Improving Breastfeeding in Rural Tanzania Using Eight-Step Policy Analysis Methodology.

Abstract

Appropriate breastfeeding has the potential to have the broadest impact on childhood survival in children under 5 years compared with all other preventive interventions. The World Health Organization and United Nations International Children's Emergency Fund recommend that all facilities providing maternal services and newborn care have a written policy addressing breastfeeding that is routinely disseminated to staff. A Mara region hospital in rural Tanzania does not have a breastfeeding policy. Collins adapted Bardach's eightfold path for policy analysis specifically for health policies. This eight-step process was used to evaluate three promising policies to improve breastfeeding in populations in and around this hospital. These policies include exclusive breastfeeding education, complementary food education, and community health worker home visits. Analysis identified exclusive breastfeeding with adjunct complementary food education as the most feasible policies to increase breastfeeding in and around the target hospital. With improved feeding practices, chronic malnutrition rates are expected to decline in the villages that the hospital serves. This methodology can be used by nurses to develop health polices addressing a wide range of health issues in a wide variety of settings.