Awareness & knowledge of frontline workers on infant & young child feeding (IYCF) practices: A qualitative study from Palghar-Maharashtra, India

Background & objectives Appropriate infant and young child feeding (IYCF) practices are crucial for growth and development during the first two years of life. Despite national initiatives, suboptimal IYCF practices prevail in tribal regions, contributing to undernutrition among under- five children. This necessitates need of specific targeted interventions through involvement of front line workers considering their role in community engagement. This study aims to assess awareness and knowledge of frontline workers about IYCF practices in Palghar district of Maharashtra. Methods This paper is part of a pre-intervention phase of a quasi-experimental study on IYCF practices in a tribal block of Palghar district, which included qualitative data through 56 in-depth interviews among frontline workers [anganwadi worker supervisor, anganwadi workers, and accredited social health activists (ASHAs)] to explore their awareness and knowledge on World Health Organization IYCF domains. Data were coded, thematically analysed, and responses were summarised descriptively to identify gaps for the intervention phase. Results While FLWs exhibited basic awareness of breastfeeding, there was limited knowledge among ASHAs on complementary feeding, minimum dietary diversity, minimum meal frequency and amylase rich flour preparation. While FLWs were aware of key IYCF messages, their implementation is uneven, likely due to limited refresher training, and the lack of user-friendly, validated tools. Interpretation & conclusions The study identified specific knowledge gaps in IYCF practices among frontline workers, particularly among ASHAs. There is an adequate scope for targeted health education to address misconceptions and supportive supervision to strengthen frontline workers' capacity to deliver accurate and consistent IYCF messages in tribal communities.