A systematic review of reviews on effective home, family and community based interventions from low- and middle-in-come countries to inform the breastfeeding action plan for South Africa
Date
2017Author
Witten, Chantell Beverley
Kruger, Salome
Taljaard, Chrisitine
Kahler, Belinda
Verstraeten, Roosmarijn
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Background and objectives:
South Africa has one of the
lowest breastfeeding rates globally
and an exclusive breastfeeding
(EBF) rate below 10%. If South Africa is to to reach the World
Health Assembly target of 50% EBF rate by 2025 and reap the full
benefits of breastfeeding, South Africa would need an evidence-in-formed action plan. We undertook a systematic review of reviews
to i) summarise the evidence on the various community-based
interventions for breastfeeding of infants aged 6-24 weeks in
low- and middle-income countries (LMICs) and ii) produce an
evidence-informed recommendation on the most appropriate interventions for South Africa.
Methods:
We searched six electronic databases for peer-reviewed reviews published between 2001 and 2017. To be included, systematic reviews had to: at least have 60% of their primary
studies conducted in LMICs, report on community-based interventions compared to routine care, be aimed at pregnant or breastfeeding women and/or their families, and report on exclusive or
any breastfeeding rates between 6 and 24 weeks as the primary
outcome. Quality of the studies included for data extraction was
appraised independently by two author pairs using the AMSTAR checklist. To assess quality of each study, we used the Cochrane
risk of bias tool.
Results:
Title and abstract screening of 1037 references resulted in retaining three eligible systematic reviews, from which six
primary studies in LMICs emerged. These six primary studies represented data collected from 1996 to 2008. To bridge this data and
publication gap, citation searches of the six primary studies were
performed which rendered four additional studies. Combined,
these ten studies now presented data from 1996 to 2015 and the
publication date ranged from 2005 to 2016. The evidence suggests
that breastfeeding counselling, despite the wide range in number
and frequency of breastfeeding counselling contact sessions, had
a positive impact on breastfeeding duration and exclusivity at 24
weeks.
Conclusions:
There is a paucity of studies in LMICs. While
our review of reviews suggests that breastfeeding counselling has
the potential to improve EBF rates, scale-up and rigorous evaluation of community-based interventions to identify the pathways
through which these effects can be sustained must be explored
URI
http://hdl.handle.net/10394/26271http://doi.org/10.1159/000480486
https://www.karger.com/Article/Abstract/480486