Community-based Strategies for Breastfeeding Promotion and Support in Developing Countries

This 30-page paper, published in 2003 by the World Health Organization, examines the evidence for the contribution that community-based interventions can make to improve infant and young child feeding, and identifies factors that may affect whether interventions are successful and sustainable. The findings show that families and communities are more than simple beneficiaries of interventions; they are also resources to shape the interventions and extend coverage close to where mothers, other caregivers and young children live.



from the Foreward:

"...it is not enough to help a mother initiate exclusive breastfeeding. She needs to be able to go back to an environment that is conducive to sustaining appropriate feeding practices and to access skilled support when she needs it."

The first chapter of the paper places community-based interventions in an historical and community
development context and provides the scientific rationale for this approach. The second chapter describes key features of - and strategies for - community-based breastfeeding promotion and support, including integration with primary and preventive health services. The third chapter presents experiences from Madagascar, Honduras and India of implementing community-based strategies on a large population scale. The fourth chapter addresses challenging circumstances to consider in implementing community-based breastfeeding programmes around the world. The paper concludes with a summary of key issues regarding community-based breastfeeding promotion and support.



from the Summary and Conclusions:

"The capacity for breastfeeding behaviour change at the community level requires effective leadership, forming intersectoral partnerships, informing and engaging opinion leaders, conducting formative research to shape explicit and effective messages, and monitoring and evaluating programme progress. Strategies for improving breastfeeding behaviour include approaches that focus on individual as well as group behaviour based on behaviour change theory and address stages of change, including trials of improved practices. Well-designed behaviour change communication, training of healthcare workers and lay counsellors to provide accessible and appropriate counselling support to mothers, and active involvement of women’s groups are important elements of effective breastfeeding behaviour change strategies that may be applied somewhat differently in diverse circumstances."