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. 2020 Apr 28;8(6):2719-2727.
doi: 10.1002/fsn3.1559. eCollection 2020 Jun.

Effectiveness of community health workers in improving early initiation and exclusive breastfeeding rates in a low-resource setting: A cluster-randomized longitudinal study

Dorothy Mituki-Mungiria  1 , Prisca Tuitoek  2 , Aniko Varpolatai  3 , Douglas Ngotho  4 , Elizabeth Kimani-Murage  5
Affiliations

Effectiveness of community health workers in improving early initiation and exclusive breastfeeding rates in a low-resource setting: A cluster-randomized longitudinal study

Dorothy Mituki-Mungiria et al. Food Sci Nutr. .

Abstract

Little evidence exists in Kenya on the potential of community health workers (CHWs) in promoting exclusive breastfeeding (EBF) and early breastfeeding initiation (EBI) in resource-restricted settings where very low EBF rates (2% to 12%) have been documented. The study utilized CHWs and assessed their effectiveness in promoting EBF and EBI. The cluster-randomized longitudinal design was used and sixteen villages from Kiandutu Slum in Thika randomly assigned into either intervention group (IG) or comparison group (CG). Pregnant women attending Maternal Child Health (MCH) clinic were recruited. The IG received nutrition education sessions conducted by CHWs at home, two prenatally and six postnatally, plus the routine MCH care. The CG went through routine MCH care only. Infants feeding data were collected at 6, 10, 14, and 24 weeks postpartum by research assistants blinded to the intervention allocation. Differences in EBF and EBI in the two groups were tested using χ 2 tests, Kaplan-Meier survival analysis and generalized estimating equations. Of the 526 recruited in the study, 431 remained and were included in the analysis (IG = 176) and CG (225). The prevalence of EBF at 24 weeks was 45.3% in the IG compared with 15.0% in the CG, revealing a statistically significant difference log rank = 20.277, (1, n = 314) p < .001. The difference was not statistically significant in EBI prevalence between the IG (58.2%) and CG (60.3%; χ 2 = 0.008, p = .928). The CHWs have potential effectiveness in promoting EBF but not EBI. The link between the health center and CHWs should be strengthened to promote EBF.

Keywords: breastfeeding initiation; community health workers; exclusive breastfeeding.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

FIGURE 1
FIGURE 1
Schematic representation of the recruitment process for the study participants
FIGURE 2
FIGURE 2
Kaplan–Meier survival analysis for duration of EBF of comparison versus intervention groups in days
See this image and copyright information in PMC

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