The Texting for Nutrition program was implemented by the World Bank together with the Decentralized Autonomous Government of the Chimborazo Province, and the Ecuadorean Ministry of Social Development Coordination (MCDS). Caregivers were enrolled into the program in urban and rural areas of Chimborazo. The Texting for Nutrition program used text messages to encourage caregiver health behavior change. The content of the text messages varied along five thematically focused treatment arms that each encouraged a unique set of behaviors. In treatment arm one (T1), caregivers were encouraged to bring their children in to their local health center for regular and timely checkups. In treatment arm two (T2), caregivers were encouraged to feed their children micronutrients specifically an iron supplement locally called “Chispas”. In treatment arm three (T3), caregivers were provided information about when they should initiate complementary feeding, and how they could increase their child's diet diversity. In treatment arm four (T4), caregivers were encouraged to ensure that water consumed by their children was potable, to wash their hands regularly, as well as to improve general food preparation and hygiene practices. Lastly in treatment arm five (T5), caregivers were sent a mix of text messages along all four content types from T1, T2, T3 and T4. Additionally, caregivers with children under six months of age were sent text messages about exclusive breast feeding, however since this treatment type was age-specific it is not included in the accompanying evaluation.
The content of the text messages was designed with four types of behavioral mechanisms in mind: providing timely new and relevant information, positively encouraging caregivers, using persuasive social norms language, and sending reminders to keep key messages ‘top of mind’. The nutrition messages were developed in collaboration with the Ecuadorean Ministry of Health, locally developed nutrition messages from the Creciendo con Nuestros Guaguas program, and several international food-security resources including the FAO Complementary Feeding for Children Aged 6-23 Months Recipe Book, among others. Each caregiver received approximately 70 text messages in total over a year and a half of program intervention.