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Efforts to improve mother and child health and reduce mortality in rural Malawi
– Reported, June 13, 2013
Malawi has high rates of neonatal and infant mortality and morbidity. Since 1990, the country has made progress towards achieving the target of Millennium Development Goal (MDG) four, reducing under-five mortality by two-thirds, and of MDG five, reducing maternal mortality by half by 2015, but like other countries in sub-Saharan Africa, the progress has been insufficient. Evidence suggests that to achieve the target Malawi would benefit from implementing interventions that improve breastfeeding practices and thus reduce rates of childhood infections and mother-to-child-transmission of HIV (MTCT). A number of studies have shown the potential of breastfeeding counselors in improving breastfeeding practices and other infant care and care-seeking practices in Mexico, Bangladesh, India, Madagascar, Ghana and Zambia.
The volunteer infant feeding and care counseling intervention aims to improve mother and child health and reduce infant mortality in Mchinji District by providing health education and support to promote appropriate maternal and child care and care-seeking behaviours.
From January 2005, the volunteer counselors began to identify pregnant women in their communities and make a home visit at five key points during pregnancy and after birth. In each visit the counselors discussed and supported women on a range of exclusive breastfeeding and other important neonatal and infant care practices.
The intervention described in this paper seeks to increase rates of exclusive breastfeeding and reduce infant mortality in Mchinji District, Malawi, through volunteer delivered infant feeding and care counseling. The intervention has been introduced in a large rural population in the district and has been running since January 2005.
It is hypothesised that through the intervention women learn new infant feeding and care behaviours by modeling the behaviour and by learning from the experiences of volunteer counselors experienced in breastfeeding and infant care. By focusing on informational and attitudinal change the intervention is expected to enhance motivation and reinforce risk reduction skills and self-efficacy. As a result, it is through counseling that behavior change is triggered and which may help to increase exclusive breastfeeding rates and reduce infant mortality. The impact of the groups on mortality and behaviour will be published in 2012.
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