GOAL Zimbabwe & Malawi Nutrition Impact and Positive Practices Default Decline and Lost to Follow Up Research

A retrospective study into declining to participate, defaulting and loss to follow-up from the NIPP circle programme. The Nutrition Impact and Positive Practices (NIPP) approach is a community-based intervention which aims to promote positive and sustained behaviour change using community ‘circles’ to learn and share positive nutrition, health and WASH behaviours. It involves an integral practical component with demonstrations of nutritious recipes using locally available resources, as well as demonstrations on constructing micro-gardens, fuel-efficient stoves and a number of other optional elements to support behaviour change. NIPP has thus far been implemented by GOAL in Malawi, Niger, South-Sudan, Sudan and Zimbabwe with promising results. As NIPP is a relatively new concept, there is a need to learn from the experiences so-far and continue to build the evidence-base before upscaling or rolling out the NIPP approach any further. Some GOAL country programmes are experiencing difficulties with participants defaulting and community members declining-to-participate, particularly in men. Default rates globally are 21% and 22% for females and males, respectively and there is an opportunity to learn from current implementation to put recommendations in place to improve future participation rates. Additionally, some programmes have experienced large attrition during the 12-month longitudinal follow-up period following graduation which is creating problems with statistical analysis and validity of the monitoring and evaluation data. The reasons behind this need to be understood to adapt the follow-up strategy to build a robust evidence-base for the NIPP approach.