The World Health Organization (WHO) recommends three primary breastfeeding practices: initiation of breastfeeding within one hour after birth (also referred to as immediate breastfeeding), exclusive breastfeeding (EBF) through six months of age, and continued breastfeeding until 24 months of age (Dyson et al., 2005; WHO, 2008). Evidence associated with the recommendation for immediate breastfeeding is limited and likely operates through the effect of exclusive breastfeeding (Bhutta et al., 2013). The Lancet, therefore, includes only EBF and continued breastfeeding in the modeling of optimal breastfeeding practices cited above.
Despite the promise of optimal breastfeeding practices, rates for the three WHO recommended breastfeeding practices remain low, and negligible progress has been made to increase these rates over the past two decades (UNICEF, 2013). According to an analysis of data from 78 low and middle income countries, rates of immediate breastfeeding range from a mean of 36% in Eastern Europe to a mean of 58% in Latin America, and the rate of exclusive breastfeeding in children one to five months of age is just 30% (Black et al, 2013). According to the UNICEF global database of national surveys from 2007-2011, the current rate of breastfeeding at one year is 76%, while the rate of breastfeeding at age two years is 58%.
This section reviews the effectiveness of social and behavior change communication (SBCC) approaches on improving breastfeeding practices.
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This briefing outlines findings from operations research on exclusive breastfeeding and early initiation – such as engaging with senior religious leaders, and identify Qu’ranic teachings that support EBF. The study supports refinement of the infant and young child feeding (IYCF) strategy implemented by the Working to Improve Nutrition in Northern Nigeria (WINNN) programme.
Summary of key recommendations:
- Strengthen messages on the water content in breastmilk.
- Integrate the showcasing of healthy EBF babies into IYCF advocacy.
- Increase the targeting of men and develop specific IEC materials for this.
- Engage with senior religious leaders, and identify Qu’ranic teachings that support EBF.
- Develop an advocacy approach for older women, including songs and participatory approaches
- Provide practical support on breastfeeding within mothers’ support groups.
- Further research to develop a Hausa term for EBF that better encapsulates the full meaning.
- Consider the need to develop a Hausa term for ‘late EBF’
- Clarify that EBF is not dependent on the mother’s consumption of the recommended foods.
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This Community Video for Nutrition Guide is a joint product of SPRING and Digital Green (DG), an international nongovernmental organization (NGO) registered in the United States and India. This guide is based on our organizations’ combined experience in implementing a proof of concept project between January and October 2013, formally known as the SPRING/DG Collaboration and Feasibility Study. This 10-month project focused on integrating content on high-impact maternal, infant, and young child nutrition (MIYCN) practices, including information on key hygiene-related behaviors, into the existing DG community-led video project, which is predominantly focused on promoting improved agricultural practices among small-scale and marginal women farmers. The target audience was pregnant women and/or mothers with children under the age of two participating in existing self-help groups (SHGs) in 30 villages in two blocks of Keonjhar District of Odisha, India. The SHGs also included a wider representation of female community members, who were targeted as key influencers for the recommended behaviors. Given that the target audience included a large number of influencers that wouldn’t be adopting the practices themselves, the project not only tracked adoptions, but also promotions of MIYCN behaviors.
The guide is specifically intended to provide organizations, projects, and practitioners interested in using or testing community video for MIYCN with the critical information and tools needed to initiate, produce, and disseminate a participatory community-video approach for MIYCN. This guide is intended to be used in combination with DG standard operating procedures (SOPs), which can be accessed openly on its website linked here. Although focused on promoting MIYCN, the Guide builds on the DG agriculture focused platform, to which other content can be added or emphasized, such as information promoting sexual and reproductive health and family planning, nutrition-sensitive agricultural practices, community institution building, government schemes, animal husbandry, financial inclusion programs, nonfarm income-generating activities, and a whole range of other topics.
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