Sanghvi Tina G, Homan Rick, Nguyen Tuan, Mahmud Zeba, Nersesyan Marina, Preware Patricia, Frongillo Edward A, Mathisen Roger
Alive & Thrive initiative, FHI 360, Family Health International, Washington DC and Durham, North Carolina, USA.
FHI 360, Health Services Research, Global Health and Population, Durham, North Carolina, USA.
Matern Child Nutr. 2025 Jul;21(3):e70031. doi: 10.1111/mcn.70031. Epub 2025 Apr 4.
Timely support given to breastfeeding mothers can result in life-saving benefits for both mothers and infants. Progress in achieving results from existing efforts to improve breastfeeding practices can be accelerated with adequate investments in effective interventions. We aimed to document expenditures incurred by three diverse programs in Bangladesh, Ethiopia, and Vietnam that demonstrated improved breastfeeding outcomes. Based on expenditure records, we retrospectively calculated annual and per participant expenditures. The results represent the incremental financial needs of strengthening existing efforts in low- and middle-income countries to inform budget planning. The programs reached between 400,000 to 1.2 million pregnant women, infants, and mothers annually at an average expenditure of USD 0.55 to 1.90 per woman and infant. The largest proportion of expenditures were incurred for training frontline workers and delivering interpersonal communication or counseling. These ranged from 73.4% of total expenditures in Bangladesh to 63.9% in Ethiopia and 55.1% in Vietnam. Management and administration expenditures ranged from 13.3% and 19.6% across countries; the range in expenditures for planning and strategy development was 2.5%-9.9%; for materials development and production was 1.1%-15.1%; and for monitoring was 1.7%-18.7%. The results show that existing cadres of facility and community workers can deliver effective breastfeeding counseling on a large scale with substantial economies of scale. Budgetary needs will differ by country due to delivery system strengths and weaknesses, pre-existing coverage, and demand for counseling services. The study provides a basis for realistic budget estimates for strengthening breastfeeding counseling in large-scale programs.
及时为母乳喂养的母亲提供支持能够为母亲和婴儿带来挽救生命的益处。通过对有效的干预措施进行充分投资，可以加速在改善母乳喂养做法的现有努力中取得成果的进程。我们旨在记录孟加拉国、埃塞俄比亚和越南三个不同项目的支出情况，这些项目显示出母乳喂养成果有所改善。基于支出记录，我们回顾性地计算了年度支出和人均支出。这些结果代表了在低收入和中等收入国家加强现有努力以指导预算规划所需增加的资金。这些项目每年惠及40万至120万孕妇、婴儿和母亲，平均每位妇女和婴儿的支出为0.55美元至1.90美元。支出的最大部分用于培训一线工作人员以及提供人际沟通或咨询服务。这一比例在孟加拉国占总支出的73.4%，在埃塞俄比亚为63.9%，在越南为55.1%。管理和行政支出在各国之间的范围为13.3%至19.6%；规划和战略制定的支出范围为2.5% - 9.9%；材料开发和生产的支出范围为1.1% - 15.1%；监测的支出范围为1.7% - 18.7%。结果表明，现有的机构和社区工作人员队伍能够大规模地提供有效的母乳喂养咨询服务，并实现显著的规模经济。由于交付系统的优缺点、先前的覆盖范围以及对咨询服务的需求不同，各国的预算需求也会有所差异。该研究为大规模项目中加强母乳喂养咨询的实际预算估计提供了依据。
