A village health worker‐led intervention to promote and support exclusive breastfeeding in rural Zimbabwe is feasible, acceptable and effective (1015.8)

Exclusive breastfeeding (EBF) is a pillar of child survival but in Zimbabwe, less than 6% of infants are exclusively breastfed for 6 mo. Peer counseling has been shown to improve rates of EBF. We pilot‐tested a Village Health Worker (VHW)‐based EBF education intervention and assessed acceptability, within‐household reach, motivators triggered, learning outcomes, and EBF intentions and behavior. The intervention delivered key messages at four times: late gestation, and <1 wk, 1 mo, and 3 mo post‐partum. Nurses trained 20 VHWs on the EBF intervention over 4.5 days. The modules were delivered to 43 women; 13, 5, 11 and 14 at the respective time points, above. Researchers conducted a knowledge survey before the VHW visit and semi‐structured in‐depth interviews with the mothers 1 wk after the visit. The interviews were translated into English, transcribed and analyzed using thematic analysis. The intervention was acceptable and directly or indirectly reached other influential household members who shape infant feeding practices. The intervention improved EBF knowledge and led to changes in infant feeding behaviors and intentions, motivated mostly by desire for a healthy baby. Some mislearning around maternal diet determining breastmilk production also occurred. We conclude that targeted messages within home‐based education modules delivered by VHWs to promote EBF are promising and should be tested at scale. Grant Funding Source : Supported by the Bill and Melinda Gates Foundation (OPP1021542) and DFID, UK