Early to Breast, Early to Thrive: Promoting Breastfeeding in Democratic Republic of Congo

Session: Breastfeeding: New Evidence About Models, Patterns, and Practice

Presenter: Matthieu Koy, Management Sciences for Health
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Background: The USAID-funded Integrated Health Project (IHP) in the Democratic Republic of Congo has supported optimal breastfeeding since 2010 for numerous benefits: early skin-to-skin contact, protective factors of colostrum, meeting full early nutritional needs, and assisting in uterine involution and postpartum hemorrhage. The IHPŠ—Ès 2011 baseline evaluation showed that 52% of infants 0-23 months were breastfed within an hour of birth (although numbers reported by health facilities were significantly lower). IHP implemented a community-based Infant and Young Child Feeding (IYCF) initiative that prioritized breastfeeding. After three years, 96% of newborns in the project area were breastfeeding within the first hour.

Methodology: To promote early breastfeeding, IHP facilitates IYCF training for health zone managers, health care providers, and community health workers (CHWs). IHP provides supportive supervision to CHWs and health facilities. CHWs sensitize pregnant women to the importance of optimal breastfeeding and help them breastfeed within the first hour, through support groups and individual visits. At the health facility, nurses and birth attendants check for problems; CHWs conduct home visits to continue counseling and help with issues, providing counseling or referral to a health center as necessary.

Results: In all project-supported health zones, the number of newborns who started breastfeeding within an hour of birth increased from 7,832 (2%) in October 2010 to 441,490 by September 2014, out of 462,162 live births. In other words, by September 2014, 96% of newborns were breastfeeding in the first hour.

Conclusion: Support groups contribute to improved nutrition among newborns and infants, as well as reductions in the number of childhood cases of diarrhea, fever, and malnutrition. The approach encourages strong community and health facility linkages for improved essential newborn care as the IYCF support groups extend breastfeeding education to other home-based infant health care needs such as umbilical cord care and danger sign recognition.