ProPAN: Process for the Promotion of Child Feeding - Field Manual

ProPAN is a tool to design, implement, and evaluate interventions and programmes to improve infant and young child diet and feeding, updated to ProPAN 2.0. It includes 1) this field manual with step-by-step guidelines on how to apply quantitative and qualitative research methods; 2) an Epi Info™-based software programme for data entry and analysis; and 3) a software user’s guide. The tool was jointly developed by the Pan American Health Organization (PAHO) and the United Nations Children's Fund (UNICEF).

The tool provides:

"A process for identifying specific breastfeeding and complementary feeding problems, based on 12 ideal practices, and defining the context in which these problems occur

• Quantitative and qualitative research techniques for joint analysis of breastfeeding and complementary feeding practices
• Software for standardized input and output of anthropometric, diet and feeding information
• A method for formulating, ranking, and selecting dietary and feeding recommendations that are practical, feasible, and acceptable to caregivers and health care providers
• Guidance on how to convert the resulting information into an intervention or program and for monitoring and evaluation"

ProPAN 2.0 includes four modules:

• "Module I provides quantitative and qualitative data collection instruments and guidelines for assessing and identifying anthropometric, dietary, and feeding problems. Quantitative instruments include a Caregiver Survey, a 24-hour Dietary Recall and Anthropometry, and a Market Survey. Qualitative methods include Opportunistic Observations, Semi-structured Interview and a Food Attributes Exercise. The main product is a list of potential recommendations to address the problems identified.
• Module II provides guidelines for a Recipe Creation Exercise and for evaluating, through behavior and recipe trials, and Focus Groups, the acceptability and feasibility of the potential recommended practices identified in Module I and for identifying locally accessible nutrient-rich foods appropriate for infants and young children. The main product is a final list of recommendations that are feasible and acceptable to caregivers and health care providers.
• Module III provides guidelines for developing an intervention plan crafted around the recommendations selected in Module II. The main products are strategies, activities, materials, and messages for promoting the selected recommendations.
• Module IV provides guidelines for designing a plan for monitoring the implementation of the intervention and evaluating its impact.

ProPAN modules can be used individually or as one comprehensive exercise, depending on the needs of the user. Modules I and II can also be used to train nutritionists in quantitative and qualitative research methods." 

Each module includes the purpose, product, and steps for design, as well as annexes of materials to carry out the module. Module III includes examining recommendations from the individual-level research done in other modules and considering the macro level, for example, social and institutional environments and communication channels. These channels vary with the audience of choice, e.g., caregivers, grandmothers, health workers, teachers, pharmacists, etc. A social and behaviour change communication (SBCC) plan is then developed to promote the selected infant and child feeding plan developed. A training package for community programme staff is developed following the Generic Community-based Infant and Young Child Feeding Counseling Package developed by UNICEF and the University Research Corporation (UNICEF and University Research Group, 2010). Community participation would be sought at each stage of development (problem analysis, planning, implementation, monitoring, and evaluation) and would include community assemblies, community mobilisations, and community representatives - each of these detailed in the document.

The planning for SBCC is outlined in the same module, and each step is detailed in the document:

• Identification of primary, secondary, and tertiary audience (defined in Module I and Module II)
• Review of recommended practices (derived in Module I and Module II)
• Definition of communication objectives
• Identification of the communications channels
• Development of creative messages and strategies
• Division into different phases
•  Market analysis
• Development, testing, and production of the materials
• Development of an implementation plan
• Estimation of the budget