Mongolia 3 kids eating snack child nutrition study

A new study by Holt’s Child Nutrition Program (CNP) describes the implementation of a program that is making a difference in thousands of children’s lives around the world.

Holt International’s Child Nutrition Program (CNP) supports children in our international programs through critical training for caregivers, growth monitoring, and nutrition and feeding interventions. Started in 2014, the program is designed to support caregivers to ensure children in their care, especially those with disabilities, are receiving optimal nutrition so they can grow and thrive.

Emily DeLacey MS, RDN, LDN is a registered and licensed dietitian/nutritionist and a PhD candidate with the London School of Hygiene and Tropical Medicine. As director of Holt’s nutrition and health programs, Emily has managed nutrition intervention and behavior change programming in more than 15 countries.

In December 2022, Holt’s CNP published a study in the high-impact journal Children. This research examines program implementation in Mongolia and the Philippines, countries that have had remarkable success with the CNP. It highlights triumphs and challenges with implementing the CNP at sites in these countries. The study is called Learning from the Implementation of the Child Nutrition Program: A Mixed Methods Evaluation of Process, and it’s available in full online.

If you don’t have time for the whole article, we also spoke to Emily DeLacey, director of Holt’s Nutrition and Health Services. In the Q&A below, Emily explains the impact of this study and the CNP program — helping thousands of children grow and thrive to their fullest potential!

What is this study and why is it important?

I started conducting research with my department at Holt, Nutrition and Health Services, in the fall of 2018. We were looking for resources to better support the programs that Holt was running, and we were finding that there just wasn’t a lot of really good information on the populations of children we were aiming to serve. So, to address this information gap, we started conducting research. Conducting research examining Holt’s work has been amazing because we’ve been able to provide evidence-based, peer-reviewed research that shows the impact of the work that Holt does. This specific paper highlights lessons learned from successfully implementing the CNP and what the implications are for other sites, programs and future growth of the CNP.

Additionally, Holt has made a commitment to conducting disability-inclusive research. This is important because children with disabilities are routinely excluded from research that could really benefit their lives. So our research helps to better address the needs of all the children we serve.

What is the biggest goal of this publication?

One main focus of our research is to better highlight the needs of vulnerable populations. By describing their needs we can better serve these vulnerable groups and raise awareness.

I really think that our research is helping to move the global conversation forward for vulnerable children, including children with disabilities or children living within institution-based care.

This particular child nutrition study is an in-progress look at how the program is working, correct?

Yes, this paper specifically looks at CNP implementation in Mongolia and the Philippines. These two countries were selected because they’ve had so much success with CNP. We wanted to take key insights with how they’ve been implementing the program to better improve programs in all countries that currently operate CNP. CNP started with two pilot sites in 2014 and since then we’ve grown to over 70 sites. As we continue to grow, we want to optimize this program so that we can ensure that our interventions are having the desired impact on children’s lives!

Holt has made a commitment to conducting disability-inclusive research. This is important because children with disabilities are routinely excluded from research that could really benefit their lives. So our research helps to better address the needs of all the children we serve.

Some of the reasons why Mongolia and the Philippines were so successful have been really helpful to share as we work with other programs or as we look to expand our programs. Some of this research has been of big interest to government partners, many of who want to move forward to grow evidence-based programming and scale up programs.

Other insights were just about the importance of the relationships we have, and Holt has such wonderful, strong relationships with so many of these sites — sites we have often partnered with for many years. Those relationships between sites, governments and Holt are essential and key to ensuring successful implementation and strong buy-in. And then there’s the training! Once caregivers go through the training, they see the direct benefit in their work every single day! Caregivers seeing the value of the interventions has been very helpful for sustained, high-quality implementation.

Caregiver feeding a girl with disabilities in Mongolia
A caregiver in Mongolia feeds a child with techniques she learned from a CNP training at their site.

How does the teamwork and information-sharing at project sites contribute to success in Mongolia and the Philippines?

Both countries reported that peer support was key. One of the ways that we ensure standardization of the CNP is by sharing the information with staff at every single level within the organization. We have kitchen staff that attend the training as well as caregivers and site leadership and nurses, and so they’ve all learned the information and then they can share information confidently with their colleagues. The program has a training-of-trainers approach, so once trained, staff can share the information with others, including new sites or new staff.

What are you most excited about right now with the CNP program?

I’m just really excited for the future Holt programs! They really have such an impact and so our ability to better share about these programs, such as the CNP, will help us to better serve children and families around the world. Other really nice things about the research that we do is that we’re able to involve partners and field teams and students in the experience so they’re able to also have opportunities to learn about the research process and provide valuable insights that only staff in the field really know.

How do you anticipate sharing insights from this work to other countries?

Dissemination has been a key aspect of our research goals and plan of action. It’s one thing to do this, but it’s really important to share information like the child nutrition studies we do with audiences that will benefit! Holt has committed to open access publication, so that anyone who wants the information can access it, thereby removing cost as a barrier.

Additionally, we’ve presented at several conferences and universities to better disseminate our findings. We are also moving forward to translate this research into local languages so our partners are able to read and share it with others. Research helps us to open conversations with government officials and other organizations about our programs and our work. We’re also starting to pick up citations by other major players such as UNICEF! When they start to cite our work, we also get a bit more traction and more readership. Another way is through social media posts about this work from our lovely Holt team and network of other professionals around the world!

Is there anything else you want to add?

I think that the biggest reason why CNP has been so successful is that caregivers and families see the impact of even small changes in the lives of children they care for. When children are happier and healthier, they have the opportunity to live their lives to the fullest!

Support Holt’s Child Nutrition Program

Your gift to Holt’s child nutrition program will provide life-changing nutrition and feeding support to children living in poverty and in orphanages around the world.

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