Effectiveness of the baby-friendly community initiative on exclusive breastfeeding in Kenya
journal contributionposted on 23.03.2021, 13:53 by EW Kimani-Murage, J Kimiywe, AN Mutoro, C Wilunda, FM Wekesah, P Muriuki, BM Mwangi, BM Samburu, NJ Madise, ST McGarvey, Paula GriffithsPaula Griffiths
© 2021 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd. 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.
NIH and the USAID through the Partnership for Enhanced Engagement in Research (PEER) Health Program, administered by the National Academy of Sciences (NAS) to Kenyatta University and the African Population and Health Research Center (Grant # PGA2000003677/8)
Wellcome Trust Fellow during the conceptualization and design of the study and initial data collection, Grant # 097146/ Z/11/Z
Wellcome Trust International Engagement Fellow Grant # 208791/Z/17/Z
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