Promotion of breast feeding in the community: impact of health education programme in rural communities in Nigeria

Abstract

Breast feeding has been recognized as a child survival strategy, while breast feeding programmes have been increasingly implemented in many communities. This study assesses the effectiveness of a breast feeding education programme launched through the primary health care programme in the rural communities of Nigeria. Late trimester pregnant women were enrolled into the study and given a questionnaire on knowledge, attitudes, and practices (KAP) about breast feeding. Women in the study group (n = 126) received breast feeding counselling before and after delivery, while those in control group (n = 130) did not receive any counselling. Both groups were monitored after delivery and followed with the KAP questionnaire. The results of the study showed marked improvements in the intervention group for colostrum feeding (p = 0.0000). Moreover, 31.6% of the mothers in the intervention group practised timely initiation of breast feeding compared to 5.6% of the controls, and the prevalence of exclusive breast feeding at 4 months was 39.8% in the intervention group compared to 13.9% for the controls. Multivariate analysis showed that the intervention was a powerful and the only significant predictor of the increase in breast feeding behaviours (p = 0.0000), and that an early initiation of breast feeding is a strong predictor of exclusive breast feeding at 4 months of age. It is concluded that breast feeding promotion in rural communities is feasible and can lead to behavioural changes.

PIP: During December 1993 to October 1994, in Nigeria, a breast feeding promotion project was implemented in Ife South Local Government Area (LGA), and its impact was evaluated. It consisted of training workshops on breast feeding for community health workers, breast feeding promotional posters displayed in prenatal care clinics and in homes, handouts on breast feeding, breast feeding talks in the clinics and in homes, and individual counseling on breast feeding before and after delivery. Pregnant women were enrolled in the program during the late trimester. During April-October 1994, researchers conducted a follow-up study of the effects of the breast feeding promotion program in the intervention area, by comparing relevant data from the intervention area and the control area Atakumosa LGA. The study methods were focus group discussions and interviews. The intervention group consisted of 126 women 15-44 years old. The control group consisted of 130 women 15-49 years old. Women in the study group were more likely to believe that infants should received colostrum after the intervention than before it (75% vs. 29.8%; p = 0.00001). More women in the study group put their infants immediately to the breast than women in the control group (31.6% vs. 5.6%). They were also more likely to be fully breast feeding at 4 months than mothers in the control group (39.8% vs. 13.9%). Stepwise multiple logistic regression analyses were conducted to determine whether the breast feeding promotion program had a positive independent effect on early initiation of breast feeding and on full breast at 4 months. They revealed that the intervention was indeed a significant predictor of early initiation of breast feeding (odds ratio [OR] = 10.71) and of full breast feeding at 4 months (OR = 5.29). Further, initiation of early breast feeding was the strongest and most significant predictor of full breast feeding at 4 months (OR = 5.6). These findings suggest that breast feeding promotion in rural villages is feasible and improves breast feeding practices.