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Table 2 Overview of topics and activities in Sumadhur

From: The development and feasibility of a group-based household-level intervention to improve preconception nutrition in Nawalparasi district of Nepal

  Title Topics and Brief Summary of Activities
1 Introduction -Program welcome; participant introductions; ground rules and expectations
2 Marital Relationships (Couples Only) -Topics: Healthy Relationships; Defining the Ideal Partner
-Activities: practice identifying relationships and behaviors as “healthy” “unhealthy” or “depends”; guided group dialogue about ideal qualities of partners, gender roles, and relationship equality
3 Household Relationships -Topics: Newly Married Life; Showing You Care Loudly
-Activities: comparison of newlywed experiences, comfort, tasks, and food security; practiced identifying example scenarios of caring
4 Gender Inequity -Topics: Gender Roles; Men and Boys as Drivers of Norm Change; Daily Routines
-Activities: sharing of gender-specific oppressions and inequalities; guided group reflection to gender role scenarios; collaborative assessment of uneven burden of daily household chores
5 Gender Roles and Household Eating Patterns -Topics: Gender Roles; Order of Household Eating
-Activities: participant skit demonstrating the consequences of uneven responsibilities impacting meaningful food access; small group activity in which members distribute increasingly limited foods and discuss who is prioritized
6 Nutrition in Pregnancy -Topics: Importance of Nutrition During Pregnancy; Dietary Diversity During Pregnancy
-Activities: comparison and discussion of photos of depicting intergenerational outcomes of nourishment; guided group reflections about images conveying food and diet variety
7 Problems and Barriers to Nutrition in Pregnancy -Topics: Nutrition During Early Pregnancy; Barriers to Adequate Nutrition During Pregnancy
-Activities: dialogue responding to images of common antenatal barriers to nutrition (i.e. nausea, heartburn, etc.); small group discussions identifying barriers and solutions to eating diverse foods, iron and folic acid supplementation, and deworming
8 Preconception Period -Topics: Importance of Nutrition in the Preconception Period; Reproductive Goals
-Activities: dialogue following a metaphor comparing the cultivation needed for wheat and for preconception/pregnant women; individual plotting and then comparing of reproductive life plans
9 Norms around fertility and birth spacing -Topics: Fertility Norms; Birth Spacing; Son Preference
-Activities: discussion about community childbearing norms; storytelling to convey benefits of birth spacing; discussion of statements about social/ cultural significance of the sex of a child
10 Biology and Menstruation -Topics: Introduction to Menstruation; Menstrual Hygiene
-Activities: gender-specific discussions of menstruation and facilitator review of the biology of fertilization and sex determination; guided dialogue about menstrual hygiene habits
11 Pregnancy Care and Safe Delivery -Topics: Importance of Antenatal Check-ups; Illness and Danger Signs During Pregnancy
-Activities: interactive review of the purpose and frequency of antenatal check-ups; guided dialogue about danger signs necessitating a hospital visit and development of household-specific birth plans for safe delivery
12 Anemia and Iron and Folic Acid -Topics: Birth Spacing; Anemia and Iron and Folic Acid
-Activities: engagement in a metaphor of strength and weakness followed by a discussion about the intergenerational, gendered effects of anemia and possible solutions; guided dialogue and debunking of myths related to iron folic acid
13 Stress and Anxiety -Topics: Adverse Events and Stress
-Activities: small group discussions about causes and consequences of adverse events (i.e. unemployment, illness, relational conflict); guided practice of breathing exercises and discussion of their benefit to reduce stress and anxiety
14 Family Planning, Miscarriage, and Abortion
(Couples Only)
-Topics: Method of Family Planning; Misconceptions Regarding Contraceptives; Miscarriage and Abortion
-Activities: interactive lesson from health worker about all methods of contraception; discussion of myths and couple-specific conversations; guided dialogue on safe abortion services in Nepal
15 Intimate Partner Violence
(Couples Only)
-Topics: Introduction to Intimate Partner Violence; Effects of Intimate Partner Violence on Women and Her Children; Ways to Prevent and Control Intimate Partner Violence
-Activities: sorting of scenarios depicting intimate partner violence vs. healthy relationships and an interactive lesson defining/ describing intimate partner violence; guided dialogue about abuse and outcomes through the antenatal period; discussion of prevention and relevant laws/ policies
16 Closing: Making Sun -Topics: Recalling the Sessions; Experience Sharing and Reflection
-Activities: reflective sharing of key program take-aways; invitation to share experiences and partake in a celebratory meal