Journal Article

Community-based behavior change promoting child health care

Alzouma, Souleymane, Dangana, Alio, Maina, Abdou, Charbit, Yves, Habi, Oumarou, Horii, Naoko

2016

Overview

Background Early initiation of breastfeeding after birth is a key behavioral health factor known to decrease neonatal mortality risks. Yet, few demographic studies examined how a community-based intervention impacts postpartum breastfeeding among the socio-economically deprived population in Sub-Saharan Africa. A post-intervention evaluation was conducted in 2011 to measure the effect of a UNICEF-led behavior change communication program promoting child health care in rural Niger. Methods A quantitative survey is based on a post hoc constitution of two groups of a study sample, exposed and unexposed households. The sample includes women aged 15–49 years, having at least one child less than 24 months born with vaginal delivery. Rate ratio for bivariate analysis and multivariate logistic regression were applied for statistical analysis. The outcome variable is the initiation of breastfeeding within the first hour of birth. Independent variables include other behavioral outcome variables, different types of communication actions, and socio-demographic and economic status of mothers. Results The gaps in socio-economic vulnerability between the exposed and unexposed groups imply that mothers deprived from accessing basic health services and hygiene facilities are likely to be excluded from the communication actions. Mothers who practiced hand washing and used a traditional latrine showed 2.0 times more likely to initiate early breastfeeding compared to those who did not (95 % CI 1.4–2.7; 1.3–3.1). Home visits by community volunteers was not significant (AOR 1.2; 95 % CI 0.9–1.5). Mothers who got actively involved in exclusive breastfeeding promotion as peers were more likely to initiate breastfeeding within the first hour of birth (AOR 2.0; 95 % CI 1.4–2.9). Conclusions A multi-sectorial approach combining hygiene practices and optimal breastfeeding promotion led to supporting early initiation of breastfeeding. A peer promotion of child health care suggests a model of behavior change communication strategy as a response to socio-economic disparity.

• Publisher: Springer Nature,BioMed Central,Springer Nature B.V
• Subject: Adolescent / Adult / Behavior / Behavior change / Behavior modification / Birth / Bivariate analysis / Breast feeding / Breast Feeding - ethnology / Breastfeeding & lactation / Change agents / Changes / Child Health Services / Childbirth & labor / Children / Childrens health / Clinical Nutrition / Communication / Communication strategies / Communities / Community / Community change / Community volunteers / Community-based programs / Constitution / Cross-Sectional Studies / Demographic variables / Demographics / Deprivation / Discourse strategies / Domiciliary visits / Economic deprivation / Economic models / Economic status / Economics / Epidemiology / Female / Follow-Up Studies / Health behavior / Health care / Health Education / Health information / Health Promotion / Health Promotion and Disease Prevention / Health risks / Health services / Health Status Disparities / Households / Humans / Hygiene / Hygiene - education / Independent variables / Infant, Newborn / Infectious Diseases / Initiation / Intervention / Male / Maternal and Child Health / Medicine / Medicine & Public Health / Mental health services / Middle Aged / Mortality / Mortality risk / Mothers / Mothers - education / Neonates / Niger / Nutrition Policy / Nutrition Surveys / Patient Compliance - ethnology / Peer Influence / Peers / Population (statistical) / Postpartum / Postpartum women / Poverty Areas / Promotion / Public Health / Quantitative analysis / Regression analysis / RESEARCH ARTICLE / Responses / Retrospective Studies / Rural Health - ethnology / Socioeconomics / Statistical analysis / Vagina / Variables / Volunteers / Young Adult