PROJECT SUMMARY

PROJECT DESCRIPTION

Neonatal mortality remains a pressing issue, particularly in developing countries like Ethiopia, where preventable conditions such as hypothermia and infections contribute to 2.4 million annual neonatal deaths. Breastfeeding, especially through skin-to-skin contact, has been proven to regulate newborn temperature and reduce the risk of sepsis. However, cultural beliefs and postoperative challenges often delay the initiation of breastfeeding, particularly after cesarean deliveries. The proposed Integrated Support and Education Program (ISEP) aims to address these challenges by improving the timing and effectiveness of breastfeeding practices at critical intervals: the first hour, 24–72 hours, day 7, week 2, and week 4. This program integrates culturally sensitive breastfeeding education with continuous skin-to-skin contact, making it both practical and promising. An innovative aspect of the initiative involves engaging trained housekeeping staff to support breastfeeding education, thereby alleviating the burden on midwives and ensuring continuous and accessible guidance for mothers.

ISEP will be implemented among post-cesarean mothers in Southern Ethiopia, leveraging Arba Minch University's Health and Demographic Survey Sites (HDSS). Using a quasi-experimental design and considering the cesarean section prevalence rate of 8% in Southern Ethiopia (EDHS 2022), we plan to enroll 1,022 cesarean delivery cases. Key components include implementing the Ten Steps to Successful Breastfeeding, distributing brochures and leaflets, conducting community campaigns about breastfeeding benefits, and highlighting symptoms of neonatal hypothermia and sepsis. The program features continuous support for timely initiation of breastfeeding, skin-to-skin contact, proper attachment and positioning, self-hygiene practices during hospital stays and home visits, mHealth alerts, and a free call service for emergencies. Data collection will occur at enrollment and on the 28th day post-enrollment through structured interviews and self-reported surveys. Primary outcomes include improved knowledge and practices related to timely and effective breastfeeding. Secondary outcomes include reduced incidences of neonatal hypothermia and sepsis, enhanced maternal acceptability, and improved mother-infant bonding.