Effectiveness of the baby-friendly community initiative in promoting exclusive breastfeeding among HIV negative and positive mothers: a randomized controlled trial in Koibatek Sub-County, Baringo, Kenya

Autor: Elizabeth W. Kimani-Murage, Frederick Wekesah, Betty Samburu, Stephen T. McGarvey, Peter Muriuki, Nyovani Madise, Sera L. Young, Milkah Njeri Wanjohi, Judith Kimiywe, Paula L. Griffiths
Rok vydání: 2020
Předmět:
Adult
Counseling
0301 basic medicine
Health Knowledge
Attitudes
Practice
Adolescent
medicine.medical_treatment
Psychological intervention
Breastfeeding
Mothers
HIV Infections
Logistic regression
Support group
law.invention
Young Adult
03 medical and health sciences
0302 clinical medicine
Practices
Randomized controlled trial
Pregnancy
law
medicine
Humans
030212 general & internal medicine
Health Education
Baby friendly community initiative
Peer counsellors
030109 nutrition & dietetics
business.industry
lcsh:Public aspects of medicine
Research
lcsh:RJ1-570
HIV
Obstetrics and Gynecology
lcsh:Pediatrics
lcsh:RA1-1270
Exclusive breastfeeding
Feeding Behavior
Middle Aged
medicine.disease
Kenya
Breast Feeding
Attitudes
Pediatrics
Perinatology and Child Health
Community health
Female
Health education
business
Demography
Zdroj: International Breastfeeding Journal
International Breastfeeding Journal, Vol 15, Iss 1, Pp 1-13 (2020)
ISSN: 1746-4358
DOI: 10.1186/s13006-020-00299-4
Popis: Background Although the baby-friendly community initiative (BFCI) has been proposed as a community-level approach to improve infant feeding practices, there is little data on its variation in effectiveness by HIV status. We conducted a study to determine the effectiveness of BFCI in changing knowledge and attitudes towards exclusive breastfeeding (EBF) and increasing the rates among HIV negative and HIV positive women in rural Kenya. Methods A community-based cluster-randomized controlled trial was implemented from April 2015 to December 2016 among 901 women enrolled across 13 clusters. The intervention groups received a minimum of 12 personalized home-based counselling sessions on infant feeding by trained community health volunteers from their first or second trimester of pregnancy until 6 months postpartum. Other interventions included education sessions at maternal child clinics, mother-to-mother support group meetings and bi-monthly baby-friendly gatherings targeting influencers. The control group received standard health education at the facility and during monthly routine home visits by community health volunteers not trained on BFCI. Primary outcome measures were the rates of EBF at week 1, months 2, 4 and 6 postpartum. Secondary outcomes included knowledge and attitudes regarding breastfeeding for HIV-exposed infants. Statistical methods included analysis of covariance and logistic regression. Results At 6 months, EBF rates among HIV negative mothers were significantly higher in the BFCI intervention arm compared to the control arm (81.7% versus 42.2% p = 0.001). HIV positive mothers in the intervention arm had higher EBF rates at 6 months than the control but the difference was not statistically significant (81.8% versus 58.4%; p = 0.504). In HIV negative group, there was greater knowledge regarding EBF for HIV-exposed infants in the intervention arm than in the control (92.1% versus 60.7% p = 0.001). Among HIV positive mothers, such knowledge was high among both the intervention and control groups (96% versus 100%, p > 0.1). HIV negative and positive mothers in the intervention arm had more favourable attitudes regarding EBF for HIV-exposed infants than the control (84.5% versus 62.1%, p = 0.001) and (94.6% versus 53.8% to p = 0.001) respectively. Conclusions BFCI interventions can complement facility-based interventions to improve exclusive and continued breastfeeding knowledge, attitudes, and behaviours among HIV negative and positive women.
Databáze: OpenAIRE
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