Example 3: Maternal and Child Health and Nutrition (MCHN) Programs: Exclusive Breastfeeding (EBF) Priority Group or Influencing Bridges To Behavior Groups Determinants Activities Activities Mothers only Priority Group: Burundian mothers 1. Increase the 1. Record/write stories about mothers Perceived negative with children 0–6 months of age give breast perception that a with children with good health/weight consequences: milk to their child who is not who do EBF and believe in EBF. Play Live in rural setting Mothers don’t children from exclusively the recording/read the testimonials Majority are illiterate know the birth to 6 breastfed can on EBF at meetings in the community/ relationship Go to church on Sunday months of become health facilities (following postnatal morning between EBF age. malnourished. care and growth monitoring and and Are busy with daily household promotion sessions). 2. Increase the malnutrition chores perception that 2. In household meetings, use growth Want to be perceived as good religious leaders charts to show the difference between mothers and wives Perceived divine approve of EBF and several children growing well who are will: that their religious exclusively breastfeeding and contrast After 3 months, they think they tradition is them to other children who are losing do not have enough milk to Mothers supportive of EBF. weight who are not EBF. breastfeed question 3. Increase the 3. Give pastors/priests/imams sermon Exclusively breastfeed until 4 whether their perception that guides on EBF and train them in their months, but give other foods at religious use. their that time leaders/ law, mothers 4. Have Care Group Volunteers (CGVs) Majority are in partial action traditions approve of EBF. include mothers-in-law when teaching stage support this 4. Decrease the mothers of young children about EBF. behavior perception that a 5. Explain to mothers (via CGVs and Influencing Groups: child will be hungry household visits) that children cry for Perceived social Mothers-in-law or lacking in many reasons, and crying does not norms: nutrition if they are always mean the child is hungry. Use exclusively Mothers believe growth charts to show mothers that breastfed. that their many children who cry a lot (identify mothers, cases ahead of time) are still growing well and therefore are not lacking mothers-in-law adequate nutrition. Teach mothers a do not approve
Example 3: Maternal and Child Health and Nutrition (MCHN) Programs: Exclusive Breastfeeding (EBF) Behavior Priority Group or Influencing Groups Determinants Bridges To Activities Activities Mothers only give breast milk to their children from birth to 6 months of age. Priority Group: Burundian mothers with children 0–6 months of age Live in rural setting Majority are illiterate Go to church on Sunday morning Are busy with daily household chores Want to be perceived as good mothers and wives After 3 months, they think they do not have enough milk to breastfeed Exclusively breastfeed until 4 months, but give other foods at that time Majority are in partial action stage Influencing Groups: Mothers-in-law Perceived negative consequences: Mothers don’t know the relationship between EBF and malnutrition Perceived divine will: Mothers question whether their religious leaders/ traditions support this behavior Perceived social norms: Mothers believe that their mothers, mothers-in-law do not approve 1. Increase the perception that a child who is not exclusively breastfed can become malnourished. 2. Increase the perception that religious leaders approve of EBF and that their religious tradition is supportive of EBF. 3. Increase the perception that their mothers approve of EBF. 4. Decrease the perception that a child will be hungry or lacking in nutrition if they are exclusively breastfed. 1. Record/write stories about mothers with children with good health/weight who do EBF and believe in EBF. Play the recording/read the testimonials on EBF at meetings in the community/ health facilities (following postnatal care and growth monitoring and promotion sessions). 2. In household meetings, use growth charts to show the difference between several children growing well who are exclusively breastfeeding and contrast them to other children who are losing weight who are not EBF. 3. Give pastors/priests/imams sermon guides on EBF and train them in their use. 4. Have Care Group Volunteers (CGVs) include mothers-in-law when teaching mothers of young children about EBF. 5. Explain to mothers (via CGVs and household visits) that children cry for many reasons, and crying does not always mean the child is hungry. Use growth charts to show mothers that many children who cry a lot (identify cases ahead of time) are still growing well and therefore are not lacking adequate nutrition. Teach mothers a law,