259977 Systematic review of community breastfeeding support in developing countries: Building on past progress

Monday, October 29, 2012 : 11:15 AM - 11:30 AM

Miriam Labbok, MD, MPH, FACPM, IBCLC, FABM , Carolina Global Breastfeeding Institute, Department of Maternal Child Health, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC
Background: Breastfeeding is a major contributor to improvements in maternal health and child survival. Breastfeeding protection, promotion and support must be available and acceptable in the community, and therefore, is an important part of a comprehensive support approach. The purpose of this systematic review is to uniquely address community breastfeeding support, to inform program, policy, and research planning. Methods: A systematic review found nearly 200 studies including 5 systematic reviews that included breastfeeding and developing countries; one case study; one review of case studies, and 28 individual articles including 19 countries. These were re-analyzed using forest plots and impact comparisons. Findings: The term “community-based” includes several strategic approaches, and programs vary widely. Nonetheless, increased impact is seen with: 1) building on existing breastfeeding programs or integrated into other accepted, 2) those that emerge from the community or in which there is active involvement of the community change agents, and 3) careful selection of content and quality of the training and supervision. Additional findings are grouped in four areas: program/intervention definition/ description, program impact, program setting, and research needs. Discussion/Recommendations: Overall recommendation is continuation of comprehensive breastfeeding-specific support as outlined in the Innocenti Declaration, Global Strategy and in USAID policy. This is complemented, but not replaced, by integration of breastfeeding support into other primary health care. For community support to be sustainable there should be supportive action by the ongoing systems. Conclusions: A complex behavior such as breastfeeding is best addressed when there is a multi-level and multi-sectoral approach, including community.

Learning Areas:
Administer health education strategies, interventions and programs
Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Program planning
Provision of health care to the public

Learning Objectives:
Describe the variety of breastfeeding support programs known as "community" programs Discuss issues in community program development for successful breastfeeding outcomes

Keywords: Community, Breastfeeding

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I authored the review
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3148.0: Maternal & Child Health 1