LINKAGES, a 10-year project to improve child health through
breastfeeding and related complementary feeding and maternal dietary practices,
led to improvements in two critical indicators: initiation of breastfeeding
within one hour of delivery and exclusive breastfeeding for the first six months
of life. LINKAGES is funded by the U.S. Agency for International Development.
Exclusive breastfeeding is the leading intervention to
prevent malnutrition, an underlying cause of more than half of all child deaths
in developing countries. It has the potential to reduce 13 percent of deaths
among children under 5, or more than 1.3 million each year.
"USAID's mandate for LINKAGES was to demonstrate that
exclusive breastfeeding is an achievable goal and to improve breastfeeding
practices in a large geographic area in five countries for public health
impact," said Margaret Burns Parlato, director of the AED Global Health,
Population, and Nutrition Group. "These goals have been accomplished."
Studies in those countries show consistent upward trends in
breastfeeding as a result of comprehensive programs focusing on counseling with
mothers, community education, training of health care providers and community
health workers, and national policies.
In
Madagascar
, timely initiation rose from 32 percent in 2000 to 68 percent in 2005, while
the rate of exclusive breastfeeding jumped from 42 percent to 70 percent. In
Bolivia
, breastfeeding initiation went from 56 percent in 2000 to 74 percent in 2003,
and exclusive breastfeeding increased from 54 percent to 65 percent. In
Zambia
, initiation rose from 53 percent in 2000 to 70 percent in 2004, and exclusive
breastfeeding increased from 57 percent to 74 percent. In
Ghana
and
Jordan
, the results were similar.
Over the past ten years, LINKAGES has worked in 30
countries worldwide.
"Belying the conventional wisdom, the LINKAGES project
has shown that women will integrate new breastfeeding practices into their daily
routines," said Parlato. "While there are many factors in the success
of this effort, one of the key things we learned is that actions need to be
small and do-able. Improved breastfeeding practices are more likely to occur if
a woman perceives them as beneficial, feasible, and socially acceptable."
LINKAGES' efforts to improve infant and young child feeding
(IYCF) encompasses:
Areas of focus: breastfeeding, complementary feeding,
maternal nutrition, lactational amenorrhea (contraceptive) method (LAM), HIV and
infant feeding
Program components: multi-level partnerships, information
and technical updates, training and skills development, community- based
strategies, behavior change communication, policy analysis and advocacy,
monitoring and evaluation
Large scale country projects:
Bolivia
,
Ethiopia
(1),
Ghana
,
Jordan
,
Madagascar
,
Zambia
Country coordinators and short-term project assistance: 24
countries
Policy guidelines: women's nutrition (South Africa) HIV
and infant feeding (Nigeria, Zambia) IYCF (Ethiopia, Nepal, Zambia) maternity
protection (Zambia) Code of Marketing Breastmilk Substitutes (Ethiopia,
Zambia) micronutrient protocols (Ethiopia, Madagascar) global guidelines on
infant feeding in emergencies
Publications: Facts for Feeding series Frequently Asked
Questions series Experience LINKAGES series on strategies, tools, and
materials World LINKAGES series on country results technical reports joint
publications with WHO, UNICEF, PAHO, WABA, La Leche League, Wellstart, Helen
Keller International, Emergency Nutrition Network, CORE Group 25 peer-reviewed
journal articles
Tools: national IYCF assessment tool benefits of
breastfeeding advocacy model HIV and breastfeeding risk model counseling cards
and educational materials in nine countries media spots in six countries
monitoring and evaluation instruments
Research studies: Impact of social marketing of a
micronutrient dietary supplement to women of reproductive age (
Bolivia
) mother-to-mother support for breastfeeding (
Guatemala
), the "positive deviance approach" for improved IYCF (
Vietnam
) counseling on HIV and breastfeeding (
Zimbabwe
) and offering LAM as a modern contraceptive method (
Jordan
)
Cost-effectiveness studies:
Ghana
,
Jordan
,
Madagascar
,
Zambia
For more information on LINKAGES, visit http://www.linkagesproject.org
Founded in 1961, the Academy for Educational Development (http://www.aed.org)
is an independent, nonprofit organization committed to solving critical social
problems. AED works in all the major areas of development with a focus on
improving health, education and economic opportunities for the least advantaged
in the
United States
and throughout the world.
(1) Survey data not yet available.
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