Assessment of the feasibility and potential effectiveness of a baby-friendly workplace support initiative in rural Kenya: a study protocol

Elizabeth W. Kimani-Murage, Teresia N. Macharia, Eva W. Kamande, Peter M. Gatheru, Hermann P. P. Donfouet, Taddese Alemu, Laura Kiige, Susan Jobando, Lynnette A. Dinga, Betty Samburu, Joyce Atinda, Samuel Watson, Claudia Mitchell, Paula Griffiths, Richard Lilford, Debra Jackson, France Begin, Grainne Moloney


Background: Employment poses a barrier in achieving the World Health Organization’s recommendation of exclusive breastfeeding for the first six months of life. Effective strategies and evidence to improve breastfeeding for women working in the agricultural sector – the main employer for women in Kenya – is lacking. This study aimed to inform (with evidence) the design and implementation of a scalable model of workplace support for breastfeeding in an agricultural setting in Kenya; as well as investigated the model’s potential operational feasibility and potential effectiveness, and its cost-effectiveness.

Methods: The study employed a mixed methods approach and participatory methods at the pre-implementation, implementation and post-implementation phases. The pre-implementation phase generated evidence to inform the implementation. Mothers with children under 12 months were interviewed at the pre-implementation (2016) and post-implementation (2018) phase. Managers, supervisors, decision and policy makers, as well as other community members were also targeted. Statistical methods will include analysis of covariance and logistic regression. Additionally, cost-effectiveness and cost-benefit analyses will be done. Qualitative data will be analysed in vivo, using thematic analysis technique.

Conclusions: Findings from this study aimed to inform the potential feasibility and potential effectiveness of a baby-friendly workplace support for breastfeeding initiative in an agricultural setting with a goal of improving child nutrition and health. The findings also contribute to policy and practice in Kenya by informing the development of workplace support guidelines.

Trial Registration: ISRCTN registry, ISRCTN 64692465; date of registration: 21 December 2016 – retrospectively registered,


Breastfeeding, Workplace support, Plantation, Kenya

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