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Strategies to work on the encouragement of breastfeeding with the health teams of the first level of care in the Almirante Brown district

General Information

Project description

The commercialization of formula milk (FM) began in Argentina at the end of the sixties. This market has grown remarkably since then, in turn, state agencies use LF as a tool to solve or combat low-weight problems in children and who for other reasons need to supplement the diet when milk is not possible exclusive breastfeeding (EBF).

The increase in LF consumption is detrimental to breastfeeding (BF). Its introduction generates a vicious circle and dependency that is difficult to reverse without adequate support for BF.

Human milk is recognized as the first healthy food in the life of human beings with effects on population health in the short, medium and long term, it is the health strategy that registers the greatest impact regarding infant mortality compared to any other intervention preventive. On the contrary, the over-prescription of LF causes adverse effects on the health of the mother, on children, and future adults, strongly impacting public health costs.

The general objective of the project is to identify and recognize biases in the health team agents regarding the prescription of formula milk in six Primary Health Care Centers (PHCC) in the municipality of Almirante Brown in Argentina, in order to design a behavioral intervention that contributes to reduce these prescriptions and stimulates the promotion of exclusive breastfeeding up to 6 months of life of children.

While the specific objectives raise three major axes:
1. Generate a situational diagnosis of the selected PHCC to identify and verify the behavioral biases that go through the practices of the health team in relation to the prescription of milk formula.
2. Design and implement behavioral interventions in the selected PHCC to intervene on the biases identified in the health team concerning the prescription of milk formula to children from 0 to 6 months.
3. Evaluate the impact of the interventions carried out regarding the evolution of the prescription of milk formula, analyzing the results obtained by comparing the experimental and control results.

Detailed information

Hypothesis

Behavioral interventions will reduce the prescription of formula milk in the PHCC of the Municipality of Almirante Brown, Buenos Aires, Argentina.

Although the unit of analysis is the LF prescriptions sent by the doctors, it is not feasible for this study to randomly select those who make the prescriptions, since most of the behavioral interventions are crossed by procedures of each PHCC. That is why the selection of the doctors was made based on their place of work, that is, through the PHCC.
Under the pretension of building homogeneous and comparable groups among themselves, the selection of the PHCC was carried out through a systematic random selection of the PHCC that accumulate the greatest number of LF prescriptions during the first semester of 2021.
The systematic random selection made it possible to capture the heterogeneity more accurately in the variability of the number of prescriptions, within the PHCC that are in the last quartile.
With this criterion, a focus was placed on those PHCC that during the first semester of 2021 have registered the highest number of LF prescriptions.

Dependent variables

Formula milk prescription rate in the Almirante Brown CAPS.

Analyses

We will test the effect of the interventions by comparing the proportion of formula prescriptions between each PHCC group.

Argentina

Municipality of Almirante Brown

Who is behind the project?

Institution: Other
Team: Behavioral Sciences and Public Policies Unit

Project status:

Methods

Methodology: 一 Other
Could you self-grade the strength of the evidence generated by this study?: 1

What is the project about?

Policy area(s): Health
Topic(s): Decision-making
Behavioural tool(s): To be completed

Date published:

23 February 2023

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