Kenya's government has made significant progress recently in developing programs to promote breastfeeding among mothers who deliver at the hospital but about 60 percent of the nation's babies are born outside a health care facility. In hopes of reaching those families, a team of researchers in Kenya and at Brown University will use a newly awarded USAID grant to test a community-based breastfeeding support initiative.
The three-year "PEER" grant of nearly $450,000 will allow the team led by Professor Judith Ongaji Kimiywe of Kenyatta University with guidance from Stephen McGarvey of Brown University's School of Public Health to conduct a pilot implementation of the "Baby Friendly Community Initiative" in the rural district of Igembe North. They'll measure the nutrition and health status and practices of more than 1,000 mother-child pairs. Some of them will receive the program's support and counseling, while others will remain with typical care as part of a control group.
A variety of cultural issues in Kenya – and in many other places – make breastfeeding a complicated issue in community settings, said McGarvey, who has also studied breastfeeding in American Samoa.
"Women now play major economic roles and breastfeeding can be seen as an impediment, for instance while running a market stall," he said. "There are also concerns in this setting about transmission of HIV in breast milk."
McGarvey credits the idea of conducting a statistically rigorous pilot study of the initiative in the community to collaborator Elizabeth Wambui Kimani, whom he met through an ongoing collaboration and scholarly exchange program between Brown, her institution the African Population and Health Research Center, the University of Colorado, and the University of the Witwatersrand in South Africa.