Counseling to Improve Maternal Nutrition: Considerations for programming with quality, equity and scale

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Women’s nutritional status is important for their health and wellbeing and for the birthweight, growth and development of their infants. Nutritious diets, essential nutrition services and optimal nutrition practices are essential to prevent all forms of malnutrition before and during pregnancy and while breastfeeding.

Maternal nutrition counselling helps a woman and her family members make decisions and take action to improve nutrition. This includes decisions and actions on the types, diversity and amounts of food a woman should eat to meet her dietary requirements, the amount of physical activity she needs, and her consumption of dietary supplements.

Many women do not receive quality nutrition counselling, even though this service is a recommended component of health care. This programme brief aims to provide UNICEF country offices and their partners with guidance on how to improve the coverage, quality and equity of maternal nutrition counselling in low- and middle-income countries. It covers adolescent girls and women aged 15–49 years during three periods: preconception (for those planning a pregnancy); pregnancy; and postnatal (at least six months after delivery).

This programme brief describes a set of approaches to strengthen maternal nutrition counselling. This begins with an understanding of the context, including the barriers and enablers to maternal nutrition counselling services and the adoption of optimal nutrition practices. It then outlines: approaches to improve the enabling environment for maternal nutrition counselling; key considerations for the design of counselling services; strategies for strengthening service delivery platforms and building the capacity of health workers and community health workers; complementary actions to improve women’s access to dietary supplements and nutritious and affordable diets; strategies for delivering maternal nutrition counselling services in humanitarian contexts; and approaches to monitoring maternal nutrition counselling services.

The evidence base on how to improve the coverage, quality and equity of maternal nutrition counselling is still developing, so this programme guidance should be considered a living document. Countries should invest in research to further build the evidence of how to strengthen the coverage, quality and equity of counselling in different settings.

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