Digitalising Myanmar’s Nutrition Promotion Month

What we know: Nutrition Promotion Month (NPM) in Myanmar aims to improve knowledge and awareness of optimal nutrition for infants, children, adolescents, and women. In recent years, coverage has been constrained by ongoing conflict, insecurity, and natural disasters. 

What this adds: For NPM 2024, innovative strategies integrating digital technology were adopted to address these challenges by leveraging the trend of increased social media use in Myanmar. As a result, NPM 2024 reached 2.1 million people compared with 400,000 in 2023. Key lessons learned included: fostering partnerships and engaging diverse stakeholders ensured buy-in and smooth implementation, while involving prominent figures and technical experts fostered trust, amplifying the campaign’s reach. Future campaigns should continue to leverage social media while exploring innovative community-based interventions to expand coverage, particularly in hard-to-reach and conflict-affected areas. 

Myanmar has been experiencing the negative repercussions of political instability, persistent conflicts, and natural disasters. These have exacerbated the existing precarious situation of malnutrition, in addition to the lingering effects of the COVID-19 pandemic. Among the many issues, suboptimal infant and young child feeding is a serious public health problem in Myanmar. Almost half of infants aged 0-5 months are not exclusively breastfed (DHS, 2016), and over two out of five children aged 6-23 months do not consume diversified nutritious meals. The situation is worse in rural and conflict-affected areas (MAPSA, 2023) of Myanmar, where almost 70% of the population live in rural areas (World Bank, 2024).

Nutrition Promotion Month (NPM) takes place in August of every year. It aims to disseminate appropriate knowledge to a wide audience to protect and promote healthy diets, services, and practices that support optimal nutrition, growth, and development, especially of children, adolescents, and women. The NPM is structured thematically by week. Week 1 celebrates world breastfeeding week in alignment with the global celebration to protect, promote, and support breastfeeding. Week 2 focuses on nutrition for children under five years, school-aged children, and adolescents. Week 3 focuses on nutrition for pregnant and breastfeeding women, while week 4 focusses on eliminating iodine deficiency and promoting food fortification. 

The NPM has been celebrated in Myanmar since 2003, reaching millions of people over the years. However, in 2020, the campaign faced disruptions due to COVID-19, internal conflict, and natural disasters. In the face of these challenges, UN Nutrition Network (UNN) in Myanmar worked to strengthen collaboration among UN agencies, civil society, the private sector, and local communities to uphold NPM’s impact. Coverage, however, remained limited also beyond the COVID-19 pandemic, because of ongoing conflict, access constraints, and service disruptions. 

In response to these constraints, in 2024 UNN led a new approach to bolstering NPM by integrating digital technology and social media to minimise the impact of the ongoing crises and boost community awareness. This initiative aligned with Myanmar’s rising social media usage, with over two-thirds of the total population accessing at least one type of social media platform (Hamza et al, 2024). Social media has the capacity to target and reach diverse audiences since it is not limited by space, time, or geography (Moorhead et al, 2013). It has proved effective in influencing behaviour change across diverse demographics, enabling participatory and interactive engagement (Kukreja et al, 2011; Benetoli et al, 2015). Efforts were made to align and integrate nutrition and care-related messages used on different platforms to maintain consistency and avoid confusion among the communities (Roy et al, 2023). Key opinion leaders and a nutritionist were engaged as resource persons for the campaign to increase engagement and acceptance. The campaign leveraged partnerships with civil society and private sector actors through Scaling Up Nutrition networks to enhance access to nutrition services for vulnerable populations. The innovative strategies adopted were tailored to Myanmar’s political landscape, focusing on direct community engagement and building on past experiences to broaden NPM’s reach and impact. 

Talk show

Central to the campaign was a pre-recorded talk show featuring celebrities and intended to generate greater interest in nutrition among the Myanmar population. Target groups were caregivers of children under five years, adolescents, community leaders, and key decision makers. The talk show aimed to raise awareness about optimal breastfeeding, address myths, and fill knowledge gaps in maternal and child nutrition. It tackled key issues related to breastfeeding, such as the importance of early initiation of breastfeeding, exclusive breastfeeding for the first six months, and continued breastfeeding up to at least two years with appropriate complementary feeding from six months. It also highlighted the need for better social support for working mothers and the risks associated with commercial milk formula feeding.

