Building Brand Identity System and Other Activities

The third trimester of pregnancy will give birth to children aged 0-12 months during the entire intervention year. Thus, after 12 months of intervention, the intervention subjects will be in the age group of 0-36 months. Therefore, the subjects evaluating the effectiveness of the intervention model will be children aged 0-36 months and their mothers.

- Exclusion criteria:

+ Children with congenital malformations such as congenital heart disease, cleft palate, cerebral palsy and children not residing in the study communes.

+ Mothers and children not permanently residing at the study site

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+ Mother is mentally ill, mentally retarded or uncooperative

2.2.2. Qualitative research

- Mothers with children aged 0-36 months residing in the research communes

- Commune-level staff: Medical staff of the health station, leaders of the People's Committee, representatives of the Women's Union, collaborators.

- District level staff: Nutrition specialist (CTDD), leader of District Health Center (TTYT)

2.3. Research method

2.3.1. Research design

Figure 2.1: Overall intervention design

To develop the intervention model and evaluate its effectiveness in the field, the following combined research methods were used:

1) Model building

2) Quasi-Experimental- Design, also known as community intervention with control group, pre-intervention survey (TCT) and post-intervention survey (SCT) to evaluate the effectiveness of the model.

3) Using quantitative methods (cross-sectional description) combined with qualitative methods (in-depth interviews and group discussions) in investigating TCT and SCT of a community intervention study with a control group.

- Cross-sectional descriptive survey of TCT to obtain baseline data on the status of SDD and related factors to help build appropriate intervention models and communication messages. Qualitative methods (PPĐT) were also used in combination with the TCT survey to further explore mothers' knowledge, concepts, attitudes about infant feeding and barriers to proper practice.

- Cross-sectional survey of SCT to obtain data and information to compare with baseline data to evaluate intervention effectiveness. In the SCT survey, PPĐT was also implemented but only in 2 intervention communes to evaluate the applicability of the model.

Below is a schematic diagram of the design of a community intervention study with a control group:

Figure 2. 2: Design diagram of community intervention study with control group

Figure 2.2 describes the design of the community intervention with a control group. From 6 coastal plain districts of Khanh Hoa province, 3 districts were intentionally selected, of which 2 were urban districts (Nha Trang city and Ninh Hoa town) and one district was

Rural area (Dien Khanh district). From 3 districts, 3 communes were randomly selected from the communes that met the selection criteria of the study. (For the selection of research communes, please see the sampling section). Two urban communes were divided into intervention communes and control communes. This intervention commune was called the urban intervention commune (CTTT). The remaining rural commune was included in the intervention group and was called the rural intervention commune (CTNT). Intervention group : Including CTTT and CTNT, which implemented the activities of the communication model and the activities of the National Target Program "Children's Information and Communication Improvement Project". Control group : In the control group, only the activities of the Child Information and Communication Improvement Project were implemented.

Steps to implement a community intervention study with a control group:

+ After having the intervention group and the control group, conduct a survey of the pre-intervention situation (time T0) using cross-sectional description combined with in-depth interviews (IDI) and group discussions (FGD).

+ Implement interventions immediately after the situation investigation within a period of 12 months (from August 2011 to the end of July 2012).

+ Post-intervention survey (time point T12) using cross-sectional description combined with PVS and TLN, compared with TCT survey results to evaluate model effectiveness and the ability to replicate the model in the field.

2.3.2. Method of building intervention model

2.3.2.1. Steps to build the model

Step 1: Overview of documents on all issues related to the research topic, review of evaluations of PCSDD interventions in the world and in Vietnam, basic theories on communication types, national strategies on PCSDD, recommendations, evaluation standards of WHO and VDD related to infant feeding

Step 2: Review the local environmental reality, projects being implemented locally (activities that have been and are being implemented, existing, gaps that have not been addressed), integrate the program and seek support.

Step 3: Build intervention model and intervention content

Step 4: Seek advice from experts and scientific and technical councils, seek resource and technical support from domestic and international organizations.

Step 5 : Build intervention toolkit, test and produce intervention toolkit

2.3.2.2. Target audience and media types

Target group of communication intervention

1) Main target group: Pregnant women in the last 3 months, mothers with children from 0-24 months old.

2) Target group 2, group with direct influence (husband, mother-in-law, biological mother, friends, health workers and collaborators);

3) Target group 3: Government leaders, unions, social organizations and communities.

Diverse communication models at the YTCS line

Using direct communication (TTTT) and indirect communication (TTGT) measures through many communication channels. The model is deployed at the commune health station with the aim of targeting the majority of local mothers, who are the working class and do not have many opportunities to access updated information on NDTN.

How to reach the target audience

Direct communication at the counseling room (PTV), in the community, in households. Indirect communication through mass media channels, leaflets, billboards, posters, radio and television.

Figure 2. 3: Media diversity and target audience

Direct communication activities in the consulting room

Information and communication activities at the PTV include individual counseling, small group counseling, large group communication and communication integrated with other health activities at the CHT. Service packages provided at the PTV include encouraging breastfeeding (for mothers in the last 3 months of pregnancy); Supporting breastfeeding (supporting mothers to breastfeed at the time of birth); Managing breastfeeding (for mothers with children aged 0-6 months); Guidance on complementary feeding and other content (for mothers with children aged 5-6 months); Managing complementary feeding (for mothers with children aged 6-24 months).

