Evaluation of a breastfeeding support group model using the positive deviance approach in ethnic minority women in Vietnam

Exclusive breastfeeding is an optimal public health solution to infant nutrition in resource-poor environments. However, immediate and sustained exclusive breastfeeding are not common practices among poor ethnic minority groups in Vietnam. An intervention using a Breastfeeding Support Groups (BFSG) model was conducted to promote breastfeeding behavior changes among the ethnic minority women in two mountainous districts of Quang Tri province. The BFSG model uses a novel approach to peer education: identify a positive deviance – a mother who experience similar challenges as others in the community but is able to adopt behavior changes – as a role model to address specific community values and practices that serve as barriers or facilitators of health behavior changes. An evaluation using quantitative and qualitative data was conducted (1) to evaluate the effectiveness of the BFSG model in promoting immediate and exclusive breastfeeding in ethnic minority women in Quang Tri, and (2) to assess the model's potential to be replicated and scaled up in other ethnic minority populations in Vietnam. Results indicated that the BFSG model was effective in promoting breastfeeding behavior changes. Mothers were 1.2 times more likely to breastfeed their child within the first hour after the intervention (95%CI: 1.09, 1.32). The duration of exclusive breastfeeding before and after the intervention were, respectively: <1 month, 56.3% and 8.8%; 1-3 months, 36.8% and 50.9%; 4-6 months, 7.0% and 40.4%. Qualitative interviews revealed the BFSG model using the positive deviance approach has the potential to be replicated and scaled up to other ethnic minority populations.