Naoko Horii soutient sa thèse

Naoko HORII soutiendra sa thèse intitulée « Postpartum Breastfeeding in Rural Niger : Demographic Analysis of a communication program for child health care », sous la direction de CHARBIT Yves.

Résumé

Introduction
This research aims to evaluate the effects of a behavior change communication program promoting early initiation of breastfeeding within the first hour of birth among the most vulnerable mothers in rural Niger.

Methods
This is a secondary analysis of cross-sectional quantitative studies conducted in Niger at different points of time based on a literature review of previous studies conducted in Sub-Saharan Africa. The cross-sectional surveys include : the 2006 Niger Demographic Health Survey (DHS), the 2012 Niger DHS and the post-intervention survey (PIS) conducted in 2011 to evaluate a communication program promoting family and community based child health care in 4 regions of Niger.

Results
Regardless of socio-economic vulnerability, hygiene practice increases the chance of early initiation of breastfeeding. Hand washing and use of a traditional latrine increases by 2.4 (95%CI : 76 ; 220) and by 2.3 (95%CI : 51 ; 248) respectively the odds of early initiation of breastfeeding. Home visits by community volunteers are not significant (IC 95% : -10 ; 54). Involvement of mothers as a peer promoting exclusive breastfeeding significantly reduces the risk of delayed initiation of breastfeeding by 2.0 odds (IC 95% : 39 ; 189). However, the number of exposures to different types of communication strategies does not influence positively early breastfeeding.

Conclusions
The impact of community volunteers and health workers is limited with regard to early breastfeeding among the most deprived group of mothers. The model of behavior change communication with participatory peer promotion and a multi-sectorial approach combining optimal hygiene promotion suggests a response to socio-economic disparity.

Le jury est composé de :

• CHARBIT Yves (Directeur de thèse, Emeritus Professor of Demography, Université Paris DESCARTES)
• Suzanne BABICH (Professor of Public Health, Indiana University)
• GAIMARD Maryse (Professor of Demography, Université de Bourgogne)
• Yves MARTIN-PREVEL (Public Health Nutritionist, Director of Research, IRD)
• PETIT Véronique (Professor of Demography, Université Paris DESCARTES)