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Journal of Human Lactation
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Improving Breastfeeding Practices on a Broad Scale at the Community Level: Success Stories From Africa and Latin America

Victoria J. Quinn, PhD

LINKAGES Project, Academy for Educational Development, Washington, DC

Agnès B. Guyon, MD, MPH

LINKAGES Project, Academy for Educational Development, Washington, DC

Joan W. Schubert, MPH

LINKAGES Project, Academy for Educational Development, Washington, DC

Maryanne Stone-Jiménez, MS, IBCLC

LINKAGES Project, Academy for Educational Development, Washington, DC

Michael D. Hainsworth, MPH

LINKAGES Project, Academy for Educational Development, Washington, DC

Luann H. Martin, MA

LINKAGES Project, Academy for Educational Development, Washington, DC

Large-scale community-level behavior change programs designed to improve breastfeeding practices were implemented in Bolivia, Ghana, and Madagascar. These programs reached sizable populations: Bolivia, 1 million; Ghana, 3.5 million; and Madagascar, 6 million. Over 3 to 4 years, timely initiation of breastfeeding (within 1 hour of birth) increased from 56% to 74% (P < .001) in Bolivia, 32% to 40% (P < .05) in Ghana, and 34% to 78% (P < .001) in Madagascar. Marked increases in exclusive breastfeeding of infants 0 to 6 months of age were also documented: from 54% to 65% (P < .001) in Bolivia, 68% to 79% (P < .001) in Ghana, and 46% to 68% (P < .001) in Madagascar. In Ghana and Madagascar, significant results were seen within 1 year of community interventions. The authors conclude that large-scale programs designed to improve breastfeeding practices are feasible and should be a central component of any child survival strategy.

Key Words: breastfeeding • infant and young child feeding • nutrition • community • behavior change

Journal of Human Lactation, Vol. 21, No. 3, 345-354 (2005)
DOI: 10.1177/0890334405278383
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