1. Improving the Quality of Nutrition Counselling in Primary Health Care Settings
Peggy Koniz-Booher
Senior Advisor Nutrition and SBCC
USAID Advancing Nutrition

2. Common characteristics of counseling
Interactive
Collaborative
Client-focused
Action-oriented
Increases knowledge
Changes attitudes
and behaviors

3. What is the role of a counselor?

4. Core competencies for counseling
Show respect and empathy
Follow ethical standards
Ask open-ended questions
Listen actively
Encourage + practices
Address client’s concerns
Communicate correct information
Check for understanding
Use communication materials effectively
Discuss and agree on action
Make appropriate referrals
Schedule next meeting
End on a positive note
Provide follow-up

6. Nutritional counseling aims to—
Increase a client’s nutritional literacy
Improve an individual’s dietary intake and energy expenditure
Support mothers and other caregivers in feeding infants and young children
Address a wide range of health problems (from heart disease and diabetes to eating disorders)

7. What does the evidence suggest?

8. The quality of counseling matters!

9. But roles are often misunderstood!

10. Let’s review the basics

11. Critical crosscutting elements of successful counseling
Establish quality standards for counseling
Prioritize training to improve counseling skills
Improve counseling content
Provide targeted, high-quality take-home educational materials for clients
Prioritize coaching/mentoring and supportive supervision to those providing counseling
Collect data on the adoption of key behaviors, adherence and outcomes.

12. Emerging opportunities

13. Theory of Change for Improving Health and Nutrition through Improved Counseling
External Inputs
Provider Outcomes
Client Outcomes
Adapted from NACS

14. Theory of Change for Improving Health and Nutrition through Improved Counseling
External Inputs
Provider Outcomes
Client Outcomes
Adapted from NACS

15. Theory of Change for Improving Health and Nutrition through Improved Counseling
External Inputs
Provider Outcomes
Client Outcomes
Adapted from NACS

16. Theory of Change for Improving Health and Nutrition through Improved Counseling
External Inputs
Provider Outcomes
Client Outcomes
Adapted from NACS

17. Codifying the basic steps in effective nutrition counseling
NACS, GALIDRAA, 5As, Triple A

18. Nutrition Assessment Counseling and Support (NACS)
Adapted from NACS model

19. GALIDRAA Counseling Model Greet, Ask, Listen, Identify, Discuss, Recommend, Agree, Appoint

20. The 5 As – a simple mnemonic
Ask
Assess
Advise
Agree
Assist

21. The 5 As – a simple mnemonic
Ask
Assess
Advise
Agree
Assist
Follow-up

22. 3-Step: Assess, Analyze, and Act
Community IYCF Counseling Package

24. But we also need greater investments in tools, training and supportive supervision…

25. …and in the innovative application of new technologies for these and follow-up care.

26. Investments in nutrition counseling are needed now!

27. For More information, contact:
USAID Advancing Nutrition is the Agency's flagship multi-sectoral nutrition project, addressing the root causes of malnutrition to save lives and enhance long-term health and development.