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Cycle 1

Feasibility and effectiveness of the baby friendly community initiative (BFCI) in Kenya: A pilot community trial in a rural setting.

Principal Investigator: Judith Kimiywe, Kenyatta University
NIH-Supported Collaborator: Stephen McGarvey, Brown University
Title of NIH Award: Diabetes Care in American Samoa

Project Overview
Nutrition in the first 1000 days of life is critical for child growth, wellbeing and survival. There is evidence that undernutrition is associated with more than half of child deaths due to its influence on morbidity. Interventions promoting optimal maternal infant and young child nutrition (MIYCN) could prevent a fifth of under five deaths. Poor MIYCN practices are widely documented in Kenya, like in other developing countries, with potential detrimental effects on child growth, health and survival. The Division of Nutrition (DON), Kenya, developed a national strategy to promote optimal MIYCN practices in 2007, actualized mainly through the baby-friendly hospital initiative (BFHI) in maternity wards.

However, since only two in five women deliver in health facilities, majority of women lack this support and MIYCN practices are greatly influenced by traditional beliefs and practices. Hence the impact of BFHI is minimal. Recognizing the need to reach women at the community level, The DON is therefore considering implementing the Baby Friendly Community Initiative (BFCI), which employs the principles of BFHI at the community level. Hard evidence on the effectiveness of BFCI and how it works best in the Kenyan context are needed to create the political buy in, budgetary allocation and effective implementation at the national level.

This study aims to pilot implementation of BFCI to determine its feasibility and effectiveness with regards to maternal and child nutrition and health status in a rural setting in Kenya.

The study will be conducted in East Pokot, a semi-arid rural district with poor health access in North Rift region of Kenya. The study will combine both qualitative and quantitative methods to answer the research questions. A formative study using participatory action research will be conducted. Then, a quasiexperimental study with both qualitative and quantitative data collection will be conducted. Data on MIYCN practices, nutritional status and health of the children will be collected on cohorts of mother-child pairs in both intervention and control arms through baseline and end-line cross-sectional surveys.

Public Health Impact:
The study will generate sound scientific evidence on the feasibility and effectiveness of implementing BFCI on maternal, infant and young child nutrition and health outcomes. This will inform effective and efficient scale-up of the BFCI in Kenya.

NIH Collaborator:
Stephen McGarvey has many years of experience in child nutritional status in low and middle income countries (LMICs) and his current behavioral intervention using community health workers (CHWs) will allow him to advise on critical implementation questions that arise.

Health Cycle 1 Recipients