title: [Effect of the Baby Friendly Hospital Initiative on the duration of exclusive breastfeeding in Kinshasa: A cluster randomized trial].
abstract: BACKGROUND
  Despite numerous advantages of breastfeeding, in Democratic Republic of the Congo, the rate of children exclusively breastfed up to six months remains low. The lack of breastfeeding support received by mothers from health care providers is an important factor of early cessation of breastfeeding. This study aimed to evaluate the effect of the training of health care providers, in the Baby Friendly Hospital Initiative, on the duration of exclusive breastfeeding (EBF) in Kinshasa.
  
  
  METHODS
  A total of 422 mothers, recruited during the first antenatal care visit in 12 maternities and followed up to six months after delivery, were included in a cluster randomized trial. In the experimental group, health care providers were trained using the "20-Hour Course For Maternity Staff". Cox proportional hazards model was used to determine the effect of the intervention on the duration of EBF.
  
  
  RESULTS
  The rate of EBF at six months was 2.8%; the median duration of EBF was 10.9 weeks (IQR 4.3 to 14.9). The hazard of discontinuing EBF before six month was 1.4 times higher in the control group (adjusted HR [95%CI]=1.40 (1.10-1.78), P=0.007).
  
  
  CONCLUSIONS
  In this study, training of health care providers in the Baby Friendly Hospital Initiative was associated with a significant improvement in the duration of EBF. Extending this training to different maternities could improve the coverage of EBF in Kinshasa.
authors.affiliation: Faculté de médecine, école de santé publique, université de Kinshasa, BP 11850, Kinshasa I, République démocratique du Congo. Electronic address: pbabakazo@yahoo.fr.
authors.forename: P
authors.initials: P
authors.lastname: Babakazo
authors.affiliation: École de santé publique, université Libre de Bruxelles, Bruxelles, Belgique.
authors.forename: P
authors.initials: P
authors.lastname: Donnen
authors.affiliation: Faculté de médecine, école de santé publique, université de Kinshasa, BP 11850, Kinshasa I, République démocratique du Congo.
authors.forename: M A
authors.initials: MA
authors.lastname: Mapatano
authors.affiliation: Faculté de médecine, école de santé publique, université de Kinshasa, BP 11850, Kinshasa I, République démocratique du Congo.
authors.forename: A
authors.initials: A
authors.lastname: Lulebo
authors.affiliation: Faculté de médecine, école de santé publique, université de Kinshasa, BP 11850, Kinshasa I, République démocratique du Congo.
authors.forename: E
authors.initials: E
authors.lastname: Okitolonda
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D015023:Democratic Republic of the Congo; D005260:Female; D006282:Health Personnel / Q000193:education*; D006761:Hospitals; D006801:Humans; D013997:Time Factors; D055815:Young Adult
keywords: Allaitement maternel exclusif; Democratic Republic of the Congo; Exclusive breastfeeding; Health personnel; Personnel de santé; RD Congo