Improving breastfeeding Evidence from States Gayatri Singh Study

Improving breastfeeding – Evidence from States Gayatri Singh

Study overview 8 EAG states and Assam 27 HPDs 81 Health facilities (9 district hospitals, 36 CHCs and 9 PHCs) 387 Health functionaries 1215 women who had delivered in the last three days 2

Do mothers need support for breastfeeding? 43% mothers were primi 18% caesarean deliveries 8% infants were sick newborns 11% of the mothers had breastfeeding problems 30% workers reported that pregnant women had concerns related to breastfeeding

How equipped are the health workers? Training 60% health functionaries trained on breastfeeding 58% ASHAs and 25% nurses trained on BF related counselling Higher % of outreach workers received training as compared to facility staff Tools 50% health staff use IEC tools when interacting with the mothers 4

How adequate was the training? 50% workers aware of importance of early initiation and exclusive breastfeeding Knowledge 35% workers aware of benefit of BF for mothers 10% outreach workers had complete knowledge about positioning 43% nurses aware of at least three aspects of attachment 5

Does training translates into practice? 40% outreach workers discuss breastfeeding with pregnant women Practice 52 % Medical Officers ask health staff to discuss benefits of early initiation with pregnant women 20 % ask the health staff to convey messages on exclusive breastfeeding Only 33% of the MOs mention breastfeeding in the discharge summary 70% MOs reported to have a plan to improve breastfeeding 6

Does training translates into practice? Practice 41% mothers reported to have contacts with healthcare providers 19% AWC 13% Home visit 12% health facility 38% women reported to have received information on early and exclusive breastfeeding during pregnancy 17% of mothers reported that the child was put to breast in the labor room 7

How adequate is the interaction? Two minutes interaction with the mother Quality Conversation was mostly one-way and instructional Only in 20% facilities support was provided to mothers for positioning and attachment 8

What can be done? • Facility based plans for improving breastfeeding • Equipping workers • Improving quality of contacts of health workers with families • Effective use of IEC materials • Monitoring and supervision

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