Inspired by real-world stories from Nigeria, Chad, and global health programs
The Challenge
Improving exclusive breastfeeding (EBF) rates remains a key public health goal in many parts of the world. While some regions adopt top-down strategies, relying on outside experts and broad campaigns, others take a grassroots approach, empowering communities from within.
So, which works better?
Grassroots Success Stories
Benue State, Nigeria
Benue introduced Breastfeeding Mother Support Groups (BFMSGs) supported by UNICEF. These groups, made up of local mothers and trained community health workers, helped educate and support breastfeeding practices.
- Activities: Peer education, home visits, tracking progress
- Outcome: EBF rates rose to 56.8% in the target area
- Why it worked: Trust, shared experience, and male involvement
Djingring Kass Village, Chad
Chantal, a mother in a rural village, challenged cultural norms by exclusively breastfeeding her baby for six months. Her story inspired others and aligned with government and UNICEF-led programs that built health infrastructure and trained local advocates.
- Result: Gradual normalization of EBF
- Approach: Local champions and integrated nutrition services
Top-Down Challenges
Global Lessons from WHO & UNICEF
Several regions rolled out aggressive campaigns discouraging traditional birth practices and promoting EBF through mass media. However, these programs sometimes neglected the role of grandmothers, TBAs, or religious figures — leading to pushback and low adoption.
- Issues: Cultural disconnect, resistance from trusted figures
- Outcome: Marginal improvement in EBF rates
Insights from Research
A review of breastfeeding interventions found that programs grounded in behavior change theories were more successful when they involved community leaders and built on local practices.
What We Can Learn
| Approach | Strengths | Weaknesses |
|---|---|---|
| Grassroots | Builds trust, respects culture, engages locals | May need more time and coordination |
| Top-Down | Scales quickly, uses expert knowledge | Risks alienating communities and traditions |
Key Takeaway: Breastfeeding programs thrive when they are community-owned, culturally informed, and involve traditional caregivers — not exclude them.
References
- UNICEF Nigeria. Community-based Breastfeeding Support Groups. Retrieved from: https://www.unicef.org/nigeria
- WHO & UNICEF. (2022). Global Breastfeeding Scorecard. Available at: https://www.who.int
- Kim, S. et al. (2021). Effectiveness of EBF interventions: A scoping review. International Breastfeeding Journal.
- UNICEF Chad. Real Lives: Exclusive Breastfeeding in Djingring Kass Village. Archived story on community engagement.
- Black RE, et al. (2013). Maternal and child undernutrition and overweight in low-income countries. The Lancet.
