A public sector social franchise to boost nutrition for infants and young children so that they can shine.
The Little Sun brings quality care and nutrition counselling to antenatal and postnatal care services to improve exclusive breastfeeding rates and infant and young child feeding practices in Viet Nam. Today, there are 1,200 Little Sun nutrition counseling clinic across 15 provinces in Viet Nam.
A sustaining innovation – An existing idea, model, product, or service in an existing market We partner with the National Institute of Nutrition of Viet Nam.
Challenging the Status Quo to Impact Nutrition
Q: What solution is offered by this innovation?
While most women breastfeed in Viet Nam, only 45.4 percent of infants under six months of age are exclusively breastfed,1 while complementary feeding practices continue to be inadequate; for example, semi-solid foods are often introduced too early and can be poor quality.
The causes of low exclusive breastfeeding rates and suboptimal infant and young child feeding (IYCF) practices are varied and include the perception among mothers, caregivers, health workers, and the public that Vietnamese women cannot produce sufficient breastmilk to initiate breastfeeding early and exclusively for six months; aggressive marketing and ready availability of infant formula; lack of support from family members and employers; and limited health worker commitment and skills to encourage and support mothers.
Our franchise model has been designed to systematically overcome these barriers, providing quality and relevant training to health workers who can encourage and support mothers to practice optimal nutrition behaviours and practices. Our franchise uses existing national decentralized services, building trust over time. As a result, we have grown in brand recognition, allowing us to continue to positively shape social norms and behaviors. Today, more than ninety percent of pregnant women in Viet Nam access antenatal care at a health facility.
Q: What is most exciting about The Little Sun franchise?
This is the first time that a social franchise model has been applied to IYCF counseling. Franchises are normally operator owned, but in Viet Nam, the model has been adopted for the public sector. Social franchising is an innovative approach to improving access to and quality of health care services, particularly in low- and middle-income countries2. It applies commercial franchising concepts so that a brand identity is equated with quality services that help achieve social and health benefits.
Q: How does The Little Sun franchise support system wide change?
Our franchise model supports targets outlined in the government of Viet Nam’s National Nutrition Strategy, including integrating nutrition activities into primary health care, improving essential services, and upgrading the training of health care providers.
The franchise increases the availability of accurate information on IYCF through fee-for service interpersonal counseling or group sessions beginning in the third trimester of pregnancy and continuing through the first two years of life. Educational content was developed by nutritionists and certified by the Viet Nam Institute of Nutrition. Standardization of service delivery, routine monitoring, and focused training builds the capacity for providers to give IYCF advice and support clients across all our clinics.
Looking Ahead: Lessons for our Impact Network
In the development and replication of our model we experienced challenges in utilization and demand creation. To solve this problem, we carried out analysis and user surveys to find loopholes in service promotion, especially for mothers with children from twelve months old. Based on findings, marketing strategies promote the franchise utilization among clients.
In the coming years, we will adjust The Little Sun nutrition counseling clinic model to fit mothers’ and families’ evolving needs and habits. We will combine playful parenting and nutrition counseling so that mothers, children, and families are driven by enjoyment and fun.
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Find out more about our impact pathway
¹ Alive &Thrive data for all 63 provinces in 2019
² Beyeler N, York De La Cruz A, Montagu D, The impact of clinical social franchising on health services in low- and middle-income countries: a systematic review, PLoS ONE2013;8:e60669