Our project partner African Population Health Research Center is working on a study looking at home based nutritional counselling interventions in urban poor settings in Nairobi, Kenya and asks whether there is a social return on investing in these initiatives?

Project Summary

In Kenya poor infant and young child feeding practices and high level of malnutrition have been documented, particularly among the urban poor. Breastfeeding for the first six months without giving any food or fluids as recommended by the World Health Organization is quasi inexistent among the urban poor while almost half of the urban poor children are too short for their age (reflective of chronic malnutrition). To provide new evidence on promoting better nutritional health in children, the African Population and Health Research Center (APHRC) in collaboration with the Unit of Nutrition and Dietetics and the Unit of Community Health Services, Ministry of Health, Kenya conducted a study with a home based nutritional counselling intervention of mothers by community health workers. The research component of the study aimed at testing how successful it would be to promote better infant feeding practices and to improve child nutritional and health outcomes in two Nairobi slums, Kenya. The study selected about 1000 pregnant women and followed them past delivery until their children were about one year of age. The study acted as a pilot study for the Baby Friendly Community Initiative (BFCI), a global initiative proposed to be started in Kenya at the national level by the Kenyan government, and aimed to inform its scale-up.

Social Return on Investment (SROI)
The study proposed here, will assess the Social Return on Investment (SROI) of the home-based nutritional counselling intervention. SROI is a method that measures the impact of an intervention in a participatory way. It measures change in ways that are relevant to the people that experience or contribute to it. Monetary values are used to represent the changes created including social, environmental and economic outcomes. The study will involve interviews and group discussions with people who directly benefited from the intervention called stakeholders. These include mothers, other household members (e.g. father), community members including health care workers, community leaders, other key actors in child health and survival including government officers and officers from other implementing organizations. Resources needed to carry out the intervention will be identified during the interviews and group discussions. The next step will be to ask the stakeholders about the achieved results of the project according to them. These effects will include both the positive and the negative. Valuation, also known as monetisation will be used to translate social or environmental effects into monetary values. At the end of process, the SROI ratio will be calculated by comparing the investments (inputs) and the financial, social and environmental returns (outcomes and impact of an intervention) as follows: SROI ratio = Total (adjusted) value of results / Total value of inputs.

Our findings
The study will explain the value of the intervention from the stakeholder point of view, which will contribute to evaluation of the real value of the intervention. This is useful in scaling up the intervention with regard to the proposed national BFCI program in Kenya. The findings will be used to inform the planning of future programming by increasing the value the intervention created in the community and society. The proposed research will also contribute to the ongoing research (e.g. in Bangladesh and Ethiopia by Transform Nutrition) in recognizing the wider benefits of a nutritional intervention in the community, society and thus not limiting the evaluation to only economic terms. Therefore, in line with Transform Nutrition’s goal, the study will address a wider goal of informing on prioritisation, implementation and scaling-up of nutrition specific interventions. Study findings will be disseminated widely to policy/decision makers and implementers in Kenya, Eastern Africa and beyond to ensure use of the evidence to inform decisions/policies and practice. As a result, it is expected that effective implementation of the BFCI in Kenya and possibly other Eastern African countries will lead to improved maternal and child with regard to the proposed national BFCI program in Kenya. The findings will be used to inform the planning of future programming by increasing the value the intervention created in the community and society. The proposed research will also contribute to the ongoing research (e.g. in Bangladesh and Ethiopia by Transform Nutrition) in recognizing the wider benefits of a nutritional intervention in the community, society and thus not limiting the evaluation to only economic terms. Therefore, in line with Transform Nutrition’s goal, the study will address a wider goal of informing on prioritisation, implementation and scaling-up of nutrition specific interventions. Study findings will be disseminated widely to policy/decision makers and implementers in Kenya, Eastern Africa and beyond to ensure use of the evidence to inform decisions/policies and practice. As a result, it is expected that effective implementation of the BFCI in Kenya and possibly other Eastern African countries will lead to improved maternal and child nutritional and health outcomes.