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Nutrition and Hygiene for Orphans and Vulnerable Children in Nigeria A Training Guide for Community-Based Organisations
Handouts and Job Aids
OCTOBER 2016
About SPRING The Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project is a six-year USAID-funded cooperative agreement to strengthen global and country efforts to scale up high-impact nutrition practices and policies and improve maternal and child nutrition outcomes The project is managed by JSI Research amp Training Institute Inc with partners Helen Keller International The Manoff Group Save the Children and the International Food Policy Research Institute
Recommended Citation SPRING 2016 Nutrition and Hygiene for Orphans and Vulnerable Children in Nigeria A Training Guide for Community-Based Organisations Handouts and Job Aids Arlington VA Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project
Disclaimer This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement AID-OAA-A-11-00031 SPRING) managed by JSI Research amp Training Institute Inc (JSI) The contents are the responsibility of JSI and do not necessarily reflect the views of USAID or the US Government
SPRING JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Phone 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Internet wwwspring-nutritionorg
Cover photos SPRINGNigeria
Acknowledgements The Nutrition and Hygiene for Orphans and Vulnerable Children Training Package was developed under the Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project managed by the JSI Research amp Training Institute Inc with generous financial support from the US Agency for International Development (USAID)
To learn from other projects and contexts the training package has drawn upon a number of existing training materials and communication tools SPRING acknowledges the adaptation of content from the Community Infant and Young Child Feeding (C-IYCF) Counselling Package Government of Nigeria Community Workersrsquo Training Guide and Handbook SPRING Designing for Behavior Change Curriculum CORE Group and USAID Nutrition Education Curriculum for the Adolescent Girls Empowerment Population Council Go Grow Glow Nutrition Curriculum University of California Cooperative Extension and GrowGlowGo Healthy Child Feeding for GoodLife Flip Chart Johns Hopkins University Center for Communication Programs (see References List for full citations)
SPRING recognizes the following individuals as the lead authors in the development of this training package Anne Mburu-de wagt (consultant) Bridget Rogers Kristina Granger Andrew Cunningham and Peggy Koniz-Booher (SPRING)
The following individuals provided technical review andor support to the finalization of the training package Oluwaseun Okediran Faith Ishaya Beatrice Eluaka Philomena Orji Barry Chovitz Altrena Mukuria Steve Sara Romilla Karnati Susan Adeyemi and Frances James A special thanks to Victor Nolasco for his work in developing and adapting the illustrations
We would also like to acknowledge all the children community volunteers teachers and civil society organizations (CSO) who participated in and contributed to our concept testing of the draft curriculum in the communities of Tunga Ashere Jiwa Gwagwa and Bassan Jiwa in Federal Capital Territory including our partners SMILE Federal Ministry of Health and the Universal Basic Education Board who helped make it possible
We have created what we hope is a useful curriculum for projects CSOs and community volunteers working with orphans and vulnerable children in Nigeria We hope this will serve as a guide for further adaptations to different national state and community contexts in the future
Although these materials have been created for the context of Nigeria any part of this package may be printed copied or adapted for related projects to meet local needs with the express written permission of SPRING Please direct any requests to reproduce or adapt these materials to infospring-nutritionorg with the understanding that the source of the materials will be fully acknowledged and the materials will be distributed at no cost
All components of the Nutrition and Hygiene for Orphans and Vulnerable Children Training Package can be found on the Nigeria page of the SPRING website httpswwwspring-nutritionorgcountriesnigeria
Handouts and Job Aids
Contents
Name Thumbnail
Nutrition
x Weight gain of approximately 25 kg per year x Increased physical activity and movement x First experience of independence from primary caregiverͶpossible changes in foods fed and
frequency of feeding
x First learning experiences Meet needs by
x Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
x Providing deworming medicine to kill any worms in the intestines x Treating illness promptly finishing all medication prescribed
x Continuing biannual vitamin A supplementation
Preadolescent boyƐ and girlƐ needs
Changes occurringactivities of preadolescents
x Girls bodies maturing toward puberty preparation for themenstruation cycle
x Boys bodies also maturing towards pubertyͶincreased muscle mass and increased bone density
x Growth spurtsͶincreased rate of increase in height x Physically activeͶplay at home and at school x At schoolͶlearning
Meet needs by
x Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation
x Eating more GROW foods to help the body meet new growth needs boys muscle and bone growth and growth spurts
x Treating illnesses promptly and completing all medicines prescribed x Ensuring clean boiled water consumed in the home
x Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl
Puberty x MenstruationͶmonthly loss of bloodͶleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green leafy vegetables and red meats)
x Bone maturation and strengthening
x Growth spurtgain in height x Increased activityͶresponsibilities in the homeͶchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
x Playing with peers at school
Throughoutthe Lifecycle x Walking to and from school
Meet needs by Promote appropriate growth by x Increasing the food intake x Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation
x Encouraging eating SHINE and GROW foods to build up her bone strength
x Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicͶhaving weak blood) x Avoiding fatty and sweet foods x Avoiding intake of coffeetea with meals x Encouraging good hygiene practices x Preventing and seeking early treatment of infections x Encouraging use of Insecticide-shy‐treated nets (ITNs) x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
x Delaying first pregnancy until at least 18 years of age
x Encouraging families to delay marriage for young girls x Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys
x Increased muscle mass x Increased bone strength
x Growth spurtͶgain in height x Increased activityͶsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
x Playing with peers at school x Walking to and from school
Meet needs by
x Increasing protein intake (GROW foods) x Increasing energy intake (MOVE foods) x Increasing calcium and magnesium intake (GROW foods) x Encouraging families to delay marriage for young girls x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
x Menstruation
x Pregnancy
x Childbirth
x Breastfeeding
x Bone loss Meet needs by
x Eating MOVE GROW and SHINE foods
x Preventing and seeking early treatment of infections x Encouraging good hygiene practices x Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
x ŶĐƌĞĂƐŝŶŐƚŚĞĨŽŽĚŝŶƚĂŬĞŽĨǁŽŵĞŶĚƵƌŝŶŐƉƌĞŐŶĂŶĐLJĞĂƚŽŶĞĞdžƚƌĂŵĞĂůŽƌƐŶĂĐŬĨŽŽĚ between meals) each day
x During breastfeeding eating two ĞdžƚƌĂŵĞĂůƐŽƌƐŶĂĐŬƐĞĂĐŚĚĂLJ x Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding x Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
x Giving vitamin A to the mother within six weeks after birth
x Preventing and seeking early treatment of infections o Completing anti-shy‐tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-shy‐worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy
o Encouraging good hygiene practices
Stages ofBehaviorChange
STAGES OF BEHAVIOR CHANGE
Maintenance (Sustaining the behavior) Action
(Adoption) Preparation (Motivation) Awareness
(Knowing)
Pre-Aware-ness (Not knowing)
Stages Not kno wing there
is a problem
Knowing there is aproblem and
looking fo r more
information
Obtaining new skills and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support Celebrating yo ur
success
Person Changing
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try something new but there are obstacles
I am trying the new
practice but I am still no t 100 certain of
the outcome
I can succeed with
support and
encouragement from my family and
community
I need to keep trying
until the change
becomes a habit because I believe the
change is positive
Yes I can
do it
Change Agent I will facilitate an
I will facilitate an
activity to help the
person to identify
I will facilitate an
activity to help the
I will facilitate a
discussion on the
benefits of adopting
I will continue to
pr o v i de t he I will monitor the I will reco gnize and
activity to help the
perso n identify the
problem
alternativ es for solving the problem
and provide them
with additional information
person to identify how
to overcome the
obstacles and organize
access to reso urces
the new practice and
the consequences of not using it to
encourage
permanent change
reinforcement and
support that are
needed for change
to be permanent
change to provide
the needed support and information
celebrate the success of a positive change
