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Nigerian J Paediatrics 2016 vol 43 issue 3

Nigerian J Paediatrics 2016 vol 43 issue 3

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Need for baby friendly community initiative to improve the low exclusive breastfeeding rates in Nigeria
Niger J Paediatr 2016; 43 (3): 229 230
OPINION
Ekanem EE
Need for baby friendly commu-
Fajola AO
nity initiative to improve the low
exclusive breastfeeding rates in
Nigeria
DOI:http://dx.doi.org/10.4314/njp.v43i3.13
Accepted: 26th April 2016
the later. The BFCI was developed by the United
Nations and UNICEF to expand on the BFHI, and aims
Ekanem EE (
)
at sustaining breastfeeding after mothers leave the hospi-
Department of Paediatrics,
tal. 6 The initiative emphasises as community involve-
University of Calabar, Calabar, Nigeria
ment, formation and training of mother support groups
Email:emmanuelekanem@unical.edu.ng
at the village level, close link to the health facility and
Fajola AO
training messages derived from the community through
interviews with community members. This initiative
6
Regional Community Health,
Sub Saharan-Africa; Shell Petroleum
has proven effective in many developing and developed
Development Company of Nigeria
countries including Kenya with an EBF rate of 97%,
Gambia, Cambodia, New Zealand and Italy
6
7
8
The initiative has the advantages of linkages between
The benefits of Exclusive Breastfeeding (EBF) are no
health facilities and communities, including men as im-
longer debatable. The Baby Friendly Hospital Initiative
portant players, mobilizing resources from the whole
(BFHI) was launched in 1991 to encourage EBF for the
community while providing governments with an entry
first six months of life and continued breastfeeding for
point for other community health and development pro-
grams, and continuity/sustainability, among others. In
6
at least one year of life. The initiative has been
1
launched in at least 152 countries worldwide and in sev-
Nigeria the traditionally strong community institutions
eral parts of Nigeria. However studies from different
1,2
such as traditional rulers, women groups and women
parts of the country have continued to show very low
leaders and NGOs could be mobilized as fulcrum for
rates of EBF despite this initiative. Agu and Agu re-
3-5
3
such initiative. This would fit well into the community
model of solving health problems in our environment
9
ported only 63% rate of initiation of EBF at birth among
254 women in south-eastern Nigeria despite 87.0% of
and the Adopt-a-Health-Centre Initiative of the Paediat-
the woman being aware of EBF. The rate had declined
ric Association of Nigeria. Communities could be incen-
to 30.5% by 4-6months.In a rather more robust study in
tivized by issuance of certificates and other benefits for
rural western Nigeria among 410 mothers, 95.1% had
meeting laid down criteria.
heard about EBF, 65% knew that EBF should be initi-
ated from birth and 21.5% knew of the benefits of EBF
Some aspects of this community involvement have
yet only 10.2% were practicing EBF at the time of the
already been demonstrated to positively influence EBF
study. Agho et al examining data from several parts of
4
5
in Sokoto, Nigeria where the use of community volun-
the country, have reported Nigeria to have the poorest
teers to counsel women on the benefits and need for
rate of EBF in the world despite good levels of aware-
EBF significantly increased the percentage of mothers
ness.
with intention to exclusive breastfeeding and their
knowledge of the benefits of EBF. In South South Ni-
11
It would appear therefore that the reasons for poor EBF
geria where Shell Nigeria has adopted some community
rates in Nigeria go beyond lack of awareness. In addi-
facilities and introduced community health insurance
tion, it is obvious that the BFHI is not able to maintain
schemes in collaboration with the communities and gov-
influence on mothers after discharge from hospital, thus
ernment, high rates of acceptance and compliance with
the rapid declines in EBF rates soon after birth. To
3-5
public health initiatives have been observed due to the
improve the EBF rates in the country we need a model
large numbers visiting such facilities and receiving
awareness education, and community participation.
12
that would address the identified impediments to EBF at
the community level which include firmly held opinions
on infant feeding and poor motivation.
3-5
Very impor-
tantly, lack of ownership by the community is an obvi-
ous limitation to continuation of EBF after hospital dis-
Conclusion
charge.
6
In view of this we propose that the Baby Friendly Com-
Knowledge of EBF is widespread in Nigeria yet practice
munity Initiative, (BFCI) would be an effective comple-
rates are abysmally low. It is obvious that the BFHI is
ment to the BFHI in Nigeria, and provide continuity to
not able to sustain EBF rates in the community. Deeply
230
tion of 2005 on Infant and Young Child Feeding . We
10
held opinions about infant feeding in the communities
play a major role in the declining rates. The BFCI is a
please invite opinions on the subject.
viable addition to the BFHI in Nigeria to improve EBF
rates and meet our obligations to the Innocenti Declara-
References
1.
UNICEF/WHO Baby Friendly
6.
African Population and Health
10. UNICEF. Innocenti Declaration
Hospital Initiative. Revised, up-
Research Center. Establishing
on the Protection, Promotion and
dated and Expanded for Integrated
Innovative Community Engage-
Support of Breastfeeding.
Care 2009. ww.who.int>nutrition>
ment Approaches in Baby Friendly
www.unicef.org/programme/
topics>bfhi Accessed 20-3-14
Initiative: A Desk Review of Exist-
breastfeeding/innocenti.htm
2.
UNICEF. Current status of Baby-
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Accessed 13-4-16
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Agho KE, Dibley MJ, Odiase JI,
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Ekanem E E. The Biopsychosocial
Ogbonwan SM. Determinants of
way as a clinical mode for handling
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