The impact of a package of behaviour change interventions on breastfeeding practices in East Java Province, Indonesia

Abstract

Suboptimal infant young child feeding practices are frequently reported globally, including in Indonesia. This analysis examined the impact of a package of behaviour change interventions on breastfeeding practices in Malang and Sidoarjo Districts, East Java Province, Indonesia. The BADUTA study (which in the Indonesian Language is an acronym for BAwah DUa TAhun, or children aged less than 2 years) was an impact evaluation using a cluster-randomized controlled trial with two parallel treatment arms. We conducted household surveys in 12 subdistricts from Malang and Sidoarjo.We collected information from 5175 mothers of children aged 0-23 months: 2435 mothers at baseline (February 2015) and 2740 mothers at endline (January to February 2017). This analysis used two indicators for fever and diarrhoea and seven breastfeeding indicators (early initiation of breastfeeding, prelacteal feeding, exclusive breastfeeding under 6 months, predominant breastfeeding, continued breastfeeding, age-appropriate breastfeeding and bottle-feeding). We used multilevel logistic regression analysis to assess the effect of the intervention. After 2 years of implementation of interventions, we observed an increased odds of exclusive breastfeeding under 6 months (adjusted odds ratio [aOR] = 1.85; 95% confidence interval [CI]: 1.35-2.53) and age-appropriate breastfeeding (aOR = 1.39; 95% CI: 1.07-1.79) in the intervention group than in the comparison group, at the endline survey. We found significantly lower odds for prelacteal feeding (aOR = 0.52; 95% CI: 0.41-0.65) in the intervention than in the comparison group. Our findings confirmed the benefits of integrated, multilayer behaviour change interventions to promote breastfeeding practices. Further research is required to develop effective interventions to reduce bottle use and improve other breastfeeding indicators that did not change with the BADUTA intervention.

Effect of Short Course on Improving the Cadres’ Knowledge in the Stunting Reducing Context through Home Visits in Yogya-karta, Indonesia

“…The cadres state that home visits are an effective intervention to overcome stunting children based on individual problems. This is also supported by previous studies aimed at solving the problem of the COVID-19 severity [38], [39], obesity, and DM during the pandemic [40], increasing the promotion of breastfeeding, IYCF, and growth children [14].…”

“…In terms of coherence, short course interventions and home visit assistance for stunting children are closely related to the ongoing program. To increase mothers' knowledge and skills, they should be aware and empowered on means of caring for their children [14]. This research location is the epicenter of stunting, therefore, when the intervention ends, the local government can implement this program as a long-term home visit until there are no more cases.…”

“…Home visits enable detailed and comprehensive prevention of malnutrition. Furthermore, several studies have stated that assistance is effective in increasing community participation in Integrated Service Posts and capturing malnutrition [10], improving family health status [11], increasing breastfeeding success [12,14], reducing early complementary feeding for children [14], promoting healthy practices [15], increasing body weight, and improving children development [16]. The Indonesian Presidential Regulation Number 72 of 2021 addresses the subject of aiding families at risk of stunting.…”

Effect of a Short Course on Improving the Cadres’ Knowledge in the Context of Reducing Stunting through Home Visits in Yogyakarta, Indonesia

“…The assistance rendered to families with children at risk of stunted growth is comprehensive, and comprises detailed measures aiming to overcome malnutrition and other health problems. Furthermore, several studies have shown that assistance is effective in increasing dietary diversity scores and identifying malnutrition [ 12 ], improving healthcare access [ 13 ], increasing breastfeeding success [ 14 ], reducing early complementary feeding for children [ 14 ], promoting healthy practices [ 15 ], increasing body weight, and improving children development [ 16 ]. The Indonesian Presidential Regulation Number 72 of 2021 addresses the subject of aiding families at risk of stunting with the aim of improving access to information and services through counseling, referral services facilitation, and social assistance programs [ 17 ].…”

Infant and Young Child Feeding Practices and Determinants of Exclusive Breastfeeding: A Study at the Bono Regional Hospital, Sunyani, Ghana

“…Breastfeeding is recognized globally as an essential component of infant and young child feeding (IYCF) practices (Dorri et al, 2022;Titaley et al, 2022). The World Health Organization (WHO) and the United Nations International Children Fund (UNICEF), having recognized the sundry benefits of breastfeeding, developed the Global Strategy for IYCF, which aims to promote safe and appropriate IYCF practices (WHO, 2021).…”