Enhancing Connections and Providing Support to Improve Breastfeeding Practices in Benin

Abstract

Abstract Objectives To measure the impact of a community-based approach in improving breastfeeding practices in Benin. Methods Pregnant and lactating women participated in monthly peer support group sessions and received household counseling. Husbands were engaged in couples counseling to improve household communication and decision making. Leadership groups (elder women, religious and traditional leaders) were established to promote optimal breastfeeding practices during household visits, traditional ceremonies and religious services. Women were counseled by midwives and breastfeeding counselors during antenatal and post-natal visits. Key decision makers from national to village level were engaged to ensure buy-in and alignment with national policies. A final evaluation was carried out in villages representing the Bariba, Peulh, and Nateni ethnic groups. Study participants were a convenience sample of the project beneficiaries and health and nutrition administrative offices. Using a mixed methods approach, Focus Group Discussions and Key Informant Interviews were selected for qualitative methods, while a survey was used for quantitative methods. Results There were substantial increases in adoption of early initiation and exclusive breastfeeding (18% and 34%, respectively). Knowledge of the benefits of colostrum and breastmilk improved among a wide range of project beneficiaries. Protecting the infant's health, increased intelligence of the infant, and healthier relationships between men and women were common motivations for adopting these practices. Traditional practices of discarding colostrum, and provision of herbal tea, water and porridge to supplement breastmilk were reduced. Barriers and enablers such as workload burden, illness and hunger of the mother, and traditional feeding practices, and support provided through the various project platforms, were identified. Conclusions A multi-pronged community-based approach can increase adoption of early initiation and exclusive breastfeeding practices. Engaging household influencers (husbands, grandmothers) and community leadership (traditional and religious leaders, community volunteers, health workers), coupled with engaging key decision makers (national, district and commune leadership) was key to the success. Funding Sources Catholic Relief Services.