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Title: Potential effectiveness of community health strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study
Authors: Kimani-Murage, Elizabeth W.
Norris, Shane A.
Mutua, Martin K.
Wekesah, Frederick
Wanjohi, Milka
Muhia, Nelson
Muriuki, Peterrock
Egondi, Thaddaeus
Kyobutungi, Catherine
Ezeh, Alex C.
Musoke, Rachel N.
McGarvey, Stephen T.
Madise, Nyovani J.
Griffiths, Paula L.
Keywords: Exclusive breastfeeding
Community health strategy
Community health
Workers
Kenya
Sub-Saharan Africa
Urban slums
Issue Date: 2016
Publisher: © Cambridge University Press (CUP)
Citation: KIMANI-MURAGE, E.W. ...et al., 2016. Potential effectiveness of community health strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study. Journal of Developmental Origins of Health and Disease, 7(2), pp.172-184.
Abstract: Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies (Pre-intervention [2007-2011; n=5824], Intervention [2012-2015; n=1110] and Comparison [2012-2014; n=487]) which followed mother-child pairs longitudinally to establish EBF rates from 0-6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0-6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a Chi square test and logistic regression. At six months, the prevalence of EBF was 2% in the Pre-intervention group compared to 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (p<0.05). After adjusting for baseline characteristics, the Odds Ratio for EBF from birth to six months was 66.9 (95% CI 45.4 to 96.4), 84.3 (95% CI 40.7 to 174.6), and 3.9 (95% CI 1.8 to 8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared to the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting exclusive breastfeeding in urban poor settings where health care access is limited.
Description: This paper was accepted for publication in the journal Journal of Developmental Origins of Health and Disease and the definitive published version is available at http://dx.doi.org/10.1017/S2040174415007941
Sponsor: This study was funded by the Wellcome Trust, Grant # 078530/Z/05/Z (Pre-intervention Study) and Grant # 097146/Z/11/Z (Intervention Study), and DANIDA, Grant # IND0912010 (Comparison study).
Version: Accepted for publication
DOI: 10.1017/S2040174415007941
URI: https://dspace.lboro.ac.uk/2134/20024
Publisher Link: http://dx.doi.org/10.1017/S2040174415007941
ISSN: 2040-1752
Appears in Collections:Published Articles (Sport, Exercise and Health Sciences)

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