The talk show featured a renowned paediatrician, a well-known actress who is also a mother and a practicing doctor, and a popular ‘doctor mommy’ blogger who regularly shares nutrition-related tips, advice, and better parenting guides through social media platforms. This diverse lineup engaged audiences by offering practical tips, motivational stories, and relatable role models, fostering greater interest and connection with viewers. Practical messages produce more meaningful behaviour changes for feeding and caring practices (Januraga et al, 2020). Moderated by a professional host, the panel delivered a balanced discussion, blending expert advice with personal insights. 

To maximise reach and address access constraints, the talk show was disseminated across multiple social media platforms, as well as community-based platforms in hard-to-reach areas with limited internet access. With support from a local production company, UNICEF creatively produced an animated video that distilled key messages from the original one hour-long talk show to increase its reach. This approach was designed to engage caregivers who may not have had the time to watch the full-length video, ensuring the content reached a wider audience across major social media channels, including the UNICEF Knowledge Talk Channel. The live talk show and the animated video reached over 2.1 million viewers and generated significant engagement, with over 1,000 participants actively taking part in associated quizzes and reward campaigns.

Live webinar 

UNN hosted a four-topic live webinar to enhance awareness and engagement in NPM among healthcare professionals, policymakers, community leaders, and civil society. The event attracted 77 participants (41 women and 36 men) from various locations and featured 10 panellists, expert presentations, and interactive discussions. The webinar was delivered in both Burmese and English and addressed topics like complementary feeding, commercial milk formula, maternal health, and food safety. Live question-and-answer sessions fostered direct communication, resolving enquiries and enhancing engagement. The live webinar saved costs that would normally be associated with in-person events (travel and accommodation) but still promoted knowledge sharing. It received positive feedback for its content, expert speakers, and engaging, interactive format. 

Community-based sessions 

In areas with less security constraints, two half-day in-person events were held at the community level. Over 170 mothers, fathers, and caregivers engaged in a range of activities designed to raise awareness about nutrition, particularly for the critical first 1,000 days of life. Through these innovative activities, the campaign succeeded in engaging the community and promoting vital nutrition knowledge in a fun, interactive way.

A 45-minute question-and-answer session on breastfeeding, complementary feeding, balanced diets, and growth monitoring was conducted in the local language. It featured rewards for correct answers and a whiteboard for community feedback, with over 70 participants sharing thoughts and experiences on nutrition. 

To visually engage participants, six large vinyl posters and pamphlets were displayed, covering key messages on infant and young child feeding. Mothers and caregivers took part in discussions and shared their experiences.

Additional innovative activities included a photo-frame session where participants took photographs with hand-held posters featuring breastfeeding messages. As the participants posted their photos on social media, messages were disseminated to wider audiences through their networks. A shopping competition where groups of mothers were tasked with selecting nutritious, locally available foods provided practical, hands-on learning. 

The event also included a television show that was a shortened version of the campaign talk show on a large TV screen, thereby reinforcing key breastfeeding messages through a different medium. The event continued with an experience-sharing session where a mother of a child aged under five years spoke about her personal journey in ensuring her child’s proper nutrition. Her story connected with the audience, presenting challenges and solutions that others could easily relate to and apply in their own lives.

A drawing competition was also organised among school-aged children with the purpose of enhancing their understanding of diversified nutritious foods, identifying locally available different varieties of food, and encouraging consumption at the household level.

Quiz contests 

Following each activity, in-person quiz contests were organised at the community level, UN offices, and with partners. The extensive quiz campaign was launched to engage participants, assess their understanding on nutrition-related topics, and identify community needs. To maximise reach, the quiz was disseminated through three main messaging platforms: the UNN Channel, the WHO Channel, and the UNICEF Knowledge Talk Channel Thuta. Awards were announced to make the events more interactive and entertaining. Prizes were awarded to individuals with the highest scores and quickest responses. Those who excelled were rewarded with a US$ 1.5 (5,000 MMK) recharge for their mobile phone. The quiz campaign attracted large audiences, drawing in 134 participants from the UNN Channel, 128 from the WHO Channel, and reaching an audience of 13,921 with 956 interactions on the UNICEF Knowledge Talk Channel. The strategy created a platform for community engagement with nutrition experts. The quiz campaign fostered community involvement, encouraging participants to reflect on their eating habits and appreciate the importance of nutrition in their daily lives. By actively engaging the public, the initiative not only raised awareness about nutrition but also empowered individuals to take charge of their health and well-being.

