Girl-Powered Nutrition Program: Key Themes from a Formative Evaluation of a Nutrition Program Co-designed and Implemented by Adolescent Girls in Low- and Middle-Income Countries

Elizabeth Dyke; Sophie Pénicaud; Jennifer Hatchard; Anne-Marie Dawson; Oresto Munishi; Chowdhury Jalal

doi:10.1093/cdn/nzab083

Girl-Powered Nutrition Program: Key Themes from a Formative Evaluation of a Nutrition Program Co-designed and Implemented by Adolescent Girls in Low- and Middle-Income Countries

Curr Dev Nutr. 2021 Jun 17;5(7):nzab083. doi: 10.1093/cdn/nzab083. eCollection 2021 Jul.

Authors

Elizabeth Dyke¹, Sophie Pénicaud¹, Jennifer Hatchard², Anne-Marie Dawson¹, Oresto Munishi³, Chowdhury Jalal²

Affiliations

¹ Universalia Management Group, Westmount, Montreal, Quebec, Canada.
² Nutrition International, Ottawa, Ontario, Canada.
³ Kilimanjaro Clinical Research Institute, Moshi, Tanzania.

Abstract

Background: To improve nutritional knowledge and attitudes of girls and young women, Nutrition International (NI) partnered with the World Association of Girl Guides and Girl Scouts (WAGGGS) to pilot the Girl-Powered Nutrition (GPN) program from 2018 to 2020 in 4 countries (Madagascar, the Philippines, Sri Lanka, and Tanzania).

Objective: The aim was to share adolescent girls' and programmers' experiences with co-designing and implementing the GPN program in low- and middle-income countries (LMICs).

Methods: A formative evaluation of the GPN program was commissioned by NI and undertaken by Universalia Management Group (Universalia). The evaluation was largely qualitative (employing focus groups, interviews, and document analysis). Based on the results of the formative evaluation, themes related to working with adolescent girls were identified.

Results: The involvement of adolescents in the design, implementation, and evaluation of nutrition programming that targets them is essential for meaningful uptake. Sufficient time and respect must be given to the co-design process, including clearly defining adolescents' roles, ensuring transparency and clear communication, and managing adolescents' expectations. Ensuring adequate exposure and suitable timing for adolescent nutrition programming from adequately trained staff were identified as good practices from the evaluation. Program curriculum and activities must be appropriately tailored to adolescent age and stage, target adolescents and their gatekeepers and duty-bearers, and address the underlying issues of poverty, gender inequality, and structural norms that negatively impact adolescents' agency and nutrition.

Conclusions: This research supports and elaborates on several documented and accepted good practices for working with adolescents to improve nutrition knowledge and attitudes. Similar programs with key features such as co-design, suitable timing, curriculum, and exposure of programs by age group, addressing underlying structural issues, the involvement of gatekeepers and duty-bearers, and confidence-building can increase adolescent girls' nutrition knowledge and attitudes.

Keywords: adolescents; evaluation; gender equality; girls; global health; implementation science/research; nutrition; program co-creation; qualitative methods.