Enablers & Barriers to Effectively Implement Baby-Friendly Community Init. in Rural Kenya

The child survival and development strategy in Kenya aims at improving child health and accelerating the reduction in child mortality through the acceleration and scale-up of evidence-based high-impact interventions. Promotion of optimal maternal infant and young child nutrition (MIYCN) practices is one such high impact intervention. Effective delivery of such high impact interventions is marred by lack of clear evidence on what works, how it works and why. Addressing barriers to the implementation of such interventions is key to achieving the objective of the Kenya’s child survival and development strategy and other health objectives. This project aims at pilot-testing promotion of optimal MIYCN practices at the community level through implementation of the Baby Friendly Community Initiative (BFCI). Evidence obtained from the pilot study will inform its scale-up in Kenya. It is anticipated that BFCI will enhance knowledge, attitudes and practices regarding infant and young child nutrition (IYCN) among mothers and community in general. This will in turn improve the health of infants and young children and consequently contribute to reductions in child mortality. One of the key component of the project was to conduct a formative qualitative study whose specific objectives were to determine the local contexts and cultural factors that influence breastfeeding and other maternal, infant and young child feeding practices in order to tailor the intervention package to the communities and to determine the enabling factors/barriers associated with the implementation of BCFI and how to address them.  A total of 205 participants were interviewed in the study which covered 12 of the 13 community units which were used as sampling units for the main project. A total of 52 interviews were done these included 16 FGDs, 14 IDIs and 22 KIIs. The key informants included chiefs, village elders, religious leaders, women leaders, CBO leaders and TBAs and  the health professionals at sub county and health facilities. In-depth interviews included pregnant women, breastfeeding women and HIV positive women and Health professionals. Focus group discussions were done with fathers, old and young mothers, grandmother and CHVs. Results revealed that cultural factors and traditions had great influence on maternal and child feeding practices. Mothers’ decisions were also highly influenced by the community and family members, and in some areas religious leaders and Traditional birth attendants.

Keywords: Baby Friendly Community Initiative, Formative study, Rural Kenya, Maternal and Child Nutrition