scaling-up exclusive breastfeeding support programmes the example of kwazulu-natal扩大纯母乳喂养支持项目夸祖鲁-纳塔尔的例子.pdfVIP

Scaling-Up Exclusive Breastfeeding Support Programmes: The Example of KwaZulu-Natal 1 2,3 1 4 5 Chris Desmond , Ruth M. Bland *, Gerard Boyce , Hoosen M. Coovadia , Anna Coutsoudis , Nigel Rollins5, Marie-Louise Newell2,6 1 Human Sciences Research Council, Durban, South Africa, 2 Africa Centre for Health and Population Studies, University of KwaZulu-Natal, Somkhele, South Africa, 3 Division of Developmental Medicine, Glasgow University, Glasgow, United Kingdom, 4 Centre for HIV/AIDS Networking, University of KwaZulu-Natal, Somkhele, South Africa, 5 Department of Paediatrics and Child Health, University of KwaZulu-Natal, Somkhele, South Africa, 6 Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, University College, London, United Kingdom Abstract Background: Exclusive breastfeeding (EBF) for six months is the mainstay of global child health and the preferred feeding option for HIV-infected mothers for whom replacement feeding is inappropriate. Promotion of community-level EBF requires effective personnel and management to ensure quality counselling and support for women. We present a costing and cost effectiveness analysis of a successful intervention to promote EBF in high HIV prevalence area in South Africa, and implications for scale-up in the province of KwaZulu-Natal. Methods and Findings: The costing of the intervention as implemented was calculated, in addition to the modelling of the costs and outcomes associated with running the intervention at provincial level under three different scenarios: full intervention (per protocol), simplified version (half the number of visits compared to the full intervention; more clinic