1. Arun Gupta Regional Coordinator IBFAN Asia
Effect of peer counselling by mother support groups on Infant and Young Child Feeding practices: The Lalitpur Experience
Arun Gupta
Regional Coordinator IBFAN Asia

2. Based on this publication
Effect of peer counselling by mother support groups on Infant and Young Child Feeding practices: The Lalitpur ExperienceKushwaha KP, Sankar J, Sankar MJ, Gupta A, Dadhich JP, Gupta YP, Bhatt GC, Ansari DA, Sharma B. PLOS One 2014, 9(11):e109181
Based on this publication

3. BFCHI: BABY FRIENDLY COMMUNITY HEALTH INITIATIVE PROJECT LALITPUR
Dr. K P Kushwaha
Principal,
Prof & Head,
BRD Medical College, Gorakhpur
District Administration, Lalitpur
B.R.D. Medical College,
Gorakhpur

4. Project Area
Slide 4
“BFCHI” (Baby Friendly Community Health Initiative) implemented in all the 6 blocks of Lalitpur

5. Objective
To evaluate the effect of peer counseling by mother support groups (MSGs) in improving the infant and young child feeding practices in the community

6. Methods
This was a quasi-experimental before and after study conducted over a period of 5 years (Dec ) by Department of Paediatrics, BRD Medical College, Gorakhpur in collaboration with UNICEF office of UP
The study population comprised of mother infant pairs
The intervention comprised of counseling and providing support to these mothers by the MSGs
Both facility and community based strategy were used

7. Methods
Step 1
Assessment of IYCF practices in 6 blocks of district Lalitpur (pre intervention research)
Step 2
Develop consensus on the goal, purpose, objectives, expected results of the BFCHI plan of action (protocol development)
Step 3
Co-ordination with ICDS, Health, NGOs, local leaders, primary school teachers in order to develop MSGs (capacity building)
Step 4
Training of resource persons (middle level trainers) using IBFAN/WHO/BPNI/UNICEF 3 in 1 modules

8. Methods Training of MSGs by middle level trainers
Step 5
Training of MSGs by middle level trainers
Step 6
Setting up of village resource centers, 6 block IYCF centers (2 IYCF counsellors available for 6 hrs/day) and referral center for referred cases from field
Step 7
Home visits by MSG members (10 visits in first 6 months, 6 visits in next 6 months and 3 visits in 2nd year)
Step 8
Counselling and helping mothers with feeding difficulties and reinforcing optimal practices
Step 9
Re-assessment of outcome variables of interest in the community

9. Results

10. Results Feeding parameter Pre-intervention (T0) N=421
Post –intervention (T1)
N=480
p value
T0 vs T1
Post-intervention (T2)
N=597
T0 vs T2
Not seeking help from family members
264 (62%)
382 (80%)
P<0.0001
549 (91%)
Help by trained worker/ANM/Dai/Doctor
35 (8%)
200 (42%)
280 (47%)
Help by doctor
21 (5%)
14 (3%)
0.05
58 (10%)
P=0.002
Mother’s belief about her milk supply as sufficient (confidence)
63 (15%)
192 (40%)
327 (55%)
Self stopping of sucking of child during feeding (responsive feeding)
83 (20%)
315 (65%)
330 (55%)

11. Strengths
There is unequivocal evidence on importance of peer group/community based counselling in reducing infant/child mortality by improving IYCF practices in the community
It is the largest community based study till date on peer counselling, use of local resources from community
The reach was universal with more than 80% of mothers counselled on more than one occasion
The project created over 1000 MSGs and 6 resource centers, integrated in state health system
The project demonstrated real convergence at village level and heightened motivation of workers to prevent malnutrition and morbidity in infants and young children

12. Results Sustained in 2013
UNICEF did an external evaluation in 2013 that showed its results are sustained.

13. Conclusions
( Lalitpur Personified Version 2015)
A significant improvement in the breastfeeding and IYCF practices
Peer counseling by MSGs improved the IYCF practices in the district and could be sustained
We did the costing per birth : 4.7 US $. ( training, capacity building, refresher courses, honorarium for workers

14. Thank You !!