These complementary reports present findings from formative research and people-driven design (PDD) workshops undertaken for a Save the Children project working in two districts in Malawi. The study aimed to provide a deeper understanding of the behaviours which drive poor maternal and child nutrition outcomes along with the barriers and entry points for shifting them, including identifying key do-able behaviours for focus in the programme’s SBC strategy, which were refined and tested in communities during the PDD phase. The formative research was undertaken using immersion research in 4 communities. Some of the findings from the formative research included:

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Sources of food and income:

• Family diets included a relatively narrow range of goods, influenced heavily by availability and affordability.

• Though families viewed their food stocks as a form of savings intended to last into the lean months, most shared that the preserved food did not last for the whole year and cash was needed to purchase basic foods before the next harvest.

Pregnant women’s care and nutrition:

• As counselling was rarely given in Antenatal care (ANC) sessions, moms did not have the opportunity to build relationships with  health workers.

Nutrition and care for babies and infants under three:

• Most moms said that they had not been given any specific advice related to nutrition.

• Across locations, babies were usually breast fed in response to crying rather than on a particular schedule.

• Given the need to juggle childcare along with other household tasks, mom’s primary interactions with babies were limited to direct care only.

Hygiene:

• Families did not prioritise hygiene and rarely shared concerns about bacteria, pathogens, or ‘getting sick’.​

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The PDD process was based on the formative research, which identified four priority behaviors for exploration: exclusive breastfeeding, dietary diversity, diarrhea prevention and management, and early learning and stimulation.