in behavior
Name Thumbnail
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Challenges Practical approaches to use when working with children in SBCC (these are the terms to be cut out
for use in the group work)
2-shy‐5 x Curious and open to learning
x Learn by playing doing imitation and repetition
x Trusting
x Excited by new experiences
x Children in this age group believe what they see directly
x Children in this age group
translate what they see to their own daily experiences
x Not able to understand
pretense x Have a limited use of words x Difficulty expressing their
feelings fears and excitement x Attention short
Use loving tones and simple language Show the children an attitude of curiosity Be playful and portray learning through play Give children simple choices Use every day experiences stories of other
children families animals and typical daily activities and routines
Use repetition and music Use a variety of examples but do not make
changes too quickly Ask simple questions Encourage children to talk ltĞĞƉƐĞƐƐŝŽŶƐƐŚŽƌƚƚŽŬĞĞƉƚŚĞĐŚŝůĚƌĞŶƐ
attention
Advantagesand Advantages and Challenges and Practical Approaches when Working with Children
ChallengesAge range
Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group work)
6-shy‐11 x Children understand
cause and effects better in this age group
x More able to control their feelings x Can still get upset x Can still be easily distracted
x Use loving and patient tones x Show that experiences of learning and achievements in school
are an opportunity to develop new interesting skills and
and Practicalx Attention span growing
x More words in vocabulary and better able to express themselves
x Friendships growing
x The children can be bored easily if ƚŚĞLJĚŽŶƚƐĞĞƚŚĞĐŽŶŶĞĐƚŝŽŶŽĨ the new topic to their own situation
x Opinions of their friends may limittheir participation in the group
talents x Show the children how to demonstrate socially positive action
such as kindness conflict resolution and caring about others x As the adult keep your personal and moral standards high to
show the children strong positive adult role models x Give the children examples of children making a difference in
Approacheswhen Working
ƚŚĞŝƌŽǁŶĂŶĚŽƚŚĞƌƐůŝǀĞƐĞǀĞŶŝŶĚŝĨĨŝĐƵůƚƐŝƚƵĂƚŝŽŶƐƌĞalistic heroines and heroes)
x WƌĞƐĞŶƚƐƚŽƌŝĞƐĂďŽƵƚĨƌŝĞŶĚƐŚŝƉůŽLJĂůƚLJĂŶĚĚŽŝŶŐƚŚĞƌŝŐŚƚ ƚŚŝŶŐ
x Present longer and more dramatic stories (varying in duration
between 30 and 45 minutes) x ͻ^ƚŽƌŝĞƐƚŽůĚƚŽƚŚĞĐŚŝůĚƌĞŶƐŚŽƵůĚĨŽĐƵƐŽŶĐŚŝůĚƌĞŶƐ
experiences and characters x Use examples that are funny to see and hear to help build the
learning experience (eg brain teasers riddles tongue twisters etc)
x Include interactive problem-shy‐solving and critical thinking
with Children
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group
work)
12-shy‐17 x Abstract thinking better developed better able to distinguish the real from the unreal
x Starting to plan for future
x More influenced by peers x Increasingly independent more
adult thinking
x More influenced by peers x More self-shy‐aware
x Behaviour may contradict held beliefs
x Use loving tones x Talk respectfully and do ŶŽƚƚĂůŬĚŽǁŶ x Present examples of positive age-shy‐group behaviours and
other adolescents who are resilient and positive x Present a variety of points of view opinions and
perspectives to help with analytical and debating skills x Portray gender-shy‐positive roles in adolescents and adults x In addition to the training materials add in materials that
use pictures and images and not full of text x Talk about issues of concern to their particular age group
(substance abuse unprotected sex violence romantic relationships bullying and discrimination friendships)
x Portray characters who are confident and excited about their situations and lives this is very useful for children from disadvantage circumstances groups and minority language groups for girls and children with disabilities
x Use a lot of humour and creativity x While presenting growing independence continue to
portray positive parent-shy‐child relationships adult-shy‐child ƌĞůĂƚŝŽŶƐŚŝƉƐƚŚĂƚĨŽƐƚĞƌƚŚĞĐŚŝůĚƐĐŽŶƚŝŶƵĞĚůĞĂƌŶŝŶŐĂŶĚ development towards adulthood
Taxi andMotorcyclewith Petrol
Growing Child
My HealthyPlatemdashFull
My HealthyPlatemdashBlank
Move Foods Move Foods
Grow Foods Grow Foods
Shine13 Foods ShineFoods
Faecal OralRoute
HandwashingTimes
HandwashingSteps
Latrine
WettingHands
Soaping Hands
Lathering13 Hands
ScrubbingFingers
ScrubbingFingernails
Rinsing Hands
Boy EatingFood
ug fects Actions to Ta
Constructing aTippy Tap(pictoral)
Constructing a Tippy Tap Materials Required
x 1 clean empty 1-‐litre bottle with a bottle top
x Set of matches
x 3 lengths of string 30 cm each
x Clean nail (﴾only the facilitator should handle this)﴿
x Clean needle
x Bar soap
x 1 extra bottle (﴾optional)﴿
x 1 small net bag (﴾optional )﴿
x Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-shy‐litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting
on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap
powder) inside a different bottle Using the heated nail make a hole in the bottle top Add
some water to the bottle and shake to dissolve the soap to make liquid soap Secure thebottle top and tie one end of the string round the neck of the soap bottle and the other end
of the string to the place of the handwashing point The soap bottle should be secured by
the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the gƌŽƵŶĚdŚĞůŝƋƵŝĚƐŽĂƉĐĂŶďĞƉŽƵƌĞĚŝŶƚŽĂƉĞƌƐŽŶƐŚĂŶĚ through the hole in the bottle top
Constructing aTippy Tap
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use
a soap dish 13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
DramaticRoleplayabout
Anaemia
Move FoodCards
Grow FoodCards
Shine13 FoodCards
HIVͶDrug Effects and Actions to Take HIVDr Ef ke
Bone strength and development can be
HIVmdashDrugEffects andWhat Actions
to Take
negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be
increased in the body
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
About SPRING The Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project is a six-year USAID-funded cooperative agreement to strengthen global and country efforts to scale up high-impact nutrition practices and policies and improve maternal and child nutrition outcomes The project is managed by JSI Research amp Training Institute Inc with partners Helen Keller International The Manoff Group Save the Children and the International Food Policy Research Institute
Recommended Citation SPRING 2016 Nutrition and Hygiene for Orphans and Vulnerable Children in Nigeria A Training Guide for Community-Based Organisations Handouts and Job Aids Arlington VA Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project
Disclaimer This report is made possible by the generous support of the American people through the United States Agency for International Development (USAID) under the terms of the Cooperative Agreement AID-OAA-A-11-00031 SPRING) managed by JSI Research amp Training Institute Inc (JSI) The contents are the responsibility of JSI and do not necessarily reflect the views of USAID or the US Government
SPRING JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Phone 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Internet wwwspring-nutritionorg
Cover photos SPRINGNigeria
Acknowledgements The Nutrition and Hygiene for Orphans and Vulnerable Children Training Package was developed under the Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project managed by the JSI Research amp Training Institute Inc with generous financial support from the US Agency for International Development (USAID)
To learn from other projects and contexts the training package has drawn upon a number of existing training materials and communication tools SPRING acknowledges the adaptation of content from the Community Infant and Young Child Feeding (C-IYCF) Counselling Package Government of Nigeria Community Workersrsquo Training Guide and Handbook SPRING Designing for Behavior Change Curriculum CORE Group and USAID Nutrition Education Curriculum for the Adolescent Girls Empowerment Population Council Go Grow Glow Nutrition Curriculum University of California Cooperative Extension and GrowGlowGo Healthy Child Feeding for GoodLife Flip Chart Johns Hopkins University Center for Communication Programs (see References List for full citations)
SPRING recognizes the following individuals as the lead authors in the development of this training package Anne Mburu-de wagt (consultant) Bridget Rogers Kristina Granger Andrew Cunningham and Peggy Koniz-Booher (SPRING)
The following individuals provided technical review andor support to the finalization of the training package Oluwaseun Okediran Faith Ishaya Beatrice Eluaka Philomena Orji Barry Chovitz Altrena Mukuria Steve Sara Romilla Karnati Susan Adeyemi and Frances James A special thanks to Victor Nolasco for his work in developing and adapting the illustrations
We would also like to acknowledge all the children community volunteers teachers and civil society organizations (CSO) who participated in and contributed to our concept testing of the draft curriculum in the communities of Tunga Ashere Jiwa Gwagwa and Bassan Jiwa in Federal Capital Territory including our partners SMILE Federal Ministry of Health and the Universal Basic Education Board who helped make it possible
We have created what we hope is a useful curriculum for projects CSOs and community volunteers working with orphans and vulnerable children in Nigeria We hope this will serve as a guide for further adaptations to different national state and community contexts in the future
