Scaling Up of Breastfeeding Promotion Programs in Low- and Middle-Income Countries: the “Breastfeeding Gear” Model12
Identifieur interne : 000E78 ( Pmc/Corpus ); précédent : 000E77; suivant : 000E79Scaling Up of Breastfeeding Promotion Programs in Low- and Middle-Income Countries: the “Breastfeeding Gear” Model12
Auteurs : Rafael Pérez-Escamilla ; Leslie Curry ; Dilpreet Minhas ; Lauren Taylor ; Elizabeth BradleySource :
- Advances in Nutrition [ 2161-8313 ] ; 2012.
Abstract
Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother–child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for scale up of BF programs in low- and middle-income countries. The review identified BF programs located in 28 countries in Africa, Latin America and the Caribbean, and Asia. Study designs included case studies, qualitative studies, and observational quantitative studies. Only 1 randomized, controlled trial was identified. A total of 22 enabling factors and 15 barriers were mapped into a scale-up framework termed “AIDED” that was used to build the parsimonious breastfeeding gear model (BFGM). Analogous to a well-oiled engine, the BFGM indicates the need for several key “gears” to be working in synchrony and coordination. Evidence-based advocacy is needed to generate the necessary political will to enact legislation and policies to protect, promote, and support BF at the hospital and community levels. This political-policy axis in turn drives the resources needed to support workforce development, program delivery, and promotion. Research and evaluation are needed to sustain the decentralized program coordination “gear” required for goal setting and system feedback. The BFGM helps explain the different levels of performance in national BF outcomes in Mexico and Brazil. Empirical research is recommended to further test the usefulness of the AIDED framework and BFGM for global scaling up of BF programs.
Url:
DOI: 10.3945/an.112.002873
PubMed: 23153733
PubMed Central: 3648703
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PMC:3648703Le document en format XML
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<author><name sortKey="Perez Escamilla, Rafael" sort="Perez Escamilla, Rafael" uniqKey="Perez Escamilla R" first="Rafael" last="Pérez-Escamilla">Rafael Pérez-Escamilla</name>
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<author><name sortKey="Curry, Leslie" sort="Curry, Leslie" uniqKey="Curry L" first="Leslie" last="Curry">Leslie Curry</name>
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<author><name sortKey="Minhas, Dilpreet" sort="Minhas, Dilpreet" uniqKey="Minhas D" first="Dilpreet" last="Minhas">Dilpreet Minhas</name>
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<author><name sortKey="Taylor, Lauren" sort="Taylor, Lauren" uniqKey="Taylor L" first="Lauren" last="Taylor">Lauren Taylor</name>
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<author><name sortKey="Bradley, Elizabeth" sort="Bradley, Elizabeth" uniqKey="Bradley E" first="Elizabeth" last="Bradley">Elizabeth Bradley</name>
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<author><name sortKey="Taylor, Lauren" sort="Taylor, Lauren" uniqKey="Taylor L" first="Lauren" last="Taylor">Lauren Taylor</name>
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<author><name sortKey="Bradley, Elizabeth" sort="Bradley, Elizabeth" uniqKey="Bradley E" first="Elizabeth" last="Bradley">Elizabeth Bradley</name>
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<series><title level="j">Advances in Nutrition</title>
<idno type="ISSN">2161-8313</idno>
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<front><div type="abstract" xml:lang="en"><p>Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother–child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for scale up of BF programs in low- and middle-income countries. The review identified BF programs located in 28 countries in Africa, Latin America and the Caribbean, and Asia. Study designs included case studies, qualitative studies, and observational quantitative studies. Only 1 randomized, controlled trial was identified. A total of 22 enabling factors and 15 barriers were mapped into a scale-up framework termed “AIDED” that was used to build the parsimonious breastfeeding gear model (BFGM). Analogous to a well-oiled engine, the BFGM indicates the need for several key “gears” to be working in synchrony and coordination. Evidence-based advocacy is needed to generate the necessary political will to enact legislation and policies to protect, promote, and support BF at the hospital and community levels. This political-policy axis in turn drives the resources needed to support workforce development, program delivery, and promotion. Research and evaluation are needed to sustain the decentralized program coordination “gear” required for goal setting and system feedback. The BFGM helps explain the different levels of performance in national BF outcomes in Mexico and Brazil. Empirical research is recommended to further test the usefulness of the AIDED framework and BFGM for global scaling up of BF programs.</p>
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<pmc article-type="other"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Adv Nutr</journal-id>
