Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings: a quasi-experimental study in Nairobi, Kenya

Elizabeth W. Kimani-Murage, African Population and Health Research Center (APHRC)
Shane Norris, University of the Witwatersrand
Martin K. Mutua, African Population and Health Research Center (APHRC)
Wekesah Fredrick, African Population and Health Research Center (APHRC)
Milka Wanjohi, African Population and Health Research Center (APHRC)
Nelson Muhia, African Population and Health Research Center (APHRC)
Peterrock Muriuki, African Population and Health Research Center (APHRC)
Thaddaeus Egondi, African Population and Health Research Center (APHRC)
Catherine Kyobutungi, African Population and Health Research Center (APHRC)
Alex C. Ezeh, African Population and Health Research Center (APHRC)
Rachel Musoke, University of Nairobi
Stephen McGarvey, Brown University
Nyovani Madise, University of Southampton
Paula Griffiths, Loughborough University

Early nutrition is critical for later health and sustainable development. We determine potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies (Pre-intervention [2007 to 2011; n=5824], Intervention [2012 to 2015; n=1110] and Comparison [2012 to 2014; n=487]). The three studies followed mother-child pairs longitudinally to establish EBF for six months. The intervention study (MIYCN study) was a cluster-randomised trial, involving regular home-based nutritional counselling visits of mothers in by Community Health Workers (CHWs). At six months, the prevalence of EBF was 2% in the Pre-intervention group compared to approx. 55% in the Intervention group and 3% in the Comparison group (p<0.05). We conclude that there is potential effectiveness of the Kenyan national Community Health strategy in promoting exclusive breastfeeding in urban poor settings, with limited health care access.