Change strategies to protect, promote, and support infant and young child feeding.

BACKGROUND: Despite the existence of a strong evidence base for investing in infant and young child feeding (IYCF), sufficiently supported IYCF policies and programs are rare.
OBJECTIVE: To develop evidence-based advocacy strategies in Bangladesh, Ethiopia, and Vietnam to enable policy change and to increase investments in and ensure scale-up and sustainability of IYCF programs.
METHODS: Situational analysis, formative and opinion leader research, and stakeholder consultations were used to develop three contextualized advocacy strategies.
RESULTS: Data were used to determine how IYCF was perceived and prioritized, identify opinion leaders and partners, identify barriers to and opportunities for strengthening commitment, and select messages, materials, and communication channels. Opinion leader research showed that malnutrition was a concern but not a priority for policy action. Where food security was an issue, poverty reduction strategies rather than IYCF programs were viewed as the solution. Few opinion leaders were aware of the importance of the first 1000 days of life. In addition to policy gaps, awareness and implementation of existing policies were limited. This was often complicated by intragovernment conflicts and perspectives. Advocacy messages needed to be evidence based and delivered by credible champions. Engaging medical associations and the media presented an opportunity rarely leveraged in IYCF advocacy. CONCLUSIONS. Although sociopolitical contexts may vary, awareness of the importance of IYCF is an overarching advocacy challenge. Consequently, investments in IYCF programs and policies lag. Evidence-based advocacy design has a potential for impact on national policies, investments, and commitment to implementation and should be used more widely to inform program design.