Abstract
Objectives
Breastfeeding and complementary feeding practices in India do not meet recommendations. Community health care workers (CHWs) are often the primary source of information for pregnant and postpartum women about Infant and Young child Feeding (IYCF) practices. While existing research has evaluated the effectiveness of content and delivery of information through CHWs, little is known about person-centric soft-skills in interpersonal communication. We analyzed the effect of high quality person-centered interactions based on respect and trust on recommended IYCF practices.
Methods
We use data from evaluation of an at-scale mHealth intervention in India that serves as a job aid to the CHWs and as a monitoring tool for their supervisors (N = 6635 mothers of children <12 m from 841 villages in 2 Indian states). The binary indicator variable for high-quality interaction is constructed using a set of 7 questions related to trust, respect, friendliness during these interactions. The binary outcomes variables are exclusive breastfeeding, timely introduction of complimentary feeding, and minimum diet diversity for infants. The estimation controlled for socio-economic-demographic characteristics, exposure to other health workers, number of interactions with the CHW, and other CHW services.
Results
Overall, 66% mothers reported exclusive breastfeeding, 69% reported timely introduction of complimentary feeding, but only 13% reported minimum dietary diversity in infant feeding. Perhaps because of the low base levels, mothers who reported higher-quality interactions were more likely to feed at least 4 food groups to infants 6–12 m (b = 0.05). Associations also existed for increased exclusive breastfeeding (b = 0.07). There was no effect on timely introduction of complimentary feeding.
Conclusions
Person-centered interactions with CHWs appears to be significantly associated with some behaviors around infant feeding. Focusing on improving social and soft skills of CHWs that can translate into better CHW-beneficiary interactions can pay rich dividend for certain behaviors which are currently less prevalent such as minimum dietary diversity or those which are perhaps more in mothers control such as exclusive breastfeeding.
Funding Sources
The Bill and Melinda Gates Foundation.
Maternal and health care workers’ perceptions of the effects of exclusive breastfeeding by HIV positive mothers on maternal and infant health in Blantyre, Malawi