Although these materials have been created for the context of Nigeria any part of this package may be printed copied or adapted for related projects to meet local needs with the express written permission of SPRING Please direct any requests to reproduce or adapt these materials to infospring-nutritionorg with the understanding that the source of the materials will be fully acknowledged and the materials will be distributed at no cost
All components of the Nutrition and Hygiene for Orphans and Vulnerable Children Training Package can be found on the Nigeria page of the SPRING website httpswwwspring-nutritionorgcountriesnigeria
Handouts and Job Aids
Contents
Name Thumbnail
Nutrition
x Weight gain of approximately 25 kg per year x Increased physical activity and movement x First experience of independence from primary caregiverͶpossible changes in foods fed and
frequency of feeding
x First learning experiences Meet needs by
x Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
x Providing deworming medicine to kill any worms in the intestines x Treating illness promptly finishing all medication prescribed
x Continuing biannual vitamin A supplementation
Preadolescent boyƐ and girlƐ needs
Changes occurringactivities of preadolescents
x Girls bodies maturing toward puberty preparation for themenstruation cycle
x Boys bodies also maturing towards pubertyͶincreased muscle mass and increased bone density
x Growth spurtsͶincreased rate of increase in height x Physically activeͶplay at home and at school x At schoolͶlearning
Meet needs by
x Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation
x Eating more GROW foods to help the body meet new growth needs boys muscle and bone growth and growth spurts
x Treating illnesses promptly and completing all medicines prescribed x Ensuring clean boiled water consumed in the home
x Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl
Puberty x MenstruationͶmonthly loss of bloodͶleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green leafy vegetables and red meats)
x Bone maturation and strengthening
x Growth spurtgain in height x Increased activityͶresponsibilities in the homeͶchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
x Playing with peers at school
Throughoutthe Lifecycle x Walking to and from school
Meet needs by Promote appropriate growth by x Increasing the food intake x Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation
x Encouraging eating SHINE and GROW foods to build up her bone strength
x Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicͶhaving weak blood) x Avoiding fatty and sweet foods x Avoiding intake of coffeetea with meals x Encouraging good hygiene practices x Preventing and seeking early treatment of infections x Encouraging use of Insecticide-shy‐treated nets (ITNs) x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
x Delaying first pregnancy until at least 18 years of age
x Encouraging families to delay marriage for young girls x Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys
x Increased muscle mass x Increased bone strength
x Growth spurtͶgain in height x Increased activityͶsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
x Playing with peers at school x Walking to and from school
Meet needs by
x Increasing protein intake (GROW foods) x Increasing energy intake (MOVE foods) x Increasing calcium and magnesium intake (GROW foods) x Encouraging families to delay marriage for young girls x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
x Menstruation
x Pregnancy
x Childbirth
x Breastfeeding
x Bone loss Meet needs by
x Eating MOVE GROW and SHINE foods
x Preventing and seeking early treatment of infections x Encouraging good hygiene practices x Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
x ŶĐƌĞĂƐŝŶŐƚŚĞĨŽŽĚŝŶƚĂŬĞŽĨǁŽŵĞŶĚƵƌŝŶŐƉƌĞŐŶĂŶĐLJĞĂƚŽŶĞĞdžƚƌĂŵĞĂůŽƌƐŶĂĐŬĨŽŽĚ between meals) each day
x During breastfeeding eating two ĞdžƚƌĂŵĞĂůƐŽƌƐŶĂĐŬƐĞĂĐŚĚĂLJ x Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding x Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
x Giving vitamin A to the mother within six weeks after birth
x Preventing and seeking early treatment of infections o Completing anti-shy‐tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-shy‐worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy
o Encouraging good hygiene practices
Stages ofBehaviorChange
STAGES OF BEHAVIOR CHANGE
Maintenance (Sustaining the behavior) Action
(Adoption) Preparation (Motivation) Awareness
(Knowing)
Pre-Aware-ness (Not knowing)
Stages Not kno wing there
is a problem
Knowing there is aproblem and
looking fo r more
information
Obtaining new skills and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support Celebrating yo ur
success
Person Changing
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try something new but there are obstacles
I am trying the new
practice but I am still no t 100 certain of
the outcome
I can succeed with
support and
encouragement from my family and
community
I need to keep trying
until the change
becomes a habit because I believe the
change is positive
Yes I can
do it
Change Agent I will facilitate an
I will facilitate an
activity to help the
person to identify
I will facilitate an
activity to help the
I will facilitate a
discussion on the
benefits of adopting
I will continue to
pr o v i de t he I will monitor the I will reco gnize and
activity to help the
perso n identify the
problem
alternativ es for solving the problem
and provide them
with additional information
person to identify how
to overcome the
obstacles and organize
access to reso urces
the new practice and
the consequences of not using it to
encourage
permanent change
reinforcement and
support that are
needed for change
to be permanent
change to provide
the needed support and information
celebrate the success of a positive change
in behavior
Name Thumbnail
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Challenges Practical approaches to use when working with children in SBCC (these are the terms to be cut out
for use in the group work)
2-shy‐5 x Curious and open to learning
x Learn by playing doing imitation and repetition
x Trusting
x Excited by new experiences
x Children in this age group believe what they see directly
x Children in this age group
translate what they see to their own daily experiences
x Not able to understand
pretense x Have a limited use of words x Difficulty expressing their
feelings fears and excitement x Attention short
Use loving tones and simple language Show the children an attitude of curiosity Be playful and portray learning through play Give children simple choices Use every day experiences stories of other
children families animals and typical daily activities and routines
Use repetition and music Use a variety of examples but do not make
changes too quickly Ask simple questions Encourage children to talk ltĞĞƉƐĞƐƐŝŽŶƐƐŚŽƌƚƚŽŬĞĞƉƚŚĞĐŚŝůĚƌĞŶƐ
attention
Advantagesand Advantages and Challenges and Practical Approaches when Working with Children
ChallengesAge range
Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group work)
6-shy‐11 x Children understand
cause and effects better in this age group
x More able to control their feelings x Can still get upset x Can still be easily distracted
x Use loving and patient tones x Show that experiences of learning and achievements in school
are an opportunity to develop new interesting skills and
and Practicalx Attention span growing
x More words in vocabulary and better able to express themselves
x Friendships growing
x The children can be bored easily if ƚŚĞLJĚŽŶƚƐĞĞƚŚĞĐŽŶŶĞĐƚŝŽŶŽĨ the new topic to their own situation
x Opinions of their friends may limittheir participation in the group
talents x Show the children how to demonstrate socially positive action
such as kindness conflict resolution and caring about others x As the adult keep your personal and moral standards high to
show the children strong positive adult role models x Give the children examples of children making a difference in
Approacheswhen Working
ƚŚĞŝƌŽǁŶĂŶĚŽƚŚĞƌƐůŝǀĞƐĞǀĞŶŝŶĚŝĨĨŝĐƵůƚƐŝƚƵĂƚŝŽŶƐƌĞalistic heroines and heroes)
x WƌĞƐĞŶƚƐƚŽƌŝĞƐĂďŽƵƚĨƌŝĞŶĚƐŚŝƉůŽLJĂůƚLJĂŶĚĚŽŝŶŐƚŚĞƌŝŐŚƚ ƚŚŝŶŐ
x Present longer and more dramatic stories (varying in duration
between 30 and 45 minutes) x ͻ^ƚŽƌŝĞƐƚŽůĚƚŽƚŚĞĐŚŝůĚƌĞŶƐŚŽƵůĚĨŽĐƵƐŽŶĐŚŝůĚƌĞŶƐ
experiences and characters x Use examples that are funny to see and hear to help build the
learning experience (eg brain teasers riddles tongue twisters etc)
x Include interactive problem-shy‐solving and critical thinking
with Children
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group
work)
12-shy‐17 x Abstract thinking better developed better able to distinguish the real from the unreal
x Starting to plan for future
x More influenced by peers x Increasingly independent more
adult thinking
x More influenced by peers x More self-shy‐aware
x Behaviour may contradict held beliefs
x Use loving tones x Talk respectfully and do ŶŽƚƚĂůŬĚŽǁŶ x Present examples of positive age-shy‐group behaviours and
other adolescents who are resilient and positive x Present a variety of points of view opinions and
perspectives to help with analytical and debating skills x Portray gender-shy‐positive roles in adolescents and adults x In addition to the training materials add in materials that
use pictures and images and not full of text x Talk about issues of concern to their particular age group