<journal-id journal-id-type="iso-abbrev">Adv Nutr</journal-id>
<journal-id journal-id-type="publisher-id">advances in nutrition</journal-id>
<journal-id journal-id-type="hwp">advannut</journal-id>
<journal-title-group><journal-title>Advances in Nutrition</journal-title>
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<issn pub-type="ppub">2161-8313</issn>
<issn pub-type="epub">2156-5376</issn>
<publisher><publisher-name>American Society for Nutrition</publisher-name>
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<article-meta><article-id pub-id-type="pmid">23153733</article-id>
<article-id pub-id-type="pmc">3648703</article-id>
<article-id pub-id-type="publisher-id">002873</article-id>
<article-id pub-id-type="doi">10.3945/an.112.002873</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Reviews from ASN EB 2012 Symposia</subject>
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<title-group><article-title>Scaling Up of Breastfeeding Promotion Programs in Low- and Middle-Income Countries: the “Breastfeeding Gear” Model<xref ref-type="author-notes" rid="fn1"><sup>1</sup>
</xref>
<xref ref-type="author-notes" rid="fn2"><sup>2</sup>
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<contrib-group><contrib contrib-type="author"><name><surname>Pérez-Escamilla</surname>
<given-names>Rafael</given-names>
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<xref ref-type="corresp" rid="cor1"><sup>*</sup>
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<contrib contrib-type="author"><name><surname>Curry</surname>
<given-names>Leslie</given-names>
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<contrib contrib-type="author"><name><surname>Minhas</surname>
<given-names>Dilpreet</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Taylor</surname>
<given-names>Lauren</given-names>
</name>
</contrib>
<contrib contrib-type="author"><name><surname>Bradley</surname>
<given-names>Elizabeth</given-names>
</name>
</contrib>
<aff id="aff1">Yale School of Public Health and Yale Global Health Leadership Institute, New Haven, CT</aff>
</contrib-group>
<author-notes><corresp id="cor1"><label>*</label>
To whom correspondence should be addressed. E-mail: <email>rafael.perez-escamilla@yale.edu</email>
.</corresp>
<fn id="fn1"><label>1</label>
<p>Presented at the symposium “Strategic, Global Approaches to Improve Breastfeeding Rates” held April 21, 2012 at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2012 in San Diego, CA. The symposium was sponsored by the American Society for Nutrition, the Lactation Research Interest Section, and the Society for International Nutrition. It was funded in part by Medela Inc. and the Bill & Melinda Gates Foundation. A summary of the symposium “Strategic, Global Approaches to Improve Breastfeeding Rates” was published in the November 2012 issue of <italic>Advances in Nutrition</italic>
.</p>
</fn>
<fn id="fn2"><label>2</label>
<p>Author disclosures: R. Pérez-Escamilla, L. Curry, D. Minhas, L. Taylor, E. Bradley, no conflicts of interest.</p>
</fn>
</author-notes>
<pub-date pub-type="epub"><day>6</day>
<month>11</month>
<year>2012</year>
</pub-date>
<pub-date pub-type="collection"><month>11</month>
<year>2012</year>
</pub-date>
<volume>3</volume>
<issue>6</issue>
<fpage>790</fpage>
<lpage>800</lpage>
<permissions><copyright-statement>© 2012 American Society for Nutrition</copyright-statement>
<copyright-year>2012</copyright-year>
</permissions>
<abstract><p>Breastfeeding (BF) promotion is one of the most cost-effective interventions to advance mother–child health. Evidence-based frameworks and models to promote the effective scale up and sustainability of BF programs are still lacking. A systematic review of peer-reviewed and gray literature reports was conducted to identify key barriers and facilitators for scale up of BF programs in low- and middle-income countries. The review identified BF programs located in 28 countries in Africa, Latin America and the Caribbean, and Asia. Study designs included case studies, qualitative studies, and observational quantitative studies. Only 1 randomized, controlled trial was identified. A total of 22 enabling factors and 15 barriers were mapped into a scale-up framework termed “AIDED” that was used to build the parsimonious breastfeeding gear model (BFGM). Analogous to a well-oiled engine, the BFGM indicates the need for several key “gears” to be working in synchrony and coordination. Evidence-based advocacy is needed to generate the necessary political will to enact legislation and policies to protect, promote, and support BF at the hospital and community levels. This political-policy axis in turn drives the resources needed to support workforce development, program delivery, and promotion. Research and evaluation are needed to sustain the decentralized program coordination “gear” required for goal setting and system feedback. The BFGM helps explain the different levels of performance in national BF outcomes in Mexico and Brazil. Empirical research is recommended to further test the usefulness of the AIDED framework and BFGM for global scaling up of BF programs.</p>
</abstract>
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