Abstract
BACKGROUND: The COVID-19 pandemic led to decline in access and utilization of the baby-friendly community initiative (BFCI) which is being implemented in Kenya. The impact of the pandemic on the BFCI and on maternal and child health and nutrition has not been documented. We undertook a qualitative study that assessed the effect of the COVID-19 pandemic on the baby-friendly community initiative (BFCI) activities, maternal and child health (MCH) services and maternal, infant and young child