Effect of a Need-Based Maternal and Child Health Module on Breastfeeding Knowledge, Attitudes and Practices among Pregnant Women in Rural Maharashtra: A Pre–Post Interventional Study

Abstract

Background: The World Health Organization recommends initiation of breastfeeding within one hour of birth and exclusive breastfeeding for the first six months, yet adherence in rural India remains suboptimal. This study assessed the effect of a need-based maternal and child health (MCH) module on breastfeeding knowledge, attitudes and practices among rural women in Maharashtra. Methods: A pre–post interventional study was conducted among 250 pregnant women in six sub-centres of a Primary Health Centre in rural Maharashtra from October 2020 to December 2022. Baseline knowledge, attitudes and practices (KAP) were assessed using a structured, interviewer-administered questionnaire. A need-based educational module was delivered over two weeks through sessions led by PHC staff and ASHAs. The same questionnaire was re-administered three months after the intervention. Pre- and post-intervention proportions were compared using the chi-square test. Results: Early initiation of breastfeeding increased from 26.4% to 43.2% (p < 0.001) and exclusive breastfeeding from 38.4% to 52.8% (p < 0.01). Knowledge of breastfeeding benefits rose from 60.3% to 78.1%, awareness of the exclusive breastfeeding recommendation from 55.5% to 72.0%, and awareness of common breastfeeding challenges from 32.0% to 48.0% (all p < 0.001). The proportion of women receiving breastfeeding support increased from 30.0% to 54.0% (p < 0.001). Conclusion: A need-based MCH module delivered through the existing PHC and ASHA network significantly improved breastfeeding knowledge, attitudes and practices among rural women. Integrating such modules into routine antenatal care may help sustain these gains.