Improving Breastfeeding Practices on a Broad Scale at the Community Level: Success Stories From Africa and Latin America

Quinn, Victoria J.; Guyon, A; Schubert, Joan; Stone-Jimenez, M; Hainsworth, Michael; Martin, Luann

doi:10.1177/0890334405278383

Cited by 61 publications

(68 citation statements)

References 6 publications

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“…These represent a 10-13 percentage point increase above baseline for infants aged 3-5?9 months, which is comparable to the increase found in Bolivia and Ghana in the LINKAGES Project where breast-feeding interventions were delivered at scale through multiple partners, including government health services, nongovernment organizations and radio stations, but lower than the 22 percentage point increase in Madagascar (18) . Unlike Madagascar, no attempt was made in Recife to saturate the primary audience with messages, and the number of individuals trained per million of the population was more than three times higher in Madagascar than in Recife.…”

Section: Discussionmentioning

confidence: 59%

“…Programmes that are integrated into routine health services may prove more enduring (16) and in India multiple delivery channels have been used, including community health workers, midwives and traditional birth attendants (17) . Although there are numerous efficacy studies of breastfeeding promotion interventions and some large-scale interventions using project-supported staff (13,18) , there are few studies of the effectiveness of programmes operating at scale within routine health systems (19,20) where impact may be reduced (1) . There is also very little research related to methods of training those delivering breast-feeding promotion interventions (10,21) .…”

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confidence: 99%

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Promotion of exclusive breast-feeding at scale within routine health services: impact of breast-feeding counselling training for community health workers in Recife, Brazil

Coutinho

Lira

Lima

et al. 2013

Public Health Nutr.

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Objective: Breast-feeding counselling has been identified as the intervention with the greatest potential for reducing child deaths, but there is little experience in delivering breast-feeding counselling at scale within routine health systems. The study aim was to compare rates of exclusive breast-feeding associated with a breast-feeding counselling intervention in which community health agents (CHA) received 20 h of training directed at counselling and practical skills with rates pre-intervention when CHA received 4 h of didactic teaching. Design: Cross-sectional surveys of breast-feeding practices were conducted pre-and post-intervention in random samples of 1266 and 1245 infants aged 0-5?9 months, respectively. Setting: Recife, Brazil, with a population of 2 million. Subjects: CHA (n 1449) of Brazil's Family Health Programme were trained to provide breast-feeding counselling at home visits. Results: Rates of exclusive breast-feeding improved when CHA were trained to provide breast-feeding counselling and were significantly higher by 10-13 percentage points at age 3-5?9 months when compared with pre-intervention rates (P , 0?05). Post-intervention point prevalence of exclusive breast-feeding for infants aged ,4 months was 63 % and for those aged ,6 months was 50 %. Conclusions: Multifunctional CHA were able to deliver breast-feeding counselling at scale within a routine health service and this was associated with a significant increase in rates of exclusive breast-feeding. The study reinforces the need to focus training on counselling and practical skills; a key component was an interactive style that utilized the knowledge and experience of CHA. The findings are relevant to the call by international organizations to scale up breast-feeding counselling.

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Section: Discussionmentioning

confidence: 59%

mentioning

confidence: 99%

Promotion of exclusive breast-feeding at scale within routine health services: impact of breast-feeding counselling training for community health workers in Recife, Brazil

Coutinho

Lira

Lima

et al. 2013

Public Health Nutr.

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“…25 Results from the Linkages project in Northern Ghana have shown that rates of early initiation can be improved with a comprehensive and well funded strategy, which included mass media, health worker training, supporting the Baby Friendly Hospital Initiative Authority, support groups, mass media and community mobilization. 10,21 However, we found little support of breast-feeding activities in the study district.…”

Section: Discussionmentioning

confidence: 83%

Early initiation of breast-feeding in Ghana: barriers and facilitators

et al. 2008

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To explore why women in Ghana initiate breast-feeding early or late, who gives advice about initiation and what foods or fluids are given to babies when breast-feeding initiation is late. Qualitative data were collected through 52 semistructured interviews with recent mothers, 8 focus group discussions with women of child-bearing age and 13 semistructured interviews with health workers, policy makers and implementers. The major reasons for delaying initiation of breast-feeding were the perception of a lack of breast milk, performing postbirth activities such as bathing, perception that the mother and the baby need rest after birth and the baby not crying for milk. Facilitating factors for early initiation included delivery in a health facility, where the staff encouraged early breast-feeding, and the belief in some ethnic groups that putting the baby to the breast encourages the milk. Policy makers tended to focus on exclusive breast-feeding rather than early initiation. Most activities for the promotion of early initiation of breast-feeding were focused on health facilities with very few community activities. It is important to raise awareness about early initiation of breast-feeding in communities and in the policy arena. Interventions should focus on addressing barriers to early initiation and should include a community component.

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“…Only once the reasons for not EBF are identified should approaches to increasing rates be implemented. There are a variety of interventions for improving rates of EBF, from education to cash transfers to mass media messages (154); the application of these to HIV-infected populations or general populations in countries with high HIV prevalence will be informative. Similarly, the evaluation of the high-priority strategies for protecting, promoting, and supporting EBF detailed in the Global Strategy for Infant and Young Child Feeding (155) would be useful in the context of HIV.…”

Section: Infant Feeding and Hiv 233mentioning

confidence: 99%

Current Knowledge and Future Research on Infant Feeding in the Context of HIV: Basic, Clinical, Behavioral, and Programmatic Perspectives

Young

Mbuya

Chantry

et al. 2011

Advances in Nutrition

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In 2008, between 129,000 and 194,000 of the 430,000 pediatric HIV infections worldwide were attributable to breastfeeding. Yet in many settings, the health, economic, and social consequences of not breastfeeding would have dire consequences for many more children. In the first part of this review we provide an overview of current knowledge about infant feeding in the context of HIV. Namely, we describe the benefits and risks of breastmilk, the evolution of recommended infant feeding modalities in high-income and low-income countries in the last two decades, and contextualize the recently revised guidelines for infant feeding in the context of HIV current knowledge. In the second section, we suggest areas for future research on the postnatal prevention of mother-to-child transmission of HIV (PMTCT) in developing and industrialized countries. We suggest two shifts in perspective. The first is to evaluate PMTCT interventions more holistically, to include the psychosocial and economic consequences as well as the biomedical ones. The second shift in perspective should be one that contextualizes postnatal PMTCT efforts in the cascade of maternal health services. We conclude by discussing basic, clinical, behavioral, and programmatic research questions pertaining to a number of PMTCT efforts, including extended postnatal ARV prophylaxis, exclusive breastfeeding promotion, counseling, breast milk pasteurization, breast milk banking, novel techniques for making breast milk safer, and optimal breastfeeding practices. We believe the research efforts outlined here will maximize the number of healthy, thriving, HIV-free children around the world. Adv. Nutr. 2: 225-243, 2011.

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Improving Breastfeeding Practices on a Broad Scale at the Community Level: Success Stories From Africa and Latin America

Cited by 61 publications

References 6 publications

Promotion of exclusive breast-feeding at scale within routine health services: impact of breast-feeding counselling training for community health workers in Recife, Brazil

Promotion of exclusive breast-feeding at scale within routine health services: impact of breast-feeding counselling training for community health workers in Recife, Brazil

Early initiation of breast-feeding in Ghana: barriers and facilitators

Current Knowledge and Future Research on Infant Feeding in the Context of HIV: Basic, Clinical, Behavioral, and Programmatic Perspectives

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