(substance abuse unprotected sex violence romantic relationships bullying and discrimination friendships)
x Portray characters who are confident and excited about their situations and lives this is very useful for children from disadvantage circumstances groups and minority language groups for girls and children with disabilities
x Use a lot of humour and creativity x While presenting growing independence continue to
portray positive parent-shy‐child relationships adult-shy‐child ƌĞůĂƚŝŽŶƐŚŝƉƐƚŚĂƚĨŽƐƚĞƌƚŚĞĐŚŝůĚƐĐŽŶƚŝŶƵĞĚůĞĂƌŶŝŶŐĂŶĚ development towards adulthood
Taxi andMotorcyclewith Petrol
Growing Child
My HealthyPlatemdashFull
My HealthyPlatemdashBlank
Move Foods Move Foods
Grow Foods Grow Foods
Shine13 Foods ShineFoods
Faecal OralRoute
HandwashingTimes
HandwashingSteps
Latrine
WettingHands
Soaping Hands
Lathering13 Hands
ScrubbingFingers
ScrubbingFingernails
Rinsing Hands
Boy EatingFood
ug fects Actions to Ta
Constructing aTippy Tap(pictoral)
Constructing a Tippy Tap Materials Required
x 1 clean empty 1-‐litre bottle with a bottle top
x Set of matches
x 3 lengths of string 30 cm each
x Clean nail (﴾only the facilitator should handle this)﴿
x Clean needle
x Bar soap
x 1 extra bottle (﴾optional)﴿
x 1 small net bag (﴾optional )﴿
x Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-shy‐litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting
on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap
powder) inside a different bottle Using the heated nail make a hole in the bottle top Add
some water to the bottle and shake to dissolve the soap to make liquid soap Secure thebottle top and tie one end of the string round the neck of the soap bottle and the other end
of the string to the place of the handwashing point The soap bottle should be secured by
the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the gƌŽƵŶĚdŚĞůŝƋƵŝĚƐŽĂƉĐĂŶďĞƉŽƵƌĞĚŝŶƚŽĂƉĞƌƐŽŶƐŚĂŶĚ through the hole in the bottle top
Constructing aTippy Tap
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use
a soap dish 13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
DramaticRoleplayabout
Anaemia
Move FoodCards
Grow FoodCards
Shine13 FoodCards
HIVͶDrug Effects and Actions to Take HIVDr Ef ke
Bone strength and development can be
HIVmdashDrugEffects andWhat Actions
to Take
negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be
increased in the body
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Acknowledgements The Nutrition and Hygiene for Orphans and Vulnerable Children Training Package was developed under the Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) project managed by the JSI Research amp Training Institute Inc with generous financial support from the US Agency for International Development (USAID)
To learn from other projects and contexts the training package has drawn upon a number of existing training materials and communication tools SPRING acknowledges the adaptation of content from the Community Infant and Young Child Feeding (C-IYCF) Counselling Package Government of Nigeria Community Workersrsquo Training Guide and Handbook SPRING Designing for Behavior Change Curriculum CORE Group and USAID Nutrition Education Curriculum for the Adolescent Girls Empowerment Population Council Go Grow Glow Nutrition Curriculum University of California Cooperative Extension and GrowGlowGo Healthy Child Feeding for GoodLife Flip Chart Johns Hopkins University Center for Communication Programs (see References List for full citations)
SPRING recognizes the following individuals as the lead authors in the development of this training package Anne Mburu-de wagt (consultant) Bridget Rogers Kristina Granger Andrew Cunningham and Peggy Koniz-Booher (SPRING)
The following individuals provided technical review andor support to the finalization of the training package Oluwaseun Okediran Faith Ishaya Beatrice Eluaka Philomena Orji Barry Chovitz Altrena Mukuria Steve Sara Romilla Karnati Susan Adeyemi and Frances James A special thanks to Victor Nolasco for his work in developing and adapting the illustrations
We would also like to acknowledge all the children community volunteers teachers and civil society organizations (CSO) who participated in and contributed to our concept testing of the draft curriculum in the communities of Tunga Ashere Jiwa Gwagwa and Bassan Jiwa in Federal Capital Territory including our partners SMILE Federal Ministry of Health and the Universal Basic Education Board who helped make it possible
We have created what we hope is a useful curriculum for projects CSOs and community volunteers working with orphans and vulnerable children in Nigeria We hope this will serve as a guide for further adaptations to different national state and community contexts in the future
Although these materials have been created for the context of Nigeria any part of this package may be printed copied or adapted for related projects to meet local needs with the express written permission of SPRING Please direct any requests to reproduce or adapt these materials to infospring-nutritionorg with the understanding that the source of the materials will be fully acknowledged and the materials will be distributed at no cost
All components of the Nutrition and Hygiene for Orphans and Vulnerable Children Training Package can be found on the Nigeria page of the SPRING website httpswwwspring-nutritionorgcountriesnigeria
Handouts and Job Aids
Contents
Name Thumbnail
Nutrition
x Weight gain of approximately 25 kg per year x Increased physical activity and movement x First experience of independence from primary caregiverͶpossible changes in foods fed and
frequency of feeding
x First learning experiences Meet needs by
x Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
x Providing deworming medicine to kill any worms in the intestines x Treating illness promptly finishing all medication prescribed
x Continuing biannual vitamin A supplementation
Preadolescent boyƐ and girlƐ needs
Changes occurringactivities of preadolescents
x Girls bodies maturing toward puberty preparation for themenstruation cycle
x Boys bodies also maturing towards pubertyͶincreased muscle mass and increased bone density
x Growth spurtsͶincreased rate of increase in height x Physically activeͶplay at home and at school x At schoolͶlearning
Meet needs by
x Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation
x Eating more GROW foods to help the body meet new growth needs boys muscle and bone growth and growth spurts
x Treating illnesses promptly and completing all medicines prescribed x Ensuring clean boiled water consumed in the home
x Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl
Puberty x MenstruationͶmonthly loss of bloodͶleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green leafy vegetables and red meats)
x Bone maturation and strengthening
x Growth spurtgain in height x Increased activityͶresponsibilities in the homeͶchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
x Playing with peers at school
Throughoutthe Lifecycle x Walking to and from school
Meet needs by Promote appropriate growth by x Increasing the food intake x Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation
x Encouraging eating SHINE and GROW foods to build up her bone strength
x Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicͶhaving weak blood) x Avoiding fatty and sweet foods x Avoiding intake of coffeetea with meals x Encouraging good hygiene practices x Preventing and seeking early treatment of infections x Encouraging use of Insecticide-shy‐treated nets (ITNs) x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
x Delaying first pregnancy until at least 18 years of age
x Encouraging families to delay marriage for young girls x Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys
x Increased muscle mass x Increased bone strength
x Growth spurtͶgain in height x Increased activityͶsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
x Playing with peers at school x Walking to and from school
Meet needs by
x Increasing protein intake (GROW foods) x Increasing energy intake (MOVE foods) x Increasing calcium and magnesium intake (GROW foods) x Encouraging families to delay marriage for young girls x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
x Menstruation
x Pregnancy
x Childbirth
x Breastfeeding
x Bone loss Meet needs by
x Eating MOVE GROW and SHINE foods
x Preventing and seeking early treatment of infections x Encouraging good hygiene practices x Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
x ŶĐƌĞĂƐŝŶŐƚŚĞĨŽŽĚŝŶƚĂŬĞŽĨǁŽŵĞŶĚƵƌŝŶŐƉƌĞŐŶĂŶĐLJĞĂƚŽŶĞĞdžƚƌĂŵĞĂůŽƌƐŶĂĐŬĨŽŽĚ between meals) each day
x During breastfeeding eating two ĞdžƚƌĂŵĞĂůƐŽƌƐŶĂĐŬƐĞĂĐŚĚĂLJ x Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding x Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
x Giving vitamin A to the mother within six weeks after birth
x Preventing and seeking early treatment of infections o Completing anti-shy‐tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-shy‐worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy
o Encouraging good hygiene practices
Stages ofBehaviorChange
STAGES OF BEHAVIOR CHANGE
Maintenance (Sustaining the behavior) Action
(Adoption) Preparation (Motivation) Awareness
(Knowing)
Pre-Aware-ness (Not knowing)
Stages Not kno wing there
is a problem
Knowing there is aproblem and
looking fo r more
information
Obtaining new skills and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support Celebrating yo ur
success
Person Changing
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try something new but there are obstacles
