Speaker-2, Dr KP Kushwaha
BFCHI:
BABY FRIENDLY
COMMUNITY
HEALTH INITIATIVE
PROJECT LALITPUR
Dr. K P Kushwaha
Principal,
Prof & Head,
BRD Medical College, Gorakhpur
Project Objectives
Total Population =9,7,7447
Mother and babies reached=
1,80,000
To improve breastfeeding and complementary feeding indicators through family and facility based counseling
To assess effect of counseling on IYCF pattern
To find effect of improved IYCF practices on health
Interventions
Pre / post intervention assessment
District level sensitization for administrators, health/ICDS/NGO workers, teachers and panchayat workers (84)
Recruitment and training of 51 local graduates as
MLT and facility based trainers at medical
College ; 7 days x 2 trainings
Identification and training of family counselors at blocks (3858)(4 days training)
Establishing counseling centers in every villages and health facility (1286 MSGs)
Sensitization of administration and health officials
Training ICDS and health workers using
BPNI module
Training of MSG’s by middle level trainers using BPNI module
Village and facility Level IYCF Support….
o
MSGs :Trained in basic knowledge and skills of breastfeeding and complementary feeding ( 1286 villages) o
Under direct supervision of MLTs - designated as “ facility level counselors ” and “ trainers” of MSGs
( 48/ 24/12) o
Supported by trained health workers : at PHCs and district hospital
–
The MSG’s - 24 hours a day throughout the year
Setting up of village resource centres
Support of BFCHI: Creating and Supporting Mother
Support Groups
Village Level activities
Helping mother to learn breastfeeding positioning
Demonstrating a thick consistency
Complement and feeding skill
Village Level activities
Antenatal education of mothers
Early initiation of breastfeeding
Helping mothers to learn positioning and attachment for effective breastfeeding
Expression of breastmilk and katori feeding
Exclusivity of breastfeeding
Preparation/demonstration of good complementary food
Training mothers to Feed enough, frequently, variety of foods through praising
Helping mothers and babies in feeding difficulty
Weekly Health and Nutrition Day (Saturday)
Results
Primary outcomes
P- value- <0.001 for all outcomes
44%
5%
39%
62%
7%
60%
4.5%
94%
100
80
60
40
20
0
Prelacteal feeds
BF within 1 hr
Pre-intervention
EBF for 6 months
CF plus continued
BF
Post- intervention
Pre-intervention-2006 ; Post-intervention-2011
Results
Primary outcomes P- value- <0.001 for both outcomes
100%
80%
60%
40%
20%
0%
30%
92%
8%
39%
Appropriate texture of feeding
Feeding during illness
88%
Responsive feeding
Preintervention
Postintervention
Results
Secondary outcomes- Mother’s confidence
P- value- <0.001 for all outcomes
65%
80
60
40
20
0
15%
40%
20%
Milk supply sufficient selfstopping after feed
Pre-intervention
Post- intervention
Results
Secondary outcomes- Mother’s confidence
P- value- <0.001 for all outcomes
65%
70
60
50
40
30
20
10
0
15%
40%
20%
Milk supply sufficient selfstopping after feed
Pre-intervention
Post- intervention
Mothers perception on health of their
Children
Slide 16
Komal P. Kushwaha1*, Jhuma
Sankar2 , M. Jeeva Sankar2 ,
Arun Gupta3, J. P. Dadhich4 , Y.
P. Gupta5,Girish C. Bhatt1,
Dilshad A. Ansari1, B. Sharma1
Effect of Peer Counselling by Mother Support
Groups on Infant and
Young Child Feeding
Practices: The Lalitpur
Experience
Citation : Kushwaha KP, Sankar J, Sankar MJ, Gupta A, Dadhich JP, et al. (2014) Effect of Peer
Counselling by Mother Support Groups on Infant and Young Child Feeding Practices: The
Lalitpur Experience. PLoS ONE 9(11): e109181. doi:10.1371/journal.pone.0109181
Strengths
There is unequivocal evidence on importance of peer group/community based counseling in improving nutritional and health status of children by improving IYCF practices in the community
It is the largest community based study till date on peer counseling, use of local resources from community
The reach was universal : 75000 families with more than 80% of mothers counseled on more than two occasions
The project created 1286 MSGs and 7 resource centers, integrated in state health system
Cost of the project was Rs 386 per family
Recommendations for improving nutritional and health status of children
Establishing national and State resource centers in partnership with BPNI.
Creating managerial and administrative body for
IYCF training, counseling and monitoring at state and district level
Establishing community and facility based IYCF counseling centre and deploying trained IYCF counselors
Setting up training resource centre and counseling centre for IYCF in Medical Colleges and other college as essential standard practice
Improving health and nutritional status of mothers through comprehensive adolescent girl care
