We could just let the figures speak for themselves: in Kenya during 2013, for example, an estimated 106,000 children died with two of the leading causes being pneumonia and diarrhea. According to Unicef, breastfed babies are 15 times less likely to die from pneumonia and 11 times less likely to die from diarrhea. The trouble is, doing the math and saying ‘breastfeeding saves lives and more African women should do it’ is easy. Implementing these strategies so they not only know this but can act on it, is trickier.
Philips has a commitment to breastfeeding support, which is why the Philips Africa Innovation Hub, supported by key stakeholders, created the Fabric of Africa (FoA) report: interviewing 400 working mothers with children under the age of two, from three socio-economic groups (Middle Class , Floating Class and Bottom of the Pyramid ), across the capital cities of Kenya and Ghana.
We already knew both countries held breastfeeding rates below World Health Organization recommendations: around 58% of Kenyan mothers initiate breastfeeding within an hour of birth and 32% exclusively breastfeed for six months. In Ghana, it is 46% for both initiation and six-month exclusive breastfeeding.
What we also wanted to know though was why these numbers fall so woefully short, and how we can change them.
Let’s start at the beginning: in hospital, right after birth. Immediate skin-to-skin contact and early initiation of breastfeeding boosts the baby’s nutrition and immunity and stimulates the mother’s further milk flow. Yet, while in our study 70% of Bottom of Pyramid and 71% of floating class mothers had done early initiation, for middle class mothers, that figure was only 58%.
This invalidates the assumption that higher economic status probably means better health knowledge and behavior, and is explained by another conflicting fact: private African birthing clinics fall short of public ones in stimulating early initiation of breastfeeding.
The next challenge comes once women have left the hospital, and are facing the very real issue of providing for their newborn child not only physically, but also financially.
The ability to balance work and motherhood in a busy African city is hard. Female labor participation rates are high in Ghana (67%) and in Kenya (62%). Compare that against maternity rights in African society: if you’re formally employed, there is three months’ paid leave if you’re informally employed (like three quarters of the population in many African countries) there is nothing. This helps explain why 52% of all women reported returning to work within three months, and 25% of lower income women were working again within one month.
What’s hard to bear is that these women know breastfeeding is best for their child, but their knowledge is no help in reality. Access to breast pumps and refrigerators – things some people take for granted - rarely exists for them. How can you express breastmilk for while you’re away working if you have nothing to do it with and nowhere to store the milk when you have done it?
Adding to the issue, urban African daycare has little regulatory oversight, with dangerous consequences. While 19% of mothers reported to have used daycare services, they also reported to be concerned about the quality and hygiene of daycare, which is often located in slum homes with an average of 12 babies per caretaker.
So far, attempts are thwarted at every turn.
But that’s where the UN’s Sustainable Development Goals come in, with their pledge to reduce preventable newborn and child deaths to zero and eliminate child malnutrition by 2030. With its enormous potential to reduce child deaths, breastfeeding has a special role to play in the achievement of these new global goals.
Naturally, there are many facets and many supporters. For World Breastfeeding Week though, at the Philips Africa Innovation Hub, we’ll focus on innovations that support breastfeeding in order to empower African women. And what kind of innovations could be created by Philips – and others?
Again, let’s go back to that critical first hour of life, where early breastfeeding can make such impact on the child and mother’s health. How can we ensure it happens? One approach is breastfeeding-supportive education of health workers, given in part by initiatives like Philips Community Life Centers, like the newly-opened one in Kiambu County, where enhanced technology and services are already promising to offer women safer births.
Moving on to the next stage – supporting African women to work and still provide their child with breastmilk – and the answer has several parts. There need to be innovations for affordable breast pumps; for solutions in pasteurization; for better baby sanitizers. There also needs to be greater development of human milk banking, where donated breast milk can further support the promotion of breastfeeding and infant survival in neonatal intensive care units. A great example of this was the South African Breastmilk Reserve's (SABR) Feed for Life program in 2013, where Philips donated a range of Avent breastfeeding products.
Finally, there needs to be modernized daycare centers, where women can not only deliver stored breastmilk, but can know it’ll be given to their child properly.
We can optimize on a new African culture too - the rising tide of mobile phones - adapting our current breastfeeding apps and introducing phone-based peer counseling (already proven by a Kenyan study to support continued breastfeeding) and ways for breastfeeding mothers to share tips and support each other.
One could argue it’s this last innovation that really symbolizes what we need to achieve: a blend of old and new; a meshing of realism and ambition.
The end goal is to empower working mothers in Africa through tailored breastfeeding-supportive innovations (products, services and education), enabling them to combine going to work with giving their child the health benefits only breastfeeding can provide.
A single change will not solve all the challenges that mothers face; to come to effective solutions we need to acknowledge the uniqueness of their lives and the barriers they face.
But if we can do this, we can also give women like Joyce that most basic right of all; the power to act on her maternal instinct.
The Un Foundation Webinar on Breastfeeding takes place on Thursday, 6 August at 9am – 10:30am EDT find out more here.