Speaker-2, Dr KP Kushwaha.pptx benefits of breast feeding and important of exclusive of breast feeding

1. COMMUNITY
HEALTH
INITIATIVE
PROJECT
LALITPUR
Dr. K P Kushwaha
Principal,
Prof & Head,
BRD Medical College, Gorakhpur

2. Project Objectives
 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
Total Population =9,7,7447
Mother and babies reached=
1,80,000

3. 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)

4. Sensitization of administration and
health officials

5. Training ICDS and health workers using
BPNI module

6. Training of MSG’s by middle level trainers
using BPNI module

7. 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
Village and facility Level IYCF Support….
– The MSG’s - 24 hours a day throughout the
year

8. Setting up of village resource centres

9. Support of BFCHI: Creating and Supporting Mother
Support Groups

10. Village Level activities
Helping mother to learn breastfeeding
positioning
Demonstrating a thick consistency
Complement and feeding skill

11. 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)

12. Results
Primary outcomes P- value- <0.001 for all
outcomes
0
20
40
60
80
100
Prelacteal
feeds
BF within 1
hr
EBF for 6
months
CF plus
continued
BF
44% 39%
7% 4.5%
5%
62% 60%
94%
Pre-intervention Post- intervention
Pre-intervention-2006 ; Post-intervention-2011

13. Results
Primary outcomes P- value- <0.001 for both
outcomes
0%
20%
40%
60%
80%
100%
Appropriate
texture of
feeding
Feeding
during illness
Responsive
feeding
30%
8%
92%
39%
88%
Pre-
intervention
Post-
intervention

14. Results
Secondary outcomes- Mother’s confidence
P- value- <0.001 for all
outcomes
0
10
20
30
40
50
60
70
Milk supply
sufficient
self-
stopping
after feed
15% 20%
40%
65%
Pre-intervention
Post- intervention

15. Results
Secondary outcomes- Mother’s confidence
P- value- <0.001 for all
outcomes
0
10
20
30
40
50
60
70
Milk supply
sufficient
self-
stopping
after feed
15%
20%
40%
65%
Pre-intervention
Post- intervention

16. Mothers perception on health of their
Children
Slide 16

17. Effect of Peer Counselling
by Mother Support
Groups on Infant and
Young Child Feeding
Practices: The Lalitpur
Experience
Komal P. Kushwaha1*, Jhuma
Sankar2 , M. Jeeva Sankar2 ,
Arun Gupta3, J. P. Dadhich4 , Y.
P. Gupta5,Girish C. Bhatt1,
Dilshad A. Ansari1, B. Sharma1
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

18. 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

19. 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

20. THANKS