, VA, USA.
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Amare Bayeh
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Daniel Girma
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Tewodros Alemayehu
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Getu Molla Tarekegn
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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Yohannes Lakew Tefera
cFederal Ministry of Health, Addis Ababa, Ethiopia.
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Meseret Zelalem Tadesse
cFederal Ministry of Health, Addis Ababa, Ethiopia.
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Hiwot Darsene Dimd
cFederal Ministry of Health, Addis Ababa, Ethiopia.
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Zenaw Adam
bJSI Research & Training Institute, Inc., Addis Ababa, Ethiopia.
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    FIGURE

    Proposed Client Flow Graphic for Integrated Nutrition and Immunization Outreach and Mobile Sessions in Ethiopiaa

    Abbreviations: ANC, antenatal care; IFA, iron and folic acid; OR/M, outreach/mobile; TT, tetanus toxoid.

    aSimilar client flow graphics were proposed for static sessions in health facilities.

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    TABLE 1.

    Time Frames for Proposed Integrated Immunization and Nutrition Services in Ethiopia

    Vaccine(s) ProvidedTarget Time/Age for InterventionNutrition-Related Services/Guidance to Provide(IFA and IYCF)
    Tetanus toxoidPregnancyPregnancyIFA supplementation, counseling on nutrition for pregnant and lactating women, recommendation regarding initiating breastfeeding immediately after birth
    BCG, OPV0At birth0–6 monthsBreastfeeding in first hour of life, colostrum feeding, exclusive breastfeeding counseling
    First dose: Penta, OPV, PCV, Rota6 weeksExclusive breastfeeding counseling
    Second dose: Penta, OPV, PCV, Rota10 weeks
    Third dose: Penta, OPV, PCV, Rota, IPV14 weeks
    First dose: Measles9 months6–23 monthsContinued breastfeeding, introduction of complementary foods, counseling for complementary feeding (messages may vary based on age of child)
    Second dose: Measles15 months
    • Abbreviations: BCG, bacille Calmette-Guerin; IFA, iron and folic acid; IYCF, infant and young child feeding; IPV, inactivated polio vaccine; OPV0, oral polio vaccine given at birth; penta, pentavalent vaccine; PCV, pneumococcal vaccine; Rota, rotavirus.

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    TABLE 2.

    Distribution of Health Facilities by District and Region, Ethiopia

    RegionDistrictHealth Facilities, No.
    AfarAssaieta11
    SomaliAdadle8
    GambelaGodere9
    Benishangul GumuzBullen19
    Total47
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Global Health: Science and Practice: 10 (5)
Global Health: Science and Practice
Vol. 10, No. 5
October 31, 2022
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Lessons Learned From Integrating Infant and Young Child Feeding Counseling and Iron-Folic Acid Distribution Into Routine Immunization Services in Ethiopia
Natasha Kanagat, Adriana Almiñana, Belayneh Dagnew, Lisa Oot, Amare Bayeh, Daniel Girma, Tewodros Alemayehu, Getu Molla Tarekegn, Yohannes Lakew Tefera, Meseret Zelalem Tadesse, Hiwot Darsene Dimd, Zenaw Adam
Global Health: Science and Practice Oct 2022, 10 (5) e2200166; DOI: 10.9745/GHSP-D-22-00166

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Lessons Learned From Integrating Infant and Young Child Feeding Counseling and Iron-Folic Acid Distribution Into Routine Immunization Services in Ethiopia
Natasha Kanagat, Adriana Almiñana, Belayneh Dagnew, Lisa Oot, Amare Bayeh, Daniel Girma, Tewodros Alemayehu, Getu Molla Tarekegn, Yohannes Lakew Tefera, Meseret Zelalem Tadesse, Hiwot Darsene Dimd, Zenaw Adam
Global Health: Science and Practice Oct 2022, 10 (5) e2200166; DOI: 10.9745/GHSP-D-22-00166
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    • ABSTRACT
    • INTRODUCTION
    • UNIVERSAL IMMUNIZATION THROUGH IMPROVING FAMILY HEALTH SERVICES PROJECT
    • PILOT STUDY DESIGN
    • THEMATIC FINDINGS
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