I am trying the new
practice but I am still no t 100 certain of
the outcome
I can succeed with
support and
encouragement from my family and
community
I need to keep trying
until the change
becomes a habit because I believe the
change is positive
Yes I can
do it
Change Agent I will facilitate an
I will facilitate an
activity to help the
person to identify
I will facilitate an
activity to help the
I will facilitate a
discussion on the
benefits of adopting
I will continue to
pr o v i de t he I will monitor the I will reco gnize and
activity to help the
perso n identify the
problem
alternativ es for solving the problem
and provide them
with additional information
person to identify how
to overcome the
obstacles and organize
access to reso urces
the new practice and
the consequences of not using it to
encourage
permanent change
reinforcement and
support that are
needed for change
to be permanent
change to provide
the needed support and information
celebrate the success of a positive change
in behavior
Name Thumbnail
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Challenges Practical approaches to use when working with children in SBCC (these are the terms to be cut out
for use in the group work)
2-shy‐5 x Curious and open to learning
x Learn by playing doing imitation and repetition
x Trusting
x Excited by new experiences
x Children in this age group believe what they see directly
x Children in this age group
translate what they see to their own daily experiences
x Not able to understand
pretense x Have a limited use of words x Difficulty expressing their
feelings fears and excitement x Attention short
Use loving tones and simple language Show the children an attitude of curiosity Be playful and portray learning through play Give children simple choices Use every day experiences stories of other
children families animals and typical daily activities and routines
Use repetition and music Use a variety of examples but do not make
changes too quickly Ask simple questions Encourage children to talk ltĞĞƉƐĞƐƐŝŽŶƐƐŚŽƌƚƚŽŬĞĞƉƚŚĞĐŚŝůĚƌĞŶƐ
attention
Advantagesand Advantages and Challenges and Practical Approaches when Working with Children
ChallengesAge range
Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group work)
6-shy‐11 x Children understand
cause and effects better in this age group
x More able to control their feelings x Can still get upset x Can still be easily distracted
x Use loving and patient tones x Show that experiences of learning and achievements in school
are an opportunity to develop new interesting skills and
and Practicalx Attention span growing
x More words in vocabulary and better able to express themselves
x Friendships growing
x The children can be bored easily if ƚŚĞLJĚŽŶƚƐĞĞƚŚĞĐŽŶŶĞĐƚŝŽŶŽĨ the new topic to their own situation
x Opinions of their friends may limittheir participation in the group
talents x Show the children how to demonstrate socially positive action
such as kindness conflict resolution and caring about others x As the adult keep your personal and moral standards high to
show the children strong positive adult role models x Give the children examples of children making a difference in
Approacheswhen Working
ƚŚĞŝƌŽǁŶĂŶĚŽƚŚĞƌƐůŝǀĞƐĞǀĞŶŝŶĚŝĨĨŝĐƵůƚƐŝƚƵĂƚŝŽŶƐƌĞalistic heroines and heroes)
x WƌĞƐĞŶƚƐƚŽƌŝĞƐĂďŽƵƚĨƌŝĞŶĚƐŚŝƉůŽLJĂůƚLJĂŶĚĚŽŝŶŐƚŚĞƌŝŐŚƚ ƚŚŝŶŐ
x Present longer and more dramatic stories (varying in duration
between 30 and 45 minutes) x ͻ^ƚŽƌŝĞƐƚŽůĚƚŽƚŚĞĐŚŝůĚƌĞŶƐŚŽƵůĚĨŽĐƵƐŽŶĐŚŝůĚƌĞŶƐ
experiences and characters x Use examples that are funny to see and hear to help build the
learning experience (eg brain teasers riddles tongue twisters etc)
x Include interactive problem-shy‐solving and critical thinking
with Children
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group
work)
12-shy‐17 x Abstract thinking better developed better able to distinguish the real from the unreal
x Starting to plan for future
x More influenced by peers x Increasingly independent more
adult thinking
x More influenced by peers x More self-shy‐aware
x Behaviour may contradict held beliefs
x Use loving tones x Talk respectfully and do ŶŽƚƚĂůŬĚŽǁŶ x Present examples of positive age-shy‐group behaviours and
other adolescents who are resilient and positive x Present a variety of points of view opinions and
perspectives to help with analytical and debating skills x Portray gender-shy‐positive roles in adolescents and adults x In addition to the training materials add in materials that
use pictures and images and not full of text x Talk about issues of concern to their particular age group
(substance abuse unprotected sex violence romantic relationships bullying and discrimination friendships)
x Portray characters who are confident and excited about their situations and lives this is very useful for children from disadvantage circumstances groups and minority language groups for girls and children with disabilities
x Use a lot of humour and creativity x While presenting growing independence continue to
portray positive parent-shy‐child relationships adult-shy‐child ƌĞůĂƚŝŽŶƐŚŝƉƐƚŚĂƚĨŽƐƚĞƌƚŚĞĐŚŝůĚƐĐŽŶƚŝŶƵĞĚůĞĂƌŶŝŶŐĂŶĚ development towards adulthood
Taxi andMotorcyclewith Petrol
Growing Child
My HealthyPlatemdashFull
My HealthyPlatemdashBlank
Move Foods Move Foods
Grow Foods Grow Foods
Shine13 Foods ShineFoods
Faecal OralRoute
HandwashingTimes
HandwashingSteps
Latrine
WettingHands
Soaping Hands
Lathering13 Hands
ScrubbingFingers
ScrubbingFingernails
Rinsing Hands
Boy EatingFood
ug fects Actions to Ta
Constructing aTippy Tap(pictoral)
Constructing a Tippy Tap Materials Required
x 1 clean empty 1-‐litre bottle with a bottle top
x Set of matches
x 3 lengths of string 30 cm each
x Clean nail (﴾only the facilitator should handle this)﴿
x Clean needle
x Bar soap
x 1 extra bottle (﴾optional)﴿
x 1 small net bag (﴾optional )﴿
x Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-shy‐litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting
on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap
powder) inside a different bottle Using the heated nail make a hole in the bottle top Add
some water to the bottle and shake to dissolve the soap to make liquid soap Secure thebottle top and tie one end of the string round the neck of the soap bottle and the other end
of the string to the place of the handwashing point The soap bottle should be secured by
the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the gƌŽƵŶĚdŚĞůŝƋƵŝĚƐŽĂƉĐĂŶďĞƉŽƵƌĞĚŝŶƚŽĂƉĞƌƐŽŶƐŚĂŶĚ through the hole in the bottle top
Constructing aTippy Tap
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use
a soap dish 13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
DramaticRoleplayabout
Anaemia
Move FoodCards
Grow FoodCards
Shine13 FoodCards
HIVͶDrug Effects and Actions to Take HIVDr Ef ke
Bone strength and development can be
HIVmdashDrugEffects andWhat Actions
to Take
negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be
increased in the body
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Contents
Name Thumbnail
Nutrition
x Weight gain of approximately 25 kg per year x Increased physical activity and movement x First experience of independence from primary caregiverͶpossible changes in foods fed and
frequency of feeding
x First learning experiences Meet needs by
x Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
x Providing deworming medicine to kill any worms in the intestines x Treating illness promptly finishing all medication prescribed
x Continuing biannual vitamin A supplementation
Preadolescent boyƐ and girlƐ needs
Changes occurringactivities of preadolescents
x Girls bodies maturing toward puberty preparation for themenstruation cycle
x Boys bodies also maturing towards pubertyͶincreased muscle mass and increased bone density
x Growth spurtsͶincreased rate of increase in height x Physically activeͶplay at home and at school x At schoolͶlearning
Meet needs by
x Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation
x Eating more GROW foods to help the body meet new growth needs boys muscle and bone growth and growth spurts
x Treating illnesses promptly and completing all medicines prescribed x Ensuring clean boiled water consumed in the home
x Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl
Puberty x MenstruationͶmonthly loss of bloodͶleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green leafy vegetables and red meats)
x Bone maturation and strengthening
x Growth spurtgain in height x Increased activityͶresponsibilities in the homeͶchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
x Playing with peers at school
Throughoutthe Lifecycle x Walking to and from school
Meet needs by Promote appropriate growth by x Increasing the food intake x Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation
x Encouraging eating SHINE and GROW foods to build up her bone strength
x Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicͶhaving weak blood) x Avoiding fatty and sweet foods x Avoiding intake of coffeetea with meals x Encouraging good hygiene practices x Preventing and seeking early treatment of infections x Encouraging use of Insecticide-shy‐treated nets (ITNs) x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
x Delaying first pregnancy until at least 18 years of age
x Encouraging families to delay marriage for young girls x Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys
x Increased muscle mass x Increased bone strength
x Growth spurtͶgain in height x Increased activityͶsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
