Promotion of exclusive breast-feeding at scale within routine health services

Impact of breast-feeding counselling training for community health workers in Recife, Brazil

Bibliographic Data

ID15090946
AuthorsSonia Bechara Coutinho (Universidade Federal de Pernambuco), Pedro IC Lira (Universidade Federal de Pernambuco), Marilia C Lima (Universidade Federal de Pernambuco), Paulo Germano Frias (0000-0003-4497-8898, Secretaria Municipal de Saúde), Sophie Helena Eickmann (0000-0002-6523-2107, Universidade Federal de Pernambuco), Ann Ashworth (0000-0002-2948-0699, London School of Hygiene & Tropical Medicine, corresponding author)
Year2014
Volume17
Issue4
Pages948-955
Publication date2014-04-01
Open AccessYes
TypeARTICLE
VenuePublic Health Nutrition (JOURNAL)
Journal identifiersISSN: 1368-9800 • E-ISSN: 1475-2727
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s1368980013001833
PMID23845723
OpenAlexW2163668669
LanguageEN
Citations received4
References cited26

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 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

Breast feeding · Community health · Environmental health · Family medicine · Health promotion · Intervention (counseling · Physical therapy · Population · Psychological intervention · Public health · Scale (ratio · Breastfeeding Practices and Influences · Food Security and Health in Diverse Populations · Maternal and Neonatal Healthcare · Medicine · Nursing · Gerontology · Pediatrics

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