Promoting breastfeeding to ensure healthier babies in Ethiopia


Abeba (right) explains content from the family health card to an expectant mother.
Abeba is a well-known traditional birth attendant in the Amhara region of Ethiopia. She has attended many deliveries in her village over the years and has used traditional birthing techniques that she thought were best. "I used to ask the mother to squat and expel the placenta, and the newborn would not drink breast milk until the placenta was expelled. This could take up to three days, in some cases," she says. "I also used to order mothers to discard their first breast milk because I thought it was bad for the baby."

Only 10 percent of births in Ethiopia are delivered by skilled attendants, and approximately 20 percent of children die before their fifth birthday. The USAID-funded JSI Essential Services for Health in Ethiopia (ESHE) project is helping to improve these health outcomes by sponsoring trainings for community health promoters.

Abeba was selected by her village leaders to be a promoter. She attended an ESHE training, where she learned to negotiate with mothers to help them adopt optimal breastfeeding. She was also given information on how to use family health cards, immunization diplomas, and T-shirts with health messages, in order to encourage healthy household practices.

After attending the training, Abeba continued contemplating the new lessons. "I learned important health messages during the community health promoters training. However, I was confused. The new messages contradicted what I thought I knew," she says. Abeba couldn't hide her look of guilt after learning she had been depriving mothers and newborns of the nutritious colostrum breast milk for such a long time. "I could not believe that immediate breastfeeding of the newborn would expel the placenta and reduce bleeding," she says.

She decided to test this theory using her pregnant cow and goat. "To my surprise, I found immediate breastfeeding of newborns helps expel the placenta even in animals. If it works for cattle, it should work for human mothers too," she says.

Abeba now confidently advises pregnant mothers on the benefits of breastfeeding before their delivery. "I counseled four mothers with newborns after I became a community health promoter. All breastfed their newborns immediately after delivery without disregarding their breast milk," she says. Abeba is proud that the traditional birthing practices in her village after delivery have been replaced by simple, doable, and healthy actions that help save babies and mothers lives.