Support tools for consultation: PTV is set up separately, with appropriate colors, equipped with TV and other office supplies, with the “Mat Troi Be Tho” brand logo, with support tools for consultation such as flipcharts, leaflets, baby models, pacifiers, breast milk pumps, fresh food, cooking stoves, etc. to guide mothers in practice and finally share the use of communication materials of other health care programs. Along with consultation activities, the service also provides ORS packages, digestive enzymes, and supplements for children when needed.

Direct communication activities in the community

Commune health workers develop communication plans. Implement rolling communication campaigns by village and residential group for target groups. Commune health workers coordinate with local socio-political organizations to communicate to target groups. Collaborators communicate when visiting households.

Indirect communication activities

Choose multiple communication channels and multiple communication levels. Communication channels include television, radio, billboards, posters, leaflets, and booklets. Provincial management boards conduct communication via television, create billboards, and posters. District management boards organize competitions and events. Commune health stations distribute leaflets, broadcast radio, etc.

Indirect and direct communication measures in the community through various communication channels were designed and implemented by the researchers. Direct communication measures in the counseling rooms in the intervention communes were implemented with funding and technical support from the Alive & Thrive project.

2.3.2.3. Intervention content

Intervention content is tailored based on initial survey results.

However, the basic propaganda content includes:

- Nutritional care for mothers during pregnancy, encourage breastfeeding

- Education about ABS, encouraging the use of a variety of foods, using foods rich in iron and avoiding foods that hinder iron absorption.

- Take care of sick children with diarrhea, respiratory infections, viral fever

- Education on personal hygiene and food safety

- Encourage mothers to participate in other child health care programs such as expanded immunization and Vitamin A programs.

- Children with malnutrition determined by total weight and children with anemia through testing are advised on diet or referred to hospital for examination and treatment.

2.3.2.4. Search for a brand logo for the consulting room

Organize a workshop to introduce the intervention model, collect feedback on the model and search for a brand logo to send for selection. During the workshop, they discussed and gave feedback on building the intervention model and divided into groups to design the brand logo. The groups drew logos and sent them to the organizing committee for selection. However, the A&T organization chose the Little Sun logo, which was not the logo proposed by Khanh Hoa province.

2.3.2.5. Building a brand identity system and other activities

Brand identity system: Take advantage of all applications on all materials and elements, seize opportunities to create a brand identity system. For example, on billboards, flyers, posters, pocket books, PTV signs, invitations for children to drink Vitamin A, invitations for vaccination, gifts (raincoats, scarves, hats), commercials, videos, wall clocks.

Brand and PTV advertising: Use all possible communication channels and brand recognition systems to promote the brand and PTV. For example, take advantage of every commune meeting such as the Women's Union, residential group and loan group meetings, CTV will introduce PTV. Make a report about PTV and broadcast it on the provincial Radio and Television station.

Khanh Hoa (KTV), PTV advertisement “Little Sun” on KTV, VTV2, VTV3 (produced by A&T organization). Finally, advertisement on Khanh Hoa newspaper.

Other supporting activities: Establishing PTVs with the same brand at provincial general hospitals, district hospitals, and reproductive health care centers to receive referrals from PTVs of commune health stations and taking advantage of every opportunity to approach and promote to mothers who have prenatal checkups and give birth at these health facilities. Creating a favorable environment for breastfeeding through inspection of the implementation of Decree 21/ND-CP of the Prime Minister dated February 27, 2006 on the Business and Use of Nutritional Products for Children

2.3.2.6. Organizational system and monitoring system diagram

Figure 2.4: Organizational system and monitoring system

o Provincial management board: Provincial management board (representing leaders of the Department of Health, Medical Professional Department, Preventive Medicine Center, and Reproductive Health Care Center). The tasks of the provincial management board are to direct general activities, issue directive documents, train source trainers for the district level, organize workshops to implement Decree 21 for medical facilities in 2 districts and towns where there are intervention communes, supervise and support intervention activities, inspect the model's activities periodically every quarter and suddenly, and promote the PTV brand on mass media.

o District management board : The district management board manages general activities, deploys the implementation of Decree 21 in the management area, participates in sending staff to train district-level source lecturers, train consultants and communicators, train collaborators, guides the organization and operation of PTVs and communication activities, inspects and supervises support for communication activities and consulting activities at NDTN consulting rooms, periodically and suddenly, and promotes the PTV brand.

o Commune health workers intervene: Station heads and nutrition specialists plan communication at the commune and at the PTVs, manage collaborators, assign tasks to collaborators, coordinate with collaborators to implement group communication activities at PTVs and outside PTVs, supervise and support collaborators, report monthly consulting activities. Adjust communication plans to suit reality. Promote PTV brand

o Collaborator : The collaborator 's task is to visit households with intervention subjects (pregnant mothers and mothers with young children), propagate at households, distribute leaflets, introduce mothers to PTV, and implement Decree 21.

2.3.2.7. Intervention process

- Organize workshops with partners and stakeholders : Department of Health, District Health Centers implementing interventions, departments, unions and communes intervening.

- Training: for health workers on NDTN care, consulting skills, communication skills, communication planning skills, how to organize communication sessions, and manage consultation rooms. Training nutrition collaborators on NDTN, assigning tasks to collaborators.

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