title: Improving breastfeeding practices on a broad scale at the community level: success stories from Africa and Latin America.
abstract: Large-scale community-level behavior change programs designed to improve breastfeeding practices were implemented in Bolivia, Ghana, and Madagascar. These programs reached sizable populations: Bolivia, 1 million; Ghana, 3.5 million; and Madagascar, 6 million. Over 3 to 4 years, timely initiation of breastfeeding (within 1 hour of birth) increased from 56% to 74% (P < .001) in Bolivia, 32% to 40% (P < .05) in Ghana, and 34% to 78% (P < .001) in Madagascar. Marked increases in exclusive breastfeeding of infants 0 to 6 months of age were also documented: from 54% to 65% (P < .001) in Bolivia, 68% to 79% (P < .001) in Ghana, and 46% to 68% (P < .001) in Madagascar. In Ghana and Madagascar, significant results were seen within 1 year of community interventions. The authors conclude that large-scale programs designed to improve breastfeeding practices are feasible and should be a central component of any child survival strategy.
authors.affiliation: LINKAGES Project, Academy for Educational Development, Washington, DC, USA.
authors.forename: Victoria J
authors.initials: VJ
authors.lastname: Quinn
authors.forename: Agnès B
authors.initials: AB
authors.lastname: Guyon
authors.forename: Joan W
authors.initials: JW
authors.lastname: Schubert
authors.forename: Maryanne
authors.initials: M
authors.lastname: Stone-Jiménez
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hainsworth
authors.forename: Luann H
authors.initials: LH
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000349:Africa / Q000453:epidemiology; D001942:Breast Feeding / Q000453:epidemiology* / Q000523:psychology / Q000706:statistics & numerical data; D003906:Developing Countries; D005260:Female; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D008875:Middle Aged