Counselling on breastfeeding: assessing knowledge and skills

Area of Science:

• Public Health
• Medical Education
• Maternal and Child Health

Background:

• Effective breastfeeding support is crucial for infant and maternal health.
• Health worker training is a key strategy to improve breastfeeding practices.
• The WHO/UNICEF "Breastfeeding counselling: a training course" aims to enhance healthcare provider skills.

Purpose of the Study:

• To evaluate the effectiveness of the "Breastfeeding counselling: a training course" on health workers' knowledge and skills.
• To assess the sustainability of the training effects over time.
• To evaluate the implementation and participant satisfaction with the course.

Main Methods:

• A randomized controlled trial was conducted with 60 health units in São Paulo, Brazil.
• Participants received the 40-hour WHO/UNICEF breastfeeding counselling course; controls did not.
• Knowledge and skills were assessed pre-course, immediately post-course, and 3 months later. Implementation was evaluated through observation and interviews.

Main Results:

• Participants showed significant immediate increases in breastfeeding knowledge and clinical/counselling skills compared to controls.
• These improvements were largely maintained at the 3-month follow-up.
• The course received an average implementation score of 8.43/10, with high marks for theory content but lower scores for clinical practice time.

Conclusions:

• The WHO/UNICEF breastfeeding counselling course effectively enhances health workers' knowledge and skills for supporting breastfeeding.
• The training demonstrates lasting positive effects on healthcare providers' capabilities.
• Course satisfaction is high, with recommendations for increased clinical practice time to further optimize effectiveness.