Over 2.1 million people were reached during NPM in 2024, compared with only around 400,000 in 2023. As well as increasing the reach of the campaign, the diversified approaches and use of social media encouraged participants to interact directly with experts and get clarification on their questions and concerns. 

Some of the quotes from participants were as follows:

“I learned so many new things about nutrition and this event encouraged me to continue breastfeeding even after two years of age. I will encourage other mothers to follow recommended breastfeeding and complementary feeding practices.” 27-year-old mother

“I didn’t know about the benefits of micronutrient tablets previously. Now, I realise that I need to consume multiple micronutrient tablets not only for the growth and development of my baby but also for our survival.” Young mother participant in community-based session

“It is not just a competition but an eye-opener. We learned how to choose the right foods for our families with the little we have. I’ve started paying more attention to what we eat.” Drawing competition participant 

Fostering partnership and coordination 

Involving key stakeholders in all stages of campaign design, along with open communication, built trust and secured buy-in from UN agencies, civil society, private sectors, and communities. Preparatory meetings encouraged experience sharing and suggestions for a successful campaign based on experience. Clear role division and regular follow-ups addressed challenges and ensured smooth and timely implementation. Bilateral discussions with key stakeholders further strengthened commitment and contribution. 

Digitalisation of the approach 

Leveraging social media was strategic, given its growing use and conflict-related inaccessibility in Myanmar. Messages were crafted to be simple, non-ambiguous, and self-sufficient, making them easily understood and appealing to caregivers. The involvement of a famous doctor, actress, and professional moderator increased engagement through the campaign’s talk show. Platforms for dissemination such as Facebook, YouTube, and Viber were chosen due to their widespread use. The more focused selection of communication channels emphasising the platform with the greatest ease of use improves the campaign’s reach and level of engagement (Roy et al, 2023). Based on regular monitoring and feedback from audiences, shortening the talk show video clip and its translation into the local language also contributed to increased reach. 

Ensuring access in hard-to-reach areas 

Social media is not a one-size-fits-all solution for behaviour change communication (Korda & Itani, 2013). Also, while social media effectively reaches broader audiences, it cannot replace interpersonal communication in vulnerable, hard-to-reach areas without internet access. Diversified community-based interventions including cooking demonstrations, experience sharing by mothers, photo-frame sessions, and quizzes can be crucial to reach those vulnerable populations. However, community-based sessions were organised only in limited locations due to conflict and current restrictions on gatherings of more than five people in some locations. 

Sustained impact 

Video clips from the campaign can be used to orient and train community health workers, volunteers, and community members, ensuring continuity of counselling services, uniformity in messaging, and minimising information loss. These tools are crucial for sustainable behaviour change efforts and extending the campaign’s reach. 

By collecting and analysing quiz responses, the initiative gathered valuable insights into community understanding and needs regarding nutrition. This information is valuable for informing future nutrition programmes and advocacy efforts aimed at addressing specific challenges and gaps for more sustained impact.

In 2024, integrating digital technology effectively increased coverage of the NPM campaign in the access-constrained context of Myanmar, capitalising on increasing social media use in the country. Engaging diverse stakeholders with clear role division increased buy-in, while involving prominent figures and technical experts fostered trust, amplifying the campaign’s reach. Future campaigns should continue leveraging social media while exploring innovative community-based interventions to expand coverage, particularly in hard-to-reach and conflict-affected areas. Community-based organisations can help organise in-person activities where internet access is limited. To address caregivers’ busy schedules, shorter video clips with key messages in local languages, targeting working mothers, are preferable. Quiz responses provide valuable insights into community needs, to inform future nutrition programming. Further analysis is required to evaluate trends in nutrition service utilisation and caregiving practices.

For more information, please contact Sanjay Kumar Das at skumardas@unicef.org

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