BREASTFEEDING COUNSELLING MENTORSHIP PROGRAM FEASIBILITY: A MIXED-METHODS STUDY.

Objectives: Determine the feasibility of implementing a facility-based breastfeeding counselling (BFC) mentorship program and its effect on mentee confidence and client perceptions of breastfeeding counselling.

Setting: Mbagathi County Referral Hospital in Nairobi, Kenya.

Participants: Health facility management, health workers (21 mentees and seven mentors), 120 pregnant women in the third trimester who attended an antenatal care appointment at Mbagathi Hospital and reported receiving BFC during a visit in the 2 weeks prior, and 120 postpartum women in the postnatal care ward who delivered a full-term infant and reported receiving breastfeeding counselling.

Design: Mixed methods study incorporating online surveys, client exit interviews, key informant interviews, and focus group discussions. The 4-month intervention involved facility-wide orientations, selection and training of mentors, assigning mentees to mentors, and implementing mentorship activities.

Results: The program successfully maintained 90.5% mentee retention (19/21) over four months. At baseline, mentees demonstrated high knowledge (94% questions answered correctly) which was maintained at endline (92%). Mentees showed significant improvement in confidence counselling on breastfeeding and infant feeding (67% at baseline vs. 95% at endline, p=0.014). The percentage of ANC clients who felt BFC gave them more knowledge increased from 73% to 97% (p<0.001). Among PNC clients, those reporting friendly treatment increased from 89% to 100% (p=0.007), verbal mistreatment declined from 7% to 0% (p=0.044), and those feeling discriminated decreased from 11% to 2% (p=0.03). Key enablers included administrative support, structured mentorship tools, and peer learning communities. Implementation barriers included scheduling conflicts, staff shortages, and high patient volumes.

Conclusions: BFC mentorship was feasible in this setting and was associated with improved health worker confidence in BFC. The program can be successfully implemented with supportive facility leadership, well-matched mentors and mentees, and adaptable mentorship approaches.