x Playing with peers at school x Walking to and from school
Meet needs by
x Increasing protein intake (GROW foods) x Increasing energy intake (MOVE foods) x Increasing calcium and magnesium intake (GROW foods) x Encouraging families to delay marriage for young girls x Encouraging parents to give girls and boys equal access to educationͶundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
x Menstruation
x Pregnancy
x Childbirth
x Breastfeeding
x Bone loss Meet needs by
x Eating MOVE GROW and SHINE foods
x Preventing and seeking early treatment of infections x Encouraging good hygiene practices x Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
x ŶĐƌĞĂƐŝŶŐƚŚĞĨŽŽĚŝŶƚĂŬĞŽĨǁŽŵĞŶĚƵƌŝŶŐƉƌĞŐŶĂŶĐLJĞĂƚŽŶĞĞdžƚƌĂŵĞĂůŽƌƐŶĂĐŬĨŽŽĚ between meals) each day
x During breastfeeding eating two ĞdžƚƌĂŵĞĂůƐŽƌƐŶĂĐŬƐĞĂĐŚĚĂLJ x Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding x Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
x Giving vitamin A to the mother within six weeks after birth
x Preventing and seeking early treatment of infections o Completing anti-shy‐tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-shy‐worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy
o Encouraging good hygiene practices
Stages ofBehaviorChange
STAGES OF BEHAVIOR CHANGE
Maintenance (Sustaining the behavior) Action
(Adoption) Preparation (Motivation) Awareness
(Knowing)
Pre-Aware-ness (Not knowing)
Stages Not kno wing there
is a problem
Knowing there is aproblem and
looking fo r more
information
Obtaining new skills and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support Celebrating yo ur
success
Person Changing
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try something new but there are obstacles
I am trying the new
practice but I am still no t 100 certain of
the outcome
I can succeed with
support and
encouragement from my family and
community
I need to keep trying
until the change
becomes a habit because I believe the
change is positive
Yes I can
do it
Change Agent I will facilitate an
I will facilitate an
activity to help the
person to identify
I will facilitate an
activity to help the
I will facilitate a
discussion on the
benefits of adopting
I will continue to
pr o v i de t he I will monitor the I will reco gnize and
activity to help the
perso n identify the
problem
alternativ es for solving the problem
and provide them
with additional information
person to identify how
to overcome the
obstacles and organize
access to reso urces
the new practice and
the consequences of not using it to
encourage
permanent change
reinforcement and
support that are
needed for change
to be permanent
change to provide
the needed support and information
celebrate the success of a positive change
in behavior
Name Thumbnail
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Challenges Practical approaches to use when working with children in SBCC (these are the terms to be cut out
for use in the group work)
2-shy‐5 x Curious and open to learning
x Learn by playing doing imitation and repetition
x Trusting
x Excited by new experiences
x Children in this age group believe what they see directly
x Children in this age group
translate what they see to their own daily experiences
x Not able to understand
pretense x Have a limited use of words x Difficulty expressing their
feelings fears and excitement x Attention short
Use loving tones and simple language Show the children an attitude of curiosity Be playful and portray learning through play Give children simple choices Use every day experiences stories of other
children families animals and typical daily activities and routines
Use repetition and music Use a variety of examples but do not make
changes too quickly Ask simple questions Encourage children to talk ltĞĞƉƐĞƐƐŝŽŶƐƐŚŽƌƚƚŽŬĞĞƉƚŚĞĐŚŝůĚƌĞŶƐ
attention
Advantagesand Advantages and Challenges and Practical Approaches when Working with Children
ChallengesAge range
Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group work)
6-shy‐11 x Children understand
cause and effects better in this age group
x More able to control their feelings x Can still get upset x Can still be easily distracted
x Use loving and patient tones x Show that experiences of learning and achievements in school
are an opportunity to develop new interesting skills and
and Practicalx Attention span growing
x More words in vocabulary and better able to express themselves
x Friendships growing
x The children can be bored easily if ƚŚĞLJĚŽŶƚƐĞĞƚŚĞĐŽŶŶĞĐƚŝŽŶŽĨ the new topic to their own situation
x Opinions of their friends may limittheir participation in the group
talents x Show the children how to demonstrate socially positive action
such as kindness conflict resolution and caring about others x As the adult keep your personal and moral standards high to
show the children strong positive adult role models x Give the children examples of children making a difference in
Approacheswhen Working
ƚŚĞŝƌŽǁŶĂŶĚŽƚŚĞƌƐůŝǀĞƐĞǀĞŶŝŶĚŝĨĨŝĐƵůƚƐŝƚƵĂƚŝŽŶƐƌĞalistic heroines and heroes)
x WƌĞƐĞŶƚƐƚŽƌŝĞƐĂďŽƵƚĨƌŝĞŶĚƐŚŝƉůŽLJĂůƚLJĂŶĚĚŽŝŶŐƚŚĞƌŝŐŚƚ ƚŚŝŶŐ
x Present longer and more dramatic stories (varying in duration
between 30 and 45 minutes) x ͻ^ƚŽƌŝĞƐƚŽůĚƚŽƚŚĞĐŚŝůĚƌĞŶƐŚŽƵůĚĨŽĐƵƐŽŶĐŚŝůĚƌĞŶƐ
experiences and characters x Use examples that are funny to see and hear to help build the
learning experience (eg brain teasers riddles tongue twisters etc)
x Include interactive problem-shy‐solving and critical thinking
with Children
Advantages and Challenges and Practical Approaches when Working with Children
Age range Advantages Limitations Practical approaches to use when working with children in SBCC (these are the terms to be cut out for use in the group
work)
12-shy‐17 x Abstract thinking better developed better able to distinguish the real from the unreal
x Starting to plan for future
x More influenced by peers x Increasingly independent more
adult thinking
x More influenced by peers x More self-shy‐aware
x Behaviour may contradict held beliefs
x Use loving tones x Talk respectfully and do ŶŽƚƚĂůŬĚŽǁŶ x Present examples of positive age-shy‐group behaviours and
other adolescents who are resilient and positive x Present a variety of points of view opinions and
perspectives to help with analytical and debating skills x Portray gender-shy‐positive roles in adolescents and adults x In addition to the training materials add in materials that
use pictures and images and not full of text x Talk about issues of concern to their particular age group
(substance abuse unprotected sex violence romantic relationships bullying and discrimination friendships)
x Portray characters who are confident and excited about their situations and lives this is very useful for children from disadvantage circumstances groups and minority language groups for girls and children with disabilities
x Use a lot of humour and creativity x While presenting growing independence continue to
portray positive parent-shy‐child relationships adult-shy‐child ƌĞůĂƚŝŽŶƐŚŝƉƐƚŚĂƚĨŽƐƚĞƌƚŚĞĐŚŝůĚƐĐŽŶƚŝŶƵĞĚůĞĂƌŶŝŶŐĂŶĚ development towards adulthood
Taxi andMotorcyclewith Petrol
Growing Child
My HealthyPlatemdashFull
My HealthyPlatemdashBlank
Move Foods Move Foods
Grow Foods Grow Foods
Shine13 Foods ShineFoods
Faecal OralRoute
HandwashingTimes
HandwashingSteps
Latrine
WettingHands
Soaping Hands
Lathering13 Hands
ScrubbingFingers
ScrubbingFingernails
Rinsing Hands
Boy EatingFood
ug fects Actions to Ta
Constructing aTippy Tap(pictoral)
Constructing a Tippy Tap Materials Required
x 1 clean empty 1-‐litre bottle with a bottle top
x Set of matches
x 3 lengths of string 30 cm each
x Clean nail (﴾only the facilitator should handle this)﴿
x Clean needle
x Bar soap
x 1 extra bottle (﴾optional)﴿
x 1 small net bag (﴾optional )﴿
x Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-shy‐litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting
on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap
powder) inside a different bottle Using the heated nail make a hole in the bottle top Add
some water to the bottle and shake to dissolve the soap to make liquid soap Secure thebottle top and tie one end of the string round the neck of the soap bottle and the other end
of the string to the place of the handwashing point The soap bottle should be secured by
the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the gƌŽƵŶĚdŚĞůŝƋƵŝĚƐŽĂƉĐĂŶďĞƉŽƵƌĞĚŝŶƚŽĂƉĞƌƐŽŶƐŚĂŶĚ through the hole in the bottle top
Constructing aTippy Tap
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use
a soap dish 13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
DramaticRoleplayabout
Anaemia
Move FoodCards
Grow FoodCards
Shine13 FoodCards
HIVͶDrug Effects and Actions to Take HIVDr Ef ke
Bone strength and development can be
HIVmdashDrugEffects andWhat Actions
to Take
negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be
increased in the body
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Move Foods Move Foods
Grow Foods Grow Foods
Shine13 Foods ShineFoods
Faecal OralRoute
HandwashingTimes
HandwashingSteps
Latrine
WettingHands
Soaping Hands
Lathering13 Hands
ScrubbingFingers
ScrubbingFingernails
Rinsing Hands
Boy EatingFood
ug fects Actions to Ta
Constructing aTippy Tap(pictoral)
Constructing a Tippy Tap Materials Required
x 1 clean empty 1-‐litre bottle with a bottle top
x Set of matches
x 3 lengths of string 30 cm each
x Clean nail (﴾only the facilitator should handle this)﴿
x Clean needle
x Bar soap
x 1 extra bottle (﴾optional)﴿
x 1 small net bag (﴾optional )﴿
x Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-shy‐litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting
on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap
powder) inside a different bottle Using the heated nail make a hole in the bottle top Add
some water to the bottle and shake to dissolve the soap to make liquid soap Secure thebottle top and tie one end of the string round the neck of the soap bottle and the other end
of the string to the place of the handwashing point The soap bottle should be secured by
the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the gƌŽƵŶĚdŚĞůŝƋƵŝĚƐŽĂƉĐĂŶďĞƉŽƵƌĞĚŝŶƚŽĂƉĞƌƐŽŶƐŚĂŶĚ through the hole in the bottle top
Constructing aTippy Tap
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use
a soap dish 13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
DramaticRoleplayabout
Anaemia
Move FoodCards
Grow FoodCards
Shine13 FoodCards
HIVͶDrug Effects and Actions to Take HIVDr Ef ke
Bone strength and development can be
HIVmdashDrugEffects andWhat Actions
to Take
negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be
increased in the body
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
ug fects Actions to Ta
Constructing aTippy Tap(pictoral)
Constructing a Tippy Tap Materials Required
x 1 clean empty 1-‐litre bottle with a bottle top
x Set of matches
x 3 lengths of string 30 cm each
x Clean nail (﴾only the facilitator should handle this)﴿
x Clean needle
x Bar soap
x 1 extra bottle (﴾optional)﴿
x 1 small net bag (﴾optional )﴿
x Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-shy‐litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting
on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap
powder) inside a different bottle Using the heated nail make a hole in the bottle top Add
some water to the bottle and shake to dissolve the soap to make liquid soap Secure thebottle top and tie one end of the string round the neck of the soap bottle and the other end
of the string to the place of the handwashing point The soap bottle should be secured by
the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the gƌŽƵŶĚdŚĞůŝƋƵŝĚƐŽĂƉĐĂŶďĞƉŽƵƌĞĚŝŶƚŽĂƉĞƌƐŽŶƐŚĂŶĚ through the hole in the bottle top
Constructing aTippy Tap
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use
a soap dish 13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
DramaticRoleplayabout
Anaemia
Move FoodCards
Grow FoodCards
Shine13 FoodCards
HIVͶDrug Effects and Actions to Take HIVDr Ef ke
Bone strength and development can be
HIVmdashDrugEffects andWhat Actions
to Take
negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be
increased in the body
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Weight gain of approximately 25 kg per year Increased physical activity and movement First experience of independence from primary caregivermdashpossible changes in foods fed and
frequency of feeding First learning experiences
Meet needs by
Giving different foods in the right quantities and frequency for the age group (MOVE GROW and SHINE foods)
Providing deworming medicine to kill any worms in the intestines Treating illness promptly finishing all medication prescribed Continuing biannual vitamin A supplementation
Preadolescent boyrsquos and girlrsquos needs
Changes occurringactivities of preadolescents Girlsrsquo bodies maturing toward puberty preparation for the
menstruation cycle
Boysrsquo bodies also maturing towards pubertymdashincreased muscle mass and increased bone density
Growth spurtsmdashincreased rate of increase in height Physically activemdashplay at home and at school At schoolmdashlearning
Meet needs by Eating more SHINE and GROW foods to provide vitamins and minerals to store in
preparation for menstruation Eating more GROW foods to help the body meet new growth needs boysrsquo muscle and bone
growth and growth spurts
Treating illnesses promptly and completing all medicines prescribed Ensuring clean boiled water consumed in the home
Using a pit latrine do not ease yourself in the open or in the yard of the house
Adolescent girl needs
Changes occurring in adolescent girl Puberty Menstruationmdashmonthly loss of bloodmdashleads to low iron stores
(iron is a mineral found in SHINE and GROW foods eg green
leafy vegetables and red meats) Bone maturation and strengthening
Growth spurtgain in height Increased activitymdashresponsibilities in the homemdashchores such as
housework fetching water or firewood running errands for parents taking care of younger siblings
Playing with peers at school
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Walking to and from school Meet needs by Promote appropriate growth by Increasing the food intake Encouraging eating SHINE and GROW foods to build up blood supply that she loses with
menstruation Encouraging eating SHINE and GROW foods to build up her bone strength Providing iron and folate supplements from the clinic where necessary (if girl is tired and
found to be anaemicmdashhaving weak blood) Avoiding fatty and sweet foods Avoiding intake of coffeetea with meals Encouraging good hygiene practices Preventing and seeking early treatment of infections Encouraging use of Insecticide-treated nets (ITNs) Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education Delaying first pregnancy until at least 18 years of age Encouraging families to delay marriage for young girls Encouraging support of teenage boys to teenage girlssisters to help meet their nutritional
requirements Adolescent boy needs
Changes occurring in adolescent boys Increased muscle mass Increased bone strength Growth spurtmdashgain in height Increased activitymdashsporting activities in schoolcommunity
responsibilities in the home such as tending flocks cleaning compound cutting firewood for the home running errands for parents taking care of younger siblings
Playing with peers at school Walking to and from school
Meet needs by
Increasing protein intake (GROW foods) Increasing energy intake (MOVE foods) Increasing calcium and magnesium intake (GROW foods) Encouraging families to delay marriage for young girls Encouraging parents to give girls and boys equal access to educationmdashundernutrition
decreases when girlswomen receive more education
Adult woman needs
Body changes
Menstruation Pregnancy
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Childbirth
Breastfeeding
Bone loss
Meet needs by
Eating MOVE GROW and SHINE foods
Preventing and seeking early treatment of infections
Encouraging good hygiene practices
Giving ironfolate supplementation
Meet needs in pregnancy childbirth and breastfeeding by
Increasing the food intake of women during pregnancy eat one extra meal or ldquosnackrdquo (food between meals) each day
During breastfeeding eating two extra meals or ldquosnacksrdquo each day Encouraging consumption of MOVE GROW and SHINE foods All foods are safe to eat
during pregnancy and while breastfeeding Giving ironfolate supplementation (or other recommended supplements for pregnant
women) to the mother as soon as mother knows she is pregnant and continuing for at least three months after delivery of the child
Giving vitamin A to the mother within six weeks after birth
Preventing and seeking early treatment of infections o Completing anti-tetanus immunizations for pregnant women (five injections in total) o Using of ITNs o De-worming and giving antimalarial drugs to pregnant women between four and six
months of pregnancy o Encouraging good hygiene practices
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
STAG
ES O
F BE
HAVI
OR
CHAN
GE
Mai
nten
ance
(S
usta
inin
g th
e be
havi
or)
Actio
n (A
dopt
ion)
Pr
epar
atio
n (M
otiv
atio
n)
Awar
enes
s (K
now
ing)
Pre-
Awar
e-ne
ss
(Not
kno
win
g)
Stag
es
Not knowing there
is a problem
Knowing there is a
problem and
looking for more
information
Obtaining new skills
and access to
resources and support
Trying out the
new practice
Reflecting on and
reinforcing the new
practice
Continuing the
practice with support
Celebrating your
success
Pers
on
Chan
ging
I do not see a
p roblem
There might be a
problem but I need
more information
and alternatives
I am ready to try
something new but
there are obstacles
I am trying the new
practice but I am still
not 100 certain of
the outcome
I can succeed with
support and
encouragement
from my family and
community
I need to keep trying
until the change
becomes a habit
because I believe the
change is positive
Yes I can
do it
Chan
ge
Agen
t I will facilitate an
activity to help the
person identify the
problem
I will facilitate an
activity to help the
person to identify
alternatives for
solving the problem
and provide them
with additional
information
I will facilitate an
activity to help the
person to identify how
to overcome the
obstacles and organize
access to resources
I will facilitate a
discussion on the
benefits of adopting
the new practice and
the consequences of
not using it to
encourage
permanent change
I will continue to
pr o v i de t he
reinforcement and
support that are
needed for change
to be permanent
I will monitor the
change to provide
the needed support
and information
I will recognize and
celebrate the success
of a positive change
in behavior
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Ch
alle
nges
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith
child
ren
in S
BCC (these are the terms to be cut out
for use in the group work)
2-5
Cu
rious
and
ope
n to
lear
ning
Lear
n by
pla
ying
doi
ng
imita
tion
and
repe
titio
n
Trus
ting
Ex
cite
d by
new
exp
erie
nces
Ch
ildre
n in
this
age
grou
p
belie
ve w
hat t
hey
see
dire
ctly
Child
