Effect of A Community Health Worker Led Intervention on the Practice of Exclusive Breastfeeding in Mwingi West Sub-County, Kenya; A Pretest-Posttest Experiment

Japheth Mativo Nzioki, James Hebert Ombaka, James Ouma, Rosebella Ogutu Onyango


Introduction: World Health Organization (WHO) recommends breast milk as the ideal food for newborns and infants. In 2011, suboptimal breastfeeding practices accounted for more than 800,000 deaths among children under five years of age. Though the 2014 Kenya Demographic and Health Survey reported Exclusive Breast-Feeding (EBF) prevalence at 61%, poor breastfeeding practices are widely documented in Kenya. In 2006, Kenya developed a new Community Health Worker (CHW) led Primary Health Care intervention referred to as the Community Health Strategy (CHS). In Mwingi West sub-county, CHS was initiated in 2011. The aim of this study was to assess the effect of CHS on EBF among infants in Mwingi west sub-county.

Methods: This was a pretest -posttest experimental study design with 1 pretest and 2 post-test surveys conducted in intervention and control sites. Sample size in each survey was 422 households. Women with a child aged 9-12 months were main respondents.

Results: CHS increased EBF prevalence marginally by 6.4% in intervention site. This increased EBF prevalence in Mwingi west sub-county from 7.9% at baseline to 13.9% at end term survey. In intervention site, infants in the end term survey were 1.4 times more likely to receive EBF compared to infants at baseline (Adj. OR=1.447, P<0.05; 95%CI: 1.145-1.829).

Conclusion and Recommendation: CHS was effective in marginally increasing EBF prevalence in intervention site compared to control. To improve EBF rates in arid and semi-arid rural areas in Kenya, the government needs to fast-track implementation of CHS in all counties.  

Key words: Community Health Strategy, Community Health Workers, Exclusive Breast-feeding

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