Objectives To design of a tailored social and behavior change communication (SBCC) strategy to improve program coverage and key nutrition behaviors of internally displaced persons (IDP) in northeast Nigeria, To determine preferred and appropriate ways of integrating one- and two-way mobile communication tools into SBCC activities, To demonstrate application of the Rapid Assessment Procedures (RAP) formative research approach in a humanitarian context with severe insecurity. Methods A RAP approach and was conducted over 4 weeks in August, 2018. It included multiple qualitative methods and various participant types for triangulation. In-depth interviews (IDI), open-ended interviews and focus group discussions (FGD) were conducted among mothers and fathers of children under 5 years, local community leaders and health workers. Semi-structured interviews were conducted among professionals (nutrition and technology experts) with contextual programming knowledge. Interviews and FGD were digitally recorded in Hausa or Kanuri before translation and transcription into English. Textual data were managed in NVivo software, where salient themes pertinent to the research questions were identified. Results A total of 29 IDI, 12 FGD and 10 semi-structured interviews were conducted among diverse stakeholders. An SBCC strategy was designed with preferred communication channels, defined audience segments and tailored messages using emic terms in local languages. Primary caregivers, typically female in this context, were identified as the primary audience. Community health workers, local leaders (e.g., imams) and husbands were identified as secondary audiences who influence the primary caregivers’ nutrition behaviors. Interpersonal (care groups), media (radio) and mobile technologies (interactive voice response calls; SMS; chatbots in low-cost websites) emerged as preferred and viable communication channels. Salient terms and phrases were applied to standard biomedical nutrition messages about breastfeeding and complementary feeding. Conclusions A RAP approach offers a viable formative research model in humanitarian contexts where security challenges might not allow for desired lengthy, in-depth formative work typical of high-quality SBCC strategy design. Funding Sources World Food Program, Korea International Cooperation Agency (KOICA). Supporting Tables, Images and/or Graphs

The World Food Programme (WFP) remains committed to exploring new modalities to improve early detection and treatment coverage for moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) and, more importantly, to prevent malnutrition altogether. The article contains various wrong assertions about WFP nutrition programming. First, WFP Nigeria has not experienced any budget reduction for MAM treatment in recent years. Equally, WFP South Sudan does not have restrictions to subcontract monitoring. Incidentally, ready-to-use supplementary food (RUSF) is not the only food supplement utilised by WFP for treating MAM children. RUSF and Super Cereal Plus are used in Niger, Nigeria and South Sudan. Similarly, in Nigeria, where targeted supplementary feeding programmes (TSFP) are not included in the national protocol, WFP has been treating MAM children using RUSF and Super Cereal Plus through blanket supplementary feeding programme (BSFP) platforms since 2017 in conflict affected areas. This article analyses the perspectives of stakeholders interviewed by the authors, affiliated with IRC, about the Combined Protocol which utilises ready-to-use therapeutic food (RUTF). Availability of RUSF was used as a proxy indicator of RUSF pipeline reliability. However, the use of Super Cereal Plus for MAM children and the provision of MAM treatment through BSFP, both related to RUSF availability, were overlooked. To assess RUSF and RUTF pipeline reliability, considering the increased caseload resulting from treating SAM and MAM with one product, the authors should have examined supply chain elements such as last mile delivery and volume, since worldwide MAM children outnumber by far SAM children.