dc.contributor.author | Mbuya, MNN | en_US |
dc.contributor.author | Matare, CR | en_US |
dc.contributor.author | Tavengwa, NV | en_US |
dc.contributor.author | Chasekwa, B | en_US |
dc.contributor.author | Ntozini, R | en_US |
dc.contributor.author | Majo, FD | en_US |
dc.contributor.author | Chigumira, A | en_US |
dc.contributor.author | Chasokela, CMZ | en_US |
dc.contributor.author | Prendergast, AJ | en_US |
dc.contributor.author | Moulton, LH | en_US |
dc.contributor.author | Stoltzfus, RJ | en_US |
dc.contributor.author | Humphrey, JH | en_US |
dc.contributor.author | SHINE Trial Team | en_US |
dc.date.accessioned | 2019-08-27T09:01:26Z | |
dc.date.available | 2018-11-19 | en_US |
dc.date.issued | 2019-04 | en_US |
dc.identifier.uri | https://qmro.qmul.ac.uk/xmlui/handle/123456789/59337 | |
dc.description.abstract | Background: Suboptimal breastfeeding contributes to >800,000 global child deaths annually. Optimal breastfeeding includes early initiation (EI) and exclusive breastfeeding (EBF) for the first 6 mo. Objectives: We tested the hypothesis that an intervention targeting context and infant age-specific barriers to EI and EBF will achieve a higher EI and EBF prevalence than those of women participating in the concurrently conducted 2015 Zimbabwe Demographic Health Survey (Z-DHS). Methods: We designed an intervention to promote EI and EBF, and implemented it within the Sanitation Hygiene Infant Nutrition Efficacy (SHINE) trial in rural Zimbabwe. Intervention modules were delivered at 4 perinatal time points by government-employed village health workers. We compared EI and EBF prevalence among SHINE women who provided outcomes at 1 mo (n = 2442) and 3 mo (n = 2728), with women in the 2015 Z-DHS. Results: In cross-sectional analyses EI prevalence was 86.6% and 64.3% in the SHINE and Z-DHS samples, respectively; absolute difference (95% CI) = 22.4% (17.5%, 27.3%). EBF prevalence was similarly high (>80%) in both surveys during the first month of life; during 1 to <2 mo, 2 to <3 mo, 3 to <4 mo, 4 to <5 mo, and 5 to <6 mo, EBF prevalence was, respectively, 85%, 90%, 90%, 84%, and 75% in SHINE, and 71%, 65%, 35%, 26%, and 25% in Z-DHS; absolute difference (95% CI) = 50.2% (34.7%, 65.7%) at 5 to <6 mo. Cesarean delivery, mother's belief that intimate partner violence was sometimes justifiable, and having a male infant negatively modified the effects of the intervention. Conclusions: The SHINE intervention achieved a high prevalence of EI and EBF. Concurrently addressing gender norms will be critical to make further progress. Formative studies to identify context- and infant age-specific barriers to EI and EBF may inform improvement of breastfeeding practices elsewhere. Important work remains to scale up this intervention beyond a research setting. SHINE was registered at www.clinicaltrials.gov as NCT01824940. | en_US |
dc.description.sponsorship | Bill and Melinda Gates Foundation (OPP1021542 and OPP1143707) | en_US |
dc.description.sponsorship | United Kingdom Department for International Development (DFID/UKAID) | en_US |
dc.description.sponsorship | Wellcome Trust (093768/Z/10/Z and 108065/Z/15/Z | en_US |
dc.description.sponsorship | Swiss Agency for Development and Cooperation | en_US |
dc.format.extent | nzy092 - ? | en_US |
dc.language | eng | en_US |
dc.language.iso | en | en_US |
dc.relation.ispartof | Curr Dev Nutr | en_US |
dc.relation.uri | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.rights | Creative Commons Attribution Non-Commercial License | |
dc.subject | Zimbabwe | en_US |
dc.subject | breast milk | en_US |
dc.subject | early breastfeeding initiation | en_US |
dc.subject | exclusive breastfeeding | en_US |
dc.subject | infants | en_US |
dc.subject | village health workers | en_US |
dc.title | Early Initiation and Exclusivity of Breastfeeding in Rural Zimbabwe: Impact of a Breastfeeding Intervention Delivered by Village Health Workers. | en_US |
dc.type | Article | |
dc.rights.holder | © American Society for Nutrition 2019 | |
dc.identifier.doi | 10.1093/cdn/nzy092 | en_US |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/30937421 | en_US |
pubs.issue | 4 | en_US |
pubs.notes | Not known | en_US |
pubs.publication-status | Published online | en_US |
pubs.volume | 3 | en_US |
dcterms.dateAccepted | 2018-11-19 | en_US |
rioxxterms.funder | Default funder | en_US |
rioxxterms.identifier.project | Default project | en_US |
qmul.funder | THE IMPACT OF MICROBIAL TRANSLOCATION AND IMMUNE ACTIVATION ON THE HEALTH OF ZIMBABWEAN CHILDREN::Wellcome Trust | en_US |
qmul.funder | THE IMPACT OF MICROBIAL TRANSLOCATION AND IMMUNE ACTIVATION ON THE HEALTH OF ZIMBABWEAN CHILDREN::Wellcome Trust | en_US |