Transcript 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
 To
Total Population =9,7,7447
Mother and babies reached=
1,80,000
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
o
o
MSGs :Trained in basic knowledge and skills of
breastfeeding and complementary feeding ( 1286 villages)
Under direct supervision of MLTs - designated as “facility
level counselors” and “trainers” of MSGs
( 48/ 24/12)
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

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



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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
94%
100
80
60
40
20
0
44%
39%
60%
62%
5%
7%
4.5%
Prelacteal BF within 1 EBF for 6
CF plus
feeds
hr
months continued
BF
Pre-intervention
Post- intervention
Pre-intervention-2006 ; Post-intervention-2011
Results
Primary outcomes
P- value- <0.001 for both
outcomes
92%
100%
88%
80%
60%
40%
39%
30%
8%
20%
0%
Preintervention
Appropriate
texture of
feeding
Feeding
during illness
Postintervention
Responsive
feeding
Results
Secondary outcomes- Mother’s confidence
P- value- <0.001 for all
outcomes
65%
80
40%
60
40
15%
20%
20
0
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
40%
15%
20%
Milk supply
selfsufficient stopping
after feed
Pre-intervention
Post- intervention
Mothers perception on health of their
Children
Slide 16
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
Strengths
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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
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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
THANKS