ren
in th
is ag
e gr
oup
tran
slate
wha
t the
y se
e to
thei
r ow
n da
ily e
xper
ienc
es
N
ot a
ble
to u
nder
stan
d pr
eten
se
Ha
ve a
lim
ited
use
of w
ords
Diffi
culty
exp
ress
ing
thei
r fe
elin
gs f
ears
and
exc
item
ent
At
tent
ion
shor
t
bull U
se lo
ving
tone
s and
sim
ple
lang
uage
bull
Show
the
child
ren
an a
ttitu
de o
f cur
iosit
y bull
Be p
layf
ul a
nd p
ortr
ay le
arni
ng th
roug
h pl
ay
bull Gi
ve c
hild
ren
simpl
e ch
oice
s bull
Use
eve
ry d
ay e
xper
ienc
es s
torie
s of o
ther
ch
ildre
n fa
mili
es a
nim
als a
nd ty
pica
l dai
ly
activ
ities
and
rout
ines
bull
Use
repe
titio
n an
d m
usic
bull
Use
a v
arie
ty o
f exa
mpl
es b
ut d
o no
t mak
e ch
ange
s too
qui
ckly
bull
Ask
simpl
e qu
estio
ns
bull En
cour
age
child
ren
to ta
lk
bull Ke
ep se
ssio
ns sh
ort t
o ke
ep th
e ch
ildre
nrsquos
atte
ntio
n
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SBC
C (these are the terms to be cut out for use in the group work)
6-11
Child
ren
unde
rsta
nd
caus
e an
d ef
fect
s bet
ter
in th
is ag
e gr
oup
At
tent
ion
span
gro
win
g
Mor
e w
ords
in
voca
bula
ry a
nd b
ette
r ab
le to
exp
ress
th
emse
lves
Frie
ndsh
ips g
row
ing
M
ore
able
to c
ontr
ol th
eir f
eelin
gs
Ca
n st
ill g
et u
pset
Can
still
be
easil
y di
stra
cted
The
child
ren
can
be b
ored
eas
ily if
th
ey d
onrsquot
see
the
conn
ectio
n of
th
e ne
w to
pic
to th
eir o
wn
situa
tion
O
pini
ons o
f the
ir fr
iend
s may
lim
it th
eir p
artic
ipat
ion
in th
e gr
oup
U
se lo
ving
and
pat
ient
tone
s
Show
tha
t exp
erie
nces
of l
earn
ing
and
achi
evem
ents
in sc
hool
ar
e an
opp
ortu
nity
to d
evel
op n
ew i
nter
estin
g sk
ills a
nd
tale
nts
Sh
ow th
e ch
ildre
n ho
w to
dem
onst
rate
soci
ally
pos
itive
act
ion
such
as k
indn
ess
conf
lict r
esol
utio
n an
d ca
ring
abou
t oth
ers
As
the
adul
t kee
p yo
ur p
erso
nal a
nd m
oral
stan
dard
s hig
h to
sh
ow th
e ch
ildre
n st
rong
pos
itive
adu
lt ro
le m
odel
s
Give
the
child
ren
exam
ples
of
child
ren
mak
ing
a di
ffere
nce
in
thei
r ow
n an
d ot
herrsquos
live
s ev
en in
diff
icul
t situ
atio
ns (r
ealis
tic
hero
ines
and
her
oes)
Pres
ent s
torie
s abo
ut fr
iend
ship
loy
alty
and
ldquodoi
ng th
e rig
ht
thin
grdquo
Pr
esen
t lon
ger a
nd m
ore
dram
atic
stor
ies (
vary
ing
in d
urat
ion
betw
een
30 a
nd 4
5 m
inut
es)
bullStories told to the children should focus on childrenrsquos
expe
rienc
es a
nd c
hara
cter
s
Use
exa
mpl
es th
at a
re fu
nny
to se
e an
d he
ar to
hel
p bu
ild th
e le
arni
ng e
xper
ienc
e (e
g
brai
n te
aser
s ri
ddle
s to
ngue
tw
ister
s e
tc)
In
clud
e in
tera
ctiv
e pr
oble
m-s
olvi
ng a
nd c
ritic
al th
inki
ng
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Adv
anta
ges
and
Chal
leng
es a
nd P
ract
ical
App
roac
hes
whe
n W
orki
ng w
ith
Child
ren
Age
rang
e Ad
vant
ages
Li
mita
tions
Pr
actic
al a
ppro
ache
s to
use
whe
n w
orki
ng w
ith ch
ildre
n in
SB
CC (these are the terms to be cut out for use in the group
work)
12-1
7
Abst
ract
thin
king
bet
ter d
evel
oped
be
tter
abl
e to
dist
ingu
ish th
e re
al
from
the
unre
al
St
artin
g to
pla
n fo
r fut
ure
M
ore
influ
ence
d by
pee
rs
In
crea
singl
y in
depe
nden
t m
ore
adul
t thi
nkin
g
M
ore
influ
ence
d by
pee
rs
M
ore
self-
awar
e
Beha
viou
r may
con
trad
ict
held
bel
iefs
U
se lo
ving
tone
s
Talk
resp
ectf
ully
and
do
not ldquo
talk
dow
nrdquo
Pr
esen
t exa
mpl
es o
f pos
itive
age
-gro
up b
ehav
iour
s and
ot
her a
dole
scen
ts w
ho a
re re
silie
nt a
nd p
ositi
ve
Pr
esen
t a v
arie
ty o
f poi
nts o
f vie
w o
pini
ons a
nd
pers
pect
ives
to h
elp
with
ana
lytic
al a
nd d
ebat
ing
skill
s
Port
ray
gend
er-p
ositi
ve ro
les i
n ad
oles
cent
s and
adu
lts
In
add
ition
to th
e tr
aini
ng m
ater
ials
add
in m
ater
ials
that
us
e pi
ctur
es a
nd im
ages
and
not
full
of te
xt
Ta
lk a
bout
issu
es o
f con
cern
to th
eir p
artic
ular
age
gro
up
(sub
stan
ce a
buse
unp
rote
cted
sex
vio
lenc
e ro
man
tic
rela
tions
hips
bul
lyin
g an
d di
scrim
inat
ion
frie
ndsh
ips)
Port
ray
char
acte
rs w
ho a
re c
onfid
ent a
nd e
xcite
d ab
out
thei
r situ
atio
ns a
nd li
ves
thi
s is v
ery
usef
ul fo
r chi
ldre
n fr
om d
isadv
anta
ge c
ircum
stan
ces
gro
ups a
nd m
inor
ity
lang
uage
gro
ups
for
girl
s a
nd c
hild
ren
with
disa
bilit
ies
U
se a
lot o
f hum
our a
nd c
reat
ivity
Whi
le p
rese
ntin
g gr
owin
g in
depe
nden
ce c
ontin
ue to
po
rtra
y po
sitiv
e pa
rent
-chi
ld re
latio
nshi
ps a
dult-
child
re
latio
nshi
ps th
at fo
ster
the
child
rsquos c
ontin
ued
lear
ning
and
de
velo
pmen
t tow
ards
adu
lthoo
d
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Grow
Shin
e
Mov
e
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Grow
Shin
e
Mov
e
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Mov
e Fo
ods
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Grow
Foods
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Shin
e Fo
ods
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
1 4 7
2 5 8
3 6 9
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
12
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
Constructing a Tippy Tap Materials Required 1 clean empty 1-litre bottle with a bottle top
Set of matches
3 lengths of string 30 cm each
Clean nail (only the facilitator should handle this)
Clean needle
Bar soap
1 extra bottle (optional)
1 small net bag (optional)
Bottom end of a small plastic bottle
Instructions 1 Mark the clean 1-litre bottle 2 cm from the bottom of the bottle 2 Light a match and heat up the needle tip 3 Use the heated needle tip to make a small hole at the mark on the bottle 4 Light another match and heat up the nail tip 5 Make the first small hole wider using the head of the heated nail by inserting the nail in the
hole made by the needle 6 Fill the bottle with water and then close the bottle with the bottle top 7 Tie one end of the string round the neck of the bottle and the other end of the string to the
place of the handwashing point The bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground If the bottle is hanging loose and may spin be sure to put a mark on the side of the bottle where the hole of the tap is to guide the users of the tippy tap
8 Alternatively tie the bottle to a wall or a post with the hole facing outward for ease of use 9 Fill the bottle with water and tightly close the bottle with the bottle top Water should not
flow out of the hole near the bottom of the bottle when the top is tightly secured 10 Soap option 1 Place the bar of soap in a small net bag and tie the bag to a post or a nail in
the wall next to the tippy tap so that it is accessible to people washing their hands and not resting on the ground
11 Soap option 2 Alternatively you can place pieces of the bar of soap (or even use soap powder) inside a different bottle Using the heated nail make a hole in the bottle top Add some water to the bottle and shake to dissolve the soap to make liquid soap Secure the bottle top and tie one end of the string round the neck of the soap bottle and the other end of the string to the place of the handwashing point The soap bottle should be secured by the string and hanging from the wall or post so that it is accessible to people washing their hands and not resting on the ground The liquid soap can be poured into a personrsquos hand through the hole in the bottle top
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
12 Soap option 3 Pierce the bottom of a small bottle that has been cut off a small bottle to use a soap dish
13 Your tippy tap is ready for use 14 Open the bottle top slightly until water flows out of the hole in the bottom of the bottle To
stop the flow of water close the bottle top 15 Remember to refill the tippy tap each time it is empty and replace the soap when it is used
up
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
HIVmdashDrug Effects and Actions to Take HIVDrug Effects Actions to Take
Bone strength and development can be negatively affected
Diarrhoea and vomiting
Sore mouth and throat
Fever
Decreased appetite
Lactose intolerance
Fat and cholesterol storage may be increased in the body
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
References List CORE Group 2013 Designing13 for Behavior13 Change Curriculum Washington DC CORE Group andUSAID
Government of Nigeria13 2012 The Community Infant and Young Child Feeding13 (C-shy‐IYCF)13 Counselling13 Package Abuja Government of Nigeria13
Population Council 2014 Nutrition13 Education Curriculum for13 the Adolescent13 Girls EmpowermentNew York13 NY13 Population Council13
SPRINGBangladesh13 2014 Community Workerrsquos13 Training13 Guide on Essential13 Nutrition13 ActionsEssential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
SPRINGBangladesh13 2014 Community Workers13 Handbook on Essential13 Nutrition13 Actions Essential13 Hygiene Actions and Homestead13 Food Production Arlington VA USAIDStrengtheningPartnerships Results and Innovations in Nutrition13 Globally (SPRING)13 Project
University of California Cooperative Extension ND13 Go Grow Glow A Nutrition13 Curriculum forPreschoolers Yuba City CA University of California Cooperative Extension
USAID Ghana Behaviour Change Support (BCS) Project ND13 Grow Glow Go Healthy13 Child Feeding13 for GoodLife Flip Chart Baltimore MD Johns Hopkins Bloomberg School of Public Health Centerfor Communication Programs
Handouts and Job Aids
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg
SPRING
JSI Research amp Training Institute Inc 1616 Fort Myer Drive 16th Floor Arlington VA 22209 USA Tel 703-528-7474 Fax 703-528-7480 Email infospring-nutritionorg Web wwwspring-nutritionorg