Effectiveness of the baby‐friendly community initiative on exclusive breastfeeding in Kenya

Abstract

The baby-friendly hospital initiative (BFHI) promotes exclusive breastfeeding (EBF) in hospitals, but this is not accessible in rural settings where mothers give birth at home, hence the need for a community intervention. We tested the effectiveness of the baby-friendly community initiative (BFCI) on EBF in rural Kenya. This cluster randomized study was conducted in 13 community units in Koibatek sub-county. Pregnant women aged 15-49 years were recruited and followed up until their children were 6 months old. Mothers in the intervention group received standard maternal, infant and young child nutrition counselling, support from trained community health volunteers, health professionals and community and mother support groups, whereas those in the control group received standard counselling only. Data on breastfeeding practices were collected longitudinally. The probability of EBF up to 6 months of age and the restricted mean survival time difference were estimated. A total of 823 (intervention group n = 351) pregnant women were recruited. Compared with children in the control group, children in the intervention group were more likely to exclusively breastfeed for 6 months (79.2% vs. 54.5%; P < .05). Children in the intervention group were also exclusively breastfed for a longer time, mean difference (95% confidence interval [CI]) 0.62 months (0.38, 0.85; P < .001). The BFCI implemented within the existing health system and including community and mother support groups led to a significant increase in EBF in a rural Kenyan setting. This intervention has the potential to improve EBF rates in similar settings.

Improving breastfeeding support through the implementation of the Baby-Friendly Hospital and Community Initiatives: a scoping review

“…The national framework in Kenya included key enablers such as: capacity building, mentorship, integration, social mobilsation and supervision [ 6 ]. Integration was also highlighted as critical for Kenya [ 6 , 106 ]. The community basis of Step 10 of the BFHI itself was seen to be critical for sustained improvements [ 10 ] and a lack of community services was seen to be a barrier to improvements [ 73 ].…”

Associations between exclusive breastfeeding duration and children’s developmental outcomes: Evidence from Siaya county, Kenya

“…Kenya remains among the few countries in Africa that have made major progress in EBF rates, with percentages of children breastfed for at least 6 months rising from 32% to 61%, between 2008 and 2014 [ 22 ]. The increase in breastfeeding rates is due to intense awareness campaigns on the importance of EBF by the Ministry of Health and early intervention programs such as Baby-Friendly Community Initiative (BFCI) and Baby-Friendly Hospital Initiative (BFHI), currently being implemented in some parts of Kenya [ 23 ]. Despite the relatively large benefits of EBF reported in other settings, little is known about the benefits of EBF for at least 6 months and its impact on children’s developmental outcomes in Kenya.…”

A descriptive analysis of the relationship between place of birth and type of birth attendant with breastfeeding feeding practices among children in Kenya

“…For example, Kimani-Murage et al found that children from mothers who received counselling from trained community health workers using the BFHI model were more likely to breastfed as compared to those who received standard care. 17 Our findings indicated that potential benefits of hospital/health care delivery did not seem to persist for long. This is because children born at home were found to be more likely to be breastfed for longer than 24 months than those born in hospitals.…”