Development Breastfeeding Participatory Integrated Promotion Model among Community Network of Maha Sarakham Hospital

Abstract

This action research was aimed at developing breastfeeding participatory integrated promotion model among community network of Maha Sarakham Hospital. The study site was Koeng Sub-district of Mueang District, Maha Sarakham Province comprising of 14 villages. Data were collected from October 2010 to January 2012. There were 4 phases of action research including (1) breastfeeding problem and situation analysis planning, (2) implementation of breastfeeding promotion activities in all villages and at the sub-district level, (3) observation, and (4) evaluation. A breastfeeding promotion committee was established in each village which was membered by 30 concerned villagers including selected members of local administration organization, pregnant women, mothers with newborn aged less than 2 years, husbands, senior villagers, young people, village health volunteers, breast-feeding ambassadors, village headman, etc. A similar committee was established at sub-district level shared by the president of sub-district administration organization. The results showed that the baseline 6-month exclusive breast-feeding rate was only 20.8%. The underlying cause was the lack of breastfeeding knowledge in pregnant and postpartum women (50.0%) and general people (50.1%). The actions in the first circle for developing breastfeeding in village level composed of trainings on breastfeeding knowledge and skill, signing the 6-month exclusive breastfeeding commitment by pregnant women, setting breastfeeding activities and formulating roles of committee members, developing work plan, conducting home visit, advocating breastfeeding for 1 month, summarizing and sharing experiences, and acknowledging successful breastfeeding mothers. The actions in the second circle were to promote breastfeeding at sub-district level; and composed of the formation of breastfeeding committees, creating breastfeeding road map, advocating breastfeeding commitment, organizing home visit committees, providing budgets to support breastfeeding mutual fund, and promoting capacity building through breastfeeding learning centers. After operating this model from 2010 to 2012, the proportion of 6-month exclusive breastfeeding increased rapidly from 20.8% at baseline to 56.8 at the end of 2011 and to 81.0 in 2012. Furthermore, the proportion of the committees’ satisfaction with the model also increased from 85.3 to 93.1. The key successes of the program were (1) public participation, (2) public policy endorsement in community, (3) mothers’ commitment on 6-month exclusive breastfeeding (4) active sub-district administration participation in establishing breastfeeding learning centers, (5) budget allocation, and (6) multi-disciplinary joint operation process.