Brazilian Strategy for Breastfeeding and Complementary Feeding Promotion: A Program Impact Pathway Analysis

Daiane Melo (), Sonia Venancio and Gabriela Buccini
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Daiane Melo: Department of Nutrition, School of Public Health, University of São Paulo, Professor Mello de Moraes Avenue, 1235, São Paulo 05508-030, SP, Brazil
Sonia Venancio: Health Institute of São Paulo, State Health Secretariat, R. Santo Antônio, 590, Bela Vista, São Paulo 01314-000, SP, Brazil
Gabriela Buccini: Department of Social and Behavioral Health, School of Public Health, University of Nevada Las Vegas, Las Vegas, NV 89119, USA

IJERPH, 2022, vol. 19, issue 16, 1-17

Abstract: Background: The Brazilian Breastfeeding and Complementary Feeding Strategy (Estratégia Amamenta e Alimenta Brasil—EAAB) aims to improve Primary Health Care (PHC) workers’ counseling skills to promote and support infant and young children feeding (IYCF). However, the maintenance and scaling up of the EAAB has been challenging. The theory-driven Program Impact Pathway (PIP) is recommended to assess and enhance the large-scale implementation of IYCF programs. The purpose of this study was to document barriers and facilitators to scale up the EAAB using a PIP analysis. Methods: First, we reviewed EAAB documents to develop an initial PIP diagram. Then, we interviewed EAAB key informants to identify Critical Quality Control Points (CCP) in the PIP. We revised and analyzed the PIP to inform the EAAB core functions and pathways. Results: Six CCPs for EAAB maintenance were identified: CCP1—Definition and strengthening of the coordination in states and municipalities; CCP2—Maintenance of tutors’ work; CCP3—Feasibility of the certification process; CCP 4—Quality improvement of IYCF activities in PHC units; CCP 5—Adequate use of monitoring systems; and CCP 6—Consistent implementation monitoring. Four implementation pathways and seven core functions identified may assist with scaling up the EAAB in Brazil. Conclusion: The PIP analysis proved to be useful for documenting the factors that influence the maintenance and scaling up of the EAAB.

Keywords: breastfeeding; complementary feeding; health policy; primary health care; implementation analysis; Program Impact Pathway (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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