Evaluation of the effect of a breastfeeding message integrated into a larger communication project

Most breastfeeding project evaluations examine the effects of separate proj ects and many do not use experimental designs. We evaluated the impact duri ng the 3rd year (March 1992-March 1993) of a simple breastfeeding message i ntegrated into a large-scale 3 year vitamin A project in northern Banglades h. It encouraged mothers to breastfeed for at least 2 years, I,ess formally , mothers were also advised to give colostrum, In both project (experimenta l) and non-project (control) areas, the proportion of mothers of children a ged 1-6 years who said they gave colostrum increased from about 69 per cent to about 77 per cent. However, children born during the year that transpir ed between the pre- and post-surveys were too young to be included in the p ost-survey. Thus this difference is an example of women reporting what they perceived as the norm or the 'correct' answer instead of what they actuall y did with their children, Thus the norm changed during the evaluation year , but it did so equally in both project and non-project areas. Although rep orted breastfeeding levels remained stable among older groups, the proporti on of children in the 2nd and 3rd years of life reported to be currently br eastfeeding increased to a similar extent in both areas. This could indicat e either a change in perception or a change in behaviour, Suckling frequenc y, not mentioned in local or national breastfeeding promotion, was unchange d in both areas at about 15 times a day for children in the 2nd year of lif e, and maintained at about eight to 10 times a day even for the small propo rtion who were still breastfed in the 5th (about 9 per cent) or 6th (about 2 per cent) years of life. While project messages (especially by radio) cou ld have spread to the nearby non-project area, it is unlikely that the impa ct would be equal. More likely these changes were the result of secular cha nges occurring at this time throughout Bangladesh. Thus this evaluation fou nd no evidence that the integration of a simple message about breastfeeding into a larger project had any measurable effect in the project area compar ed to the non-project area. More effective approaches may be required, tail ored to the particular needs of women in the area.