Cultural and contextual considerations in designing programs to support the incorporation of early childhood development within ongoing national nutrition programmes: A focus on the Baby-Friendly Community Initiative (BFCI) in a rural African context

Abstract The Baby Friendly Community Initiative (BFCI) offers a unique platform for integration of counselling on early childhood development (ECD) with existing maternal and child health and nutrition messages. To understand how to efficiently deliver such a program, this study determined the feasibility of integrating counselling on child stimulation into the Kenyan BFCI activities. Qualitative interviews (N=97) among female (aged 15-49 years) and male users, stakeholders, and services providers in Koibatek sub-County (mainly inhabited by the Tugen people, a Nilotic group in sub-Saharan Africa) provided extensive information on understanding regarding ECD, caregiving beliefs, needs at different levels and barriers and facilitators. Contextual influences and existing health system infrastructure are important considerations when designing integrated interventions to improve nurturing care of children.