Testing the Feasibility of Incorporating Support for Early Childhood Development into the Baby Friendly Community Initiative in Kenya

The Baby Friendly Community Initiative (BFCI) is a community-based intervention delivered through community health volunteers (CHVs) in rural Kenya. Over 66% of children in sub-Saharan Africa remain affected by poor developmental outcomes. The research team is working closely with stakeholders in the Ministry of Health to generate evidence on: 1) the potential impact of the BFCI on early childhood development outcomes; 2) user, stakeholder and service provider needs for incorporating parental support for early childhood development into the BFCI; 3) culturally appropriate tools for the delivery and monitoring of early childhood development within the BFCI. The objective is to co-produce a sustainable plan for incorporating early childhood development into future BFCI delivery/outcome monitoring.

Poor breastfeeding and infant feeding practices contribute to more than 10,000 deaths annually in Kenya. In 2002, the country began implementing the Baby Friendly Hospital Initiative (BFHI) to encourage immediate initiation of breastfeeding and exclusive breastfeeding for the first six months of a child’s life. However, one of every three women give birth at home and consequently may miss out on this advice and support from healthcare providers. BFHI is a global effort launched by WHO and UNICEF to implement practices that protect, promote and support breastfeeding. The initiative aims to promote breastfeeding in maternity wards worldwide.

The African Population and Health Research Center (APHRC) conducted a two-year study from August 2014 to December 2016, in rural Kenya, to determine whether the same information might be shared with mothers delivering at home. The study, dubbed the Baby Friendly Community Initiative (BFCI), involved training of community health volunteers to counsel and support expectant and new mothers on optimal breastfeeding and early nutrition practices.

BFCI led to significant improvements in breastfeeding practices: 90% of children whose mothers were visited by community health volunteers were initiated on breastfeeding within the first hour of birth, as recommended by WHO, compared to 81% for those who did not participate. Further, 95% of children aged 0 to 2 months visited by the volunteers were exclusively breastfed compared to 86% of those not receiving volunteer support and counseling.

In addition to providing valuable evidence, this project is an opportunity to build capacity of health care workers and community health volunteers on the Care for Child Development (CCD) model - an intervention to support families in promotion of healthy growth and psychosocial development of children through responsive play and communication.   The project is timely, since Kenya is in the process of adopting a WHO/UNICEF CCD package. The findings will assist the Kenyan government to adopt successful ways of integrating early childhood development into the Baby Friendly Community Initiative which is expected to be implemented countrywide. 

Principal Investigator: Professor Paula Griffiths, Loughborough University