Nutrition Impact and Positive Practice
GOAL designed the Nutrition Impact and Positive Practice (NIPP) approach as a gendered, grass-roots approach, directly tackling a package of the underlying behavioural causes of malnutrition, irrespective of the particular manifestation.
NIPP is agile and adapted to the context of its implementation.
It uses positive deviance and is focused around there being easy and viable solutions to improve and protect household health and nutrition within the community.
GOAL field-tested the approach in 2012 and rolled it out since 2013 in five GOAL country programmes – Sudan, South Sudan, Niger, Malawi and Zimbabwe.
Although GOAL takes a systemic approach to programming, direct interaction with beneficiaries remains an integral part of the NIPP approach.
Impetus for designing a new nutrition approach
The original stimulus for designing a new nutrition approach was to find an alternative to heavily input focused food-based aid programmes that have either not been found effective in reducing rates of malnutrition or have only had short lived effects, whereby their sustainability is usually untenable. GOAL also identified other programming issues, including the difficulty of implementing truly multi-sectoral initiatives, due to the inherently siloed approach of sectors.
Therefore, by designing an initiative that innately incorporates sectorally sensitive elements (Health, Water-Sanitation-Hygiene and Livelihoods), GOAL removed the need to get “buy-in” from other sectors to work collaboratively.
Currently, many nutritional programmes focus solely on the curative element of malnutrition. However, the rates of malnutrition at the global level make a compelling case for the implementation of interventions that, as well as improving the nutritional status of those already malnourished, also focus more holistically on attempting to ‘prevent’ the occurrence of malnutrition in the first instance, through changes in behaviour and practice.
Our solution are NIPP circles
GOAL has created a framework to improve the nutrition security and care practices of households either affected by, or at risk of malnutrition.
NIPP circles are male and female gatherings of community members who meet on a regular basis for a recommended period of 12 weeks to share and practice positive behaviours.
NIPP circles aim to improve the nutrition security and care practices of households either affected by, or at risk of suffering from malnutrition, through participatory nutrition/health/hygiene-sanitation learning and diet diversity promotion (including small-scale agricultural production).
The circles aim to facilitate knowledge and skills sharing of both men and women using locally available resources with discussion, practical exercises and positive reinforcement to help families adopt sustainable, positive behaviours. The concept is focused around there being easy and viable solutions accessible to all participating families.
To ensure a holistic approach, the circles provide participants with knowledge and skills through 3 main components, including a package of ‘must-have’ or ’non-negotiable’ extras:
Practical behaviour change sessions
Focused on key causes on malnutrition for improved awareness and practice.
For improved households nutrition security.
Participatory cooking demonstrations
For improved nutritional status, feeding and care practices.
A different approach
Our NIPP approach focuses on reducing malnutrition in the long term. It aims to supports communities, both men, women and leaders, in the sharing and practice of positive behaviours to reduce malnutrition.
Since the beginning of NIPP implementation in 2012, the approach has reached over 19,000 direct beneficiaries in Malawi, Niger, South Sudan, Sudan and Zimbabwe. Across these countries, NIPP has had a positive impact on nutrition-specific and sensitive behaviours.
From 2012 to 2016, diet diversity in 2,991 children aged 6-23 months who reached graduation increased from 28% on admission to 71% on graduation; and of 3,328 children aged 6-59 months admitted to NIPP with moderate acute malnutrition, 82% were discharged cured.
Who is the NIPP toolkit for?
For those who wish to implement the NIPP approach.
The toolkit aims to meet the needs of the Ministry of Health and other organisations nutrition programme managers, coordinators, and advisors who wish to implement the NIPP approach.
In addition to the implementation guidelines for the NIPP approach supporting the rollout and the monitoring of NIPP circles, the toolkit contains planning, costing and communication tools.
In countries with existing national protocols for the treatment of acute malnutrition and the prevention of chronic malnutrition, this toolkit should be adapted to be aligned with and to support the existing nutrition policies.
Implementation guidelines for Nutrition Impact and Positive Practice (NIPP) approach
The aim of the implementation guidelines for the NIPP approach is to provide public access to NIPP guidelines and tools developed by GOAL. GOAL will strive to disseminate information that is accurate and up-to-date on the day it was initiated. Every effort will be made to correct any errors that are brought to our attention.