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    Goudet, Sophie Griffiths, Paula L. Wainaina, Caroline W. Macharia, Teresia N. Wekesah, Frederick M. Wanjohi, Milka Muriuki, Peter and Kimani-Murage, Elizabeth 2018. Social value of a nutritional counselling and support program for breastfeeding in urban poor settings, Nairobi. BMC Public Health, Vol. 18, Issue. 1,
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Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study

  • E. W. Kimani-Murage (a1) (a2), S. A. Norris (a3), M. K. Mutua (a1), F. Wekesah (a1), M. Wanjohi (a1), N. Muhia (a1), P. Muriuki (a1), T. Egondi (a1), C. Kyobutungi (a1), A. C. Ezeh (a1), R. N. Musoke (a4), S. T. McGarvey (a2), N. J. Madise (a5) and P. L. Griffiths (a3) (a6)...
Abstract

Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007–2011; n=5824), Intervention (2012–2015; n=1110) and Comparison (2012–2014; n=487)], which followed mother–child pairs longitudinally to establish EBF rates from 0 to 6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0 to 6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a χ 2 test and logistic regression. At 6 months, the prevalence of EBF was 2% in the Pre-intervention group compared with 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (P<0.05). After adjusting for baseline characteristics, the odds ratio for EBF from birth to 6 months was 66.9 (95% CI 45.4–96.4), 84.3 (95% CI 40.7–174.6) and 3.9 (95% CI 1.8–8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared with the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting EBF in urban poor settings where health care access is limited.

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Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2015
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
*Address for correspondence: E. W. Kimani-Murage, African Population and Health Research Center (APHRC), P.O. 10787, 00100 Nairobi, Kenya. (Email ekimani@aphrc.org)
References
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1. Bhutta, ZA, Das, JK, Rizvi, A, et al. Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? Lancet. 2013; 382, 452–477.
2. Bhutta, ZA, Ahmed, T, Black, RE, et al. What works? Interventions for maternal and child undernutrition and survival. Lancet. 2008; 371, 417–440.
3. Gareth, J, Richard, WS, Robert, EB, Zulfiqar, AB, Saul, SM. How many child deaths can we prevent this year? Lancet. 2003; 362, 65–71.
4. Kramer, MS, Kakuma, R. The optimal duration of exclusive breastfeeding: a systematic review. Adv Exp Med Biol. 2004; 554, 63–77.
5. Oddy, WH, Kendall, GE, Blair, E, et al. Breast feeding and cognitive development in childhood: a prospective birth cohort study. Paediatr Perinat Epidemiol. 2003; 17, 81–90.
6. WHO. The optimal duration of exclusive breastfeeding. Report of an Expert Consultation, 2002. WHO, Geneva.
7. Arifeen, S, Black, RE, Antelman, G, Baqui, A, Caulfield, L, Becker, S. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 2001; 108, E67.
8. WHO. Global Strategy for Infant and Young Child Feeding. 2003. WHO: Geneva.
9. Diallo, FB, Bell, L, Moutquin, JM, Garant, MP. The effects of exclusive versus non-exclusive breastfeeding on specific infant morbidities in Conakry. Pan Afr Med J. 2009; 2, 2.
10. Bahl, R, Frost, C, Kirkwood, BR, et al. Infant feeding patterns and risks of death and hospitalization in the first half of infancy: multicentre cohort study. Bull World Health Organ. 2005; 83, 418–426.
11. Victora, CG, Horta, BL, de Mola, CL, et al. Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil. Lancet Glob Health. 2015; 3, e199–e205.
12. Martens, PJ. What do Kramer’s Baby-Friendly Hospital Initiative PROBIT studies tell us? A review of a decade of research. J Hum Lact. 2012; 28, 335–342.
13. Perez-Escamilla, R. Evidence based breast-feeding promotion: the Baby-Friendly Hospital Initiative. J Nutr. 2007; 137, 484–487.
14. Merten, S, Dratva, J, Ackermann-Liebrich, U. Do baby-friendly hospitals influence breastfeeding duration on a national level? Pediatrics. 2005; 116, e702–e708.
15. Braun, ML, Giugliani, ER, Soares, ME, et al. Evaluation of the impact of the baby-friendly hospital initiative on rates of breastfeeding. Am J Public Health. 2003; 93, 1277–1279.
16. Montagu, D, Yamey, G, Visconti, A, Harding, A, Yoong, J. Where do poor women in developing countries give birth? A multi-country analysis of demographic and health survey data. PLoS One. 2011; 6, e17155.
17. Kenya National Bureau of Statistics and ICF Macro. Kenya demographic and health survey 2008–09, 2009. KNBS and ICF Macro, Calverton, MD.
18. CBS Kenya, Ministry of Health [Kenya], ORC Macro. Kenya demographic and health survey 2003: key findings, 2004. CBS, MOH and ORC Macro, Calverton, MD.
19. Kimani-Murage, E, Madise, N, Fotso, J-C, et al. Patterns and determinants of breastfeeding and complementary feeding practices in urban informal settlements, Nairobi Kenya. BMC Public Health. 2011; 11, 396.
20. Ministry of Public Health and Sanitation. National Strategy on Infant and Young Child Feeding Strategy 2007–2010. 2007. Ministry of Public Health and Sanitation: Nairobi, Kenya.
21. Jelliffe, DB, Jelliffe, EFP. Programmes to Promote Breastfeeding, 1st edn, 1988. Oxford University Press: Oxford and New York, NY.
22. Ministry of Health [Kenya]. Taking the Kenya essential package for health to the community: a strategy for the delivery of level one services, 2006. Ministry of Health, Kenya.
23. United Nations Children’s Fund. Evaluation Report of the Community Health Strategy Implementation in Kenya. 2010. UNICEF: Nairobi.
24. Kimani-Murage, EW, Kyobutungi, C, Ezeh, AC, et al. Effectiveness of personalised, home-based nutritional counselling on infant feeding practices, morbidity and nutritional outcomes among infants in Nairobi slums: study protocol for a cluster randomised controlled trial. Trials. 2013; 14, 445.
25. African Population and Health Research Center. Population and health dynamics in Nairobi’s informal settlements, 2002. APHRC, Nairobi.
26. African Population and Health Research Center. Population and health dynamics in Nairobi’s informal settlements: report of the Nairobi cross-sectional slums survey (NCSS) 2012, 2014. APHRC, Nairobi.
27. Kimani-Murage, EW, Fotso, JC, Egondi, T, et al. Trends in childhood mortality in Kenya: the urban advantage has seemingly been wiped out. Health Place. 2014; 29C, 95–103.
28. Mberu, BU, Ciera, JM, Elungata, P, Ezeh, AC. Patterns and determinants of poverty transitions among poor urban households in Nairobi. Afr Dev Rev. 2014; 26, 172–185.
29. Mutua, MK, Kimani-Murage, E, Ettarh, RR. Childhood vaccination in informal urban settlements in Nairobi, Kenya: who gets vaccinated? BMC Public Health. 2011; 11, 6.
30. Kimani-Murage, EW, Wekesah, F, Wanjohi, M, et al. Factors affecting actualisation of the WHO breastfeeding recommendations in urban poor settings in Kenya. Matern & Child Nutr. 2015; 11, 314–332.
31. Kimani-Murage, EW, Schofield, L, Wekesah, F, et al. Vulnerability to food insecurity in urban slums: experiences from Nairobi, Kenya. J Urban Health. 2014; 91, 1098–1113.
32. Kimani-Murage, EW, Muthuri, SK, Oti, SO, Mutua, MK, van de Vijver, S, Kyobutungi, C. Evidence of a double burden of malnutrition in urban poor settings in Nairobi, Kenya. PLoS One. 2015; 10, e0129943.
33. Fotso, JC, Madise, N, Baschieri, A, et al. Child growth in urban deprived settings: does household poverty status matter? At which stage of child development? Health Place. 2012; 18, 375–384.
34. Emina, J, Beguy, D, Zulu, EM, et al. Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System. J Urban Health. 2011; 88 (Suppl. 2), S200–S218.
35. Campbell, MK, Elbourne, DR, Altman, DG. CONSORT statement: extension to cluster randomised trials. BMJ. 2004; 328, 702–708.
36. Reading, R, Harvey, I, McLean, M. Cluster randomised trials in maternal and child health: implications for power and sample size. Arch Dis Child. 2000; 82, 79–83.
37. Ndugwa, RP, Kabiru, CW, Cleland, J, et al. Adolescent problem behavior in Nairobi’s informal settlements: applying problem behavior theory in Sub-Saharan Africa. J Urban Health. 2011; 88 (Suppl. 2), S298–S317.
38. WHO. Infant and Young Child Feeding Counselling: An Integrated Course. 2006. WHO Document Production Services: Geneva.
39. Amendah, DD, Mutua, MK, Kyobutungi, C, Buliva, E, Bellows, B. Reproductive health voucher program and facility based delivery in informal settlements in Nairobi: a longitudinal analysis. PLoS One. 2013; 8, e80582.
40. World Health Organization. Indicators for assessing breastfeeding practices (reprinted report of an informal meeting 11–12 June), 1991. World Health Organization, Geneva.
41. Kenya National Bureau of Statistics, Ministry of Health, National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development. Kenya demographic and health survey 2014: key indicators report, 2015. Kenya National Bureau of Statistics, Ministry of Health, National AIDS Control Council, Kenya Medical Research Institute, National Council for Population and Development, Nairobi.
42. Fotso, JC, Ezeh, A, Madise, N, Ziraba, A, Ogollah, R. What does access to maternal care mean among the urban poor? Factors associated with use of appropriate maternal health services in the slum settlements of Nairobi, Kenya. Matern Child Health J. 2009; 13, 130–137.
43. Pallas, SW, Minhas, D, Perez-Escamilla, R, Taylor, L, Curry, L, Bradley, EH. Community health workers in low- and middle-income countries: what do we know about scaling up and sustainability? Am J Public Health. 2013; 103, e74–e82.
44. Haider, R, Ashworth, A, Kabir, I, Huttly, S. Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomised controlled trial. Lancet. 2000; 356, 1643–1647.
45. Wangalwa, G, Cudjoe, B, Wamalwa, D, et al. Effectiveness of Kenya’s Community Health Strategy in delivering community-based maternal and newborn health care in Busia County, Kenya: non-randomized pre-test post test study. Pan Afr Med J. 2012; 13 (Suppl. 1), 12.
46. Aidam, BA, Perez-Escamilla, R, Lartey, A. Lactation counseling increases exclusive breast-feeding rates in Ghana. J Nutr. 2005; 135, 1691–1695.
47. Coutinho, SB, de Lira, PI, de Carvalho Lima, M, Ashworth, A. Comparison of the effect of two systems for the promotion of exclusive breastfeeding. Lancet. 2005; 366, 1094–1100.
48. Bhutta, AZ, Lassi, ZS, Pariyo, G, Huicho, L. Global Experience of Community Health Workers for Delivery of Health Related Millennium Development Goals: A Systematic Review, Country Case Studies and Recommendation for Integration into National Health Systems. 2010. World Health Organization: Global Health Workforce Alliance: Geneva.
49. Haines, A, Sanders, D, Lehmann, U, et al. Achieving child survival goals: potential contribution of community health workers. Lancet. 2007; 369, 2121–2131.
50. Lassi, ZS, Das, JK, Salam, RA, Bhutta, ZA. Evidence from community level inputs to improve quality of care for maternal and newborn health: interventions and findings. Reprod Health. 2014; 11 (Suppl. 2), S2.
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