Community-based behavior change promoting child health care: a response to socio-economic disparity.

Naoko Horii,Yves Charbit,Alio Dangana,Abdou Maina,Oumarou Habi,Souleymane Alzouma

doi:10.1186/s41043-016-0048-y

Abstract

BackgroundEarly initiation of breastfeeding after birth is a key behavioral health factor known to decrease neonatal mortality risks. Yet, few demographic studies examined how a community-based intervention impacts postpartum breastfeeding among the socio-economically deprived population in Sub-Saharan Africa. A post-intervention evaluation was conducted in 2011 to measure the effect of a UNICEF-led behavior change communication program promoting child health care in rural Niger.MethodsA quantitative survey is based on a post hoc constitution of two groups of a study sample, exposed and unexposed households. The sample includes women aged 15–49 years, having at least one child less than 24 months born with vaginal delivery. Rate ratio for bivariate analysis and multivariate logistic regression were applied for statistical analysis. The outcome variable is the initiation of breastfeeding within the first hour of birth. Independent variables include other behavioral outcome variables, different types of communication actions, and socio-demographic and economic status of mothers.ResultsThe gaps in socio-economic vulnerability between the exposed and unexposed groups imply that mothers deprived from accessing basic health services and hygiene facilities are likely to be excluded from the communication actions. Mothers who practiced hand washing and used a traditional latrine showed 2.0 times more likely to initiate early breastfeeding compared to those who did not (95 % CI 1.4–2.7; 1.3–3.1). Home visits by community volunteers was not significant (AOR 1.2; 95 % CI 0.9–1.5). Mothers who got actively involved in exclusive breastfeeding promotion as peers were more likely to initiate breastfeeding within the first hour of birth (AOR 2.0; 95 % CI 1.4–2.9).ConclusionsA multi-sectorial approach combining hygiene practices and optimal breastfeeding promotion led to supporting early initiation of breastfeeding. A peer promotion of child health care suggests a model of behavior change communication strategy as a response to socio-economic disparity.

Highlights

Initiation of breastfeeding after birth is a key behavioral health factor known to decrease neonatal mortality risks
Patterns of postpartum breastfeeding When comparing the proportion of early initiation of breastfeeding between the group exposed and that not exposed to the interventions, mothers exposed to the interventions were 2.2 times more likely to initiate breastfeeding within the first hour of birth (n = 394, 89 %) than those not exposed (n = 348, 40 %) [23]
We examined each type of communication action to measure its influence on postpartum breastfeeding practices

Summary

Introduction

Initiation of breastfeeding after birth is a key behavioral health factor known to decrease neonatal mortality risks. Few demographic studies examined how a community-based intervention impacts postpartum breastfeeding among the socio-economically deprived population in Sub-Saharan Africa. The 50 % global decline of child mortality in the last decade is mostly attributed to successful preventive and outreach delivery of oral rehydration salts and tetanus and measle vaccines. These interventions had a direct impact on child mortality reduction [10]. Further reduction of neonatal mortality requires familyand community-based approaches aimed at improving perinatal health care and child under-nutrition [11, 12]

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Discussion

Conclusion