Coverage and determinants of newborn feeding practices in rural Burkina Faso.

OBJECTIVE: Newborn feeding practices are important to neonatal health and survival, but understudied in sub-Saharan Africa. We assessed the prevalence and determinants of newborn feeding practices in Burkina Faso. STUDY DESIGN: An 18 000 household survey was conducted in rural Burkina Faso in 2010 to 2011. Women of reproductive age were asked about antenatal, delivery and newborn care practices for their most recent live birth. Coverage of newborn feeding practices was estimated and multivariate regression was used to assess determinants of these practices. RESULT: Seventy-six percent of live births were breastfed within 24 h of birth, 84% were given colostrum and 21% received prelacteals. Facility delivery and antenatal care attendance were associated with positive feeding practices. CONCLUSION: Positive newborn feeding practices were common in rural Burkina Faso, relative to other low-income settings. Interventions are needed to improve feeding practices among home-born babies, and to encourage earlier initiation of breastfeeding among facility-born newborns.

Quantifying the indirect effects of key child survival interventions for pneumonia, diarrhoea, and measles.

To date many studies have measured the effect of key child survival interventions on the main cause of mortality while anecdotally reporting effects on all-cause mortality. We conducted a systematic literature review and abstracted cause-specific and all-cause mortality data from included studies. We then estimated the effect of the intervention on the disease of primary interest and calculated the additional deaths prevented (i.e. the indirect effect). We calculated that insecticide-treated nets have been shown to result in a 12% reduction [95% confidence interval (CI) 0·0-23] among non-malaria deaths. We found pneumonia case management to reduce non-pneumonia mortality by 20% (95% CI 8-22). For measles vaccine, seven of the 10 studies reporting an effect on all-cause mortality demonstrated an additional benefit of vaccine on all-cause mortality. These interventions may have benefits on causes of death beyond the specific cause of death they are targeted to prevent and this should be considered when evaluating the effects of implementation of interventions.