Effectiveness of personalised home based nutritional counselling on infant feeding practices in urban informal settlements, Nairobi, Kenya Seminar

Abstract
The WHO recommends exclusive breastfeeding in the first six months to meet the infant’s nutritional requirements and achieve optimal growth, development and health. Introduction of appropriate complementary feeding at six months, with continued breastfeeding up to two years or beyond is recommended. Poor infant and young child feeding (IYCF) practices are widely documented in the developing countries including Kenya. For example in Kenya, only one-third of children are exclusively breastfed for six months. The Kenyan government developed a strategy to promote optimal IYCF practices nationally in 2007, actualised mainly through the baby friendly hospital initiative (BFHI) in public health facilities. Urban informal settlements, where most urban residents live, present a unique challenge with respect to actualising the strategy as they are systematically excluded due to lack of public health facilities. Evidence indicates very poor IYCF practices and high levels of malnutrition in these settings; for example only two percent of infants under six months are exclusively breastfed, while more than half of children are stunted at age two years. Clearly innovative strategies to reach urban poor residents are paramount. We propose to implement and assess the effectiveness of personalised home-based nutritional counselling on infant feeding practices and consequently morbidity and nutritional outcomes in two Nairobi slums, using a cluster randomised controlled trial.