Implementing a multilevel, multicomponent intervention to engage fathers in complementary feeding in Northern Nigeria: Perceptions of deliverers and recipients

The Alive & Thrive multilevel, multicomponent intervention to engage fathers in complementary feeding in Kaduna State, Nigeria previously showed significant increases in complementary feeding practices for children. This analysis explores the perceptions of intervention deliverers and recipients to inform future spread. The intervention components included counseling cards, home visits, feeding bowls, texts/prerecorded messages, posters, leaflets, sermon guides, talking points, radio and television spots. In-depth interviews (24) were conducted with intervention deliverers (community health extension workers, community and religious leaders) and focus group discussions (16) with recipients (parents of children 6-23 months) from 6 rural and urban wards. Participants were purposively sampled; parents were not selected as couples. Eligibility for CHEWs and CRLs included being ≥ 18 years and having participated in intervention implementation. Eligibility for parents included being ≥18 years (or married mothers 15-17 years), having a biological child 6-23 months, and receiving the intervention. Transcripts were coded descriptively in Atlas.ti and the results were mapped to the domains and constructs of the Consolidated Framework for Implementation Research 2.0. For the innovation domain, intervention deliverers and recipients reported high acceptability and appropriateness of the intervention components. For the outer domain, the intervention was perceived to be influenced by values and beliefs (fathers' roles as providers), systemic conditions (economic hardships), and critical incidents (COVID-19). The intervention was also influenced by relational connections, compatibility, intervention deliverers and recipients, teaming, tailoring strategies and engaging for the domains of inner setting, individuals, and implementation process, respectively. For implementation strategies, intervention deliverers liked the training and monthly meetings where they shared experiences and problem solved. The Alive & Thrive intervention in Kaduna State, Nigeria was acceptable, appropriate, and feasible for intervention deliverers and recipients.