Assessment of Four Essential Features of the Alive & Thrive Initiative to Improve Maternal, Infant, Young Child, and Adolescent Nutrition.

Alive & Thrive has been a major global nutrition initiative that aimed to learn how to improve maternal, infant, young child, and adolescent nutrition and health on a large scale. During 2009-2014, Alive & Thrive developed and implemented interventions to improve infant and young child feeding at scale in three countries. Subsequently, Alive & Thrive expanded its work to more than 15 geographies, including six country-specific and two regional programs, to additionally address maternal and adolescent nutrition while adding agriculture and social protection programs to improve maternal, infant, and young child nutrition. Reflecting on the big picture of what the Alive & Thrive initiative has accomplished in its 16 years and how it did so, four features warranted emphasis because additional learning was needed. These four features were: commitment to exemplary large-scale social and behaviour change communication, explicit focus on policy and advocacy to achieve and sustain change, promotion of country-led initiatives through technical assistance, and attention to quality assurance and improvement in programming. For each feature, an assessment across the Alive & Thrive portfolio was commissioned, each led by an external consultant or team. The assessments highlighted designing and implementing exemplary social and behaviour change programming and policy advocacy in each country, undertaking a large-scale effort through careful, in-depth, and evidence-based planning that is bolstered by strong engagement with relevant stakeholders at multiple levels. The assessments also highlighted technical assistance that is responsive to country contexts to support country-led initiatives and attention to assuring and improving the quality of programming to achieve effectiveness.