Content Analysis of Training Modules on IFE
By Caroline Wyrosdick, BA, MS
Caroline Wyrosdick recently completed her MSc at Tufts University, concentrating in humanitarian assistance. She works as a nutritionist with the Supplemental Nutrition Programme for Women, Infants and Children (WIC) in Asheville, North Carolina.
Two orientation/training modules on Infant and Young Child Feeding in Emergencies (IFE) have been developed through interagency collaboration1. In 2007, an independent evaluation of the effectiveness of both Modules as a tool for addressing the challenges of infant and young child feeding in emergencies was initiated and carried out. Key findings of this evaluation are summarized below (the full evaluation is available at www.ennonline.net/ife).
A set of four key criteria were used to evaluate the effectiveness of the Modules' content. The term 'effective' was defined as being comprehensive, applicable and therefore, useful, in various emergency contexts.
Criteria for Analysis
The materials were evaluated against four integral criteria ('characteristics'):
- Clear objectives and evidence of assessment and evaluation
- Use of scientific arguments
- Challenge identification and provision of clear, practical tools for addressing challenges
Each criterion had key defined conditions for their evaluation (Box 1). Modules fulfilling all four characteristics were deemed likely to be most useful to their targeted audiences. If the Module analysed met at least two conditions (and, in the case of characteristic 2, only 1 condition) of a given characteristic, this characteristic was considered to be met.
Box 1: Criteria/characteristics and conditions for content analysis
|Table 1: Associated pathologies at admission
|1. Clear objectives and evidence of assessment and evaluation
||a. Clear objectives including a defined target audience.
b. The Modules were created after some form of careful and thorough assessment of challenges involved with infant feeding in emergency contexts.
c. Instruction given in the Modules emphasises the necessity of organisations' incorporation of an analysis of infant feeding into any current assessments of food and livelihood security, as well as all rapid assessments conducted after the occurrence of an emergency.
d. Within the Modules, the [IFE] Core Group asks for feedback, thus informing their working group of necessary updates.
|2. Condition regarding use of scientific arguments
||a. Modules support claims regarding the health benefits of breast feeding with scientific arguments.
|3. Conditions of challenge identification and provision of clear, understandable tools for addressing said challenges
||a. Specific and common challenges to infant feeding in emergencies are identified.
b. Practical solutions including specific tools useful in addressing identified challenges are given.
c. Pictures, figures and graphs used as tools are informative and culturally appropriate for various contexts.
d. The information and tools offered speak to previously identified target audiences and their dissemination is feasible.
|4. Conditions of Accessibility
||a. Evidence of interagency collaboration in Module creation.
b. Module contains clear and concise language and definitions are provided for key terms.
c. Modules are accessible to those who want and need to use them.
d. Translations of the Modules are available.
Outcomes of Content Analysis
The evaluation explored how the Modules met each of the conditions, extensively citing examples from the Modules to evidence findings. Modules 1 and 2 met at least two conditions of each characteristic (excepting characteristic 2 that only had one condition), and therefore met all four identified criteria. Conditions noted as strongly met were: identification of challenges to IFE (Condition 3a) and practical tools to address them (Condition 3b), evidence of interagency collaboration in their creation (Condition 3a) and scientific arguments used (Condition 2).
There were characteristics where all the conditions were not met and/or there was room for improvement. The most significant were:
Condition 1a. Clear objectives including a defined target audience
Though target audiences are clearly identified and included individuals involved at all levels in emergency response, Module 1's target audience includes "decisionmakers and regional planners". This is too vague. It would be helpful to define where possible who the "decisionmakers" of interest are.
Condition 3c. Pictures, figures and graphs used as tools are informative and culturally appropriate for various contexts.
Both Modules include extensive graphs, pictures and figures to offer case studies and facilitate discussion. However, many of the pictures in both Modules are of African women and show exposed breasts that may not be culturally acceptable elsewhere. Tailoring pictures in the manuals for different audiences/contexts is recommended.
Condition 3d. The information and tools offered speak to previously identified target audiences and their dissemination is feasible.
Both Modules 1 and 2 include guidelines for facilitators, including mode of delivery and suggested duration to cover topics for both Modules 1 and 2 and so meet Condition 3d. However, a potential problem may be the ability of field managers to disseminate and field practitioners to filter and process all of the information contained in the Modules in order to devise an orientation/ training. Planning time for devising training and dissemination was suggested as crucial, rather than relying on the distribution of these resources in the midst of an emergency for reference. Including the Modules in routine staff training would be ideal.
Condition 1d: Within the Modules the Core Group asks for feedback, thus informing their working group of necessary changes.
Since both Modules are considered 'working documents', feedback should be solicited more explicitly in the print version of the Modules (feedback is sought online).
Condition 4d. Translations of the Modules are available.
At the time of the evaluation (2007), both Modules were only available in English and this was identified as a significant limitation2.
The time lag between production of Module 1 (2001) and the more technical Module 2 (2004) was also noted in the evaluation. Lack of funds to support the module development and the need to address technical gaps (artificial feeding in emergencies and managing malnourished infants under six months) identified in the course of development of Module 2 were the main reasons identified for the delay.
The evaluation concludes that the reviewed Modules are an effective tool and their thoroughness is demonstrated in the content analysis. A limitation of the evaluation is that there is no formal qualitative or quantitative analysis of the Modules' impact. The detailed analysis of the evaluation, especially where conditions are not fully met, should provide useful guidance in the development of these materials and support their implementation.
Since this evaluation, Module 1 on IFE is being extensively revised by the IFE Core Group funded by the IASC Nutrition Cluster. Version 2.0 of Module 1 should be available by Dec 2008 (see news piece in this issue of Field Exchange).
The full evaluation report is available on the ENN website, www.ennonline.net/ife in the IFE Resource Library. For further information, contact: Caroline Wyrosdick, email: Wyrosdick@gmail.com
1Module 1 on IFE was developed to respond to an identified gap in capacity of emergency relief staff to support IFE. It supported the implementation of the Operational Guidance on IFE that was first produced also in 2001. Module 2 on IFE was finalised in 2004 and targets nutrition and health staff directly involved with supporting mothers and children in emergencies. Both are in print and online at www.ennonline.net/ife.
2Since then, Module 2 has been translated into French and Bahasa (Indonesia). Module 1 is being revised through 2008 and translation will be sought for the new version.
Taken from Field Exchange Issue 34, October 2008