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Accepted manuscript

BREASTFEEDING COUNSELLING MENTORSHIP PROGRAM FEASIBILITY: A MIXED-METHODS STUDY

Published online by Cambridge University Press:  04 July 2025

Brian Micino Njoroge
Affiliation:
USAID Advancing Nutrition
Sascha Lamstein*
Affiliation:
USAID Advancing Nutrition JSI Research & Training Institute, Inc.
Kathryn Beck
Affiliation:
USAID Advancing Nutrition JSI Research & Training Institute, Inc.
Jackline A. Odhiambo
Affiliation:
Nyanam Widows Rising, Kisumu, Kenya
Silvia Alayon
Affiliation:
Save the Children, US
Beatrice C. Mutai
Affiliation:
University of Nairobi, Faculty of Health Sciences, Department of Paediatrics and Child Health
Esther Mogusu
Affiliation:
Department of Health, Wellness and Nutrition, Nairobi City County
Josephine Wandia Munene
Affiliation:
Kenya Association for Breastfeeding
James Njiru Kanyuira
Affiliation:
Independent Consultant
Susan A. Were
Affiliation:
Save the Children, Kenya
Delaney Ward
Affiliation:
Save the Children, US
Iscah Achieng Akello
Affiliation:
Mbagathi County Referral Hospital, Nairobi City County, Kenya
Julie Koroso
Affiliation:
Mbagathi County Referral Hospital, Nairobi City County, Kenya
Caroline K. Arimi
Affiliation:
Ministry of Health Division of Family Wellness, Nutrition and Dietetics
Florence Mugo
Affiliation:
Ministry of Health Division of Family Wellness, Nutrition and Dietetics
*
Corresponding author: Sascha Lamstein, 16 Bellflower St, Lexington, MA 02421, slamstein@gmail.com, 617-877-3821
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Abstract

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Objectives:

Determine the feasibility of implementing a facility-based breastfeeding counselling (BFC) mentorship program and its effect on mentee confidence and client perceptions of breastfeeding counselling.

Setting:

Mbagathi County Referral Hospital in Nairobi, Kenya

Participants:

Health facility management, health workers (21 mentees and seven mentors), 120 pregnant women in the third trimester who attended an antenatal care appointment at Mbagathi Hospital and reported receiving BFC during a visit in the 2 weeks prior, and 120 postpartum women in the postnatal care ward who delivered a full-term infant and reported receiving breastfeeding counselling.

Design:

Mixed methods study incorporating online surveys, client exit interviews, key informant interviews, and focus group discussions. The 4-month intervention involved facility-wide orientations, selection and training of mentors, assigning mentees to mentors, and implementing mentorship activities.

Results:

The program successfully maintained 90.5% mentee retention (19/21) over four months. At baseline, mentees demonstrated high knowledge (94% questions answered correctly) which was maintained at endline (92%). Mentees showed significant improvement in confidence counselling on breastfeeding and infant feeding (67% at baseline vs. 95% at endline, p=0.014). The percentage of ANC clients who felt BFC gave them more knowledge increased from 73% to 97% (p<0.001). Among PNC clients, those reporting friendly treatment increased from 89% to 100% (p=0.007), verbal mistreatment declined from 7% to 0% (p=0.044), and those feeling discriminated decreased from 11% to 2% (p=0.03). Key enablers included administrative support, structured mentorship tools, and peer learning communities. Implementation barriers included scheduling conflicts, staff shortages, and high patient volumes.

Conclusions:

BFC mentorship was feasible in this setting and was associated with improved health worker confidence in BFC. The program can be successfully implemented with supportive facility leadership, well-matched mentors and mentees, and adaptable mentorship approaches.

Information

Type
Research Paper
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society

Footnotes

Co-authors email addresses: Brian Micino Njoroge (bnjoroge@3uj.or.ke or brianmichino@gmail.com), Sascha Lamstein (sascha_lamstein@jsi.com), Kathryn Beck (kathryn.beck1@gmail.com), Jackline A. Odhiambo (jatienodhiambo@gmail.com), Silvia Alayon (salayon@savechildren.org), Beatrice C. Mutai (mutaibc@gmail.com), Esther Mogusu (mogusuek@gmail.com), Josephine Wandia Munene (josie.w.munene@gmail.com), James Kanyuira Njiru (njirukan14@gmail.com), Susan A. Were (cswere.a@gmail.com), Delaney Ward (dward@savechildren.org), Iscah Achieng Akello(iscahomondi@gmail.com), Julie Koroso, (korosojulie@gmail.com), Caroline K. Arimi (carolarimi@yahoo.co.uk), Florence Mugo (flomugo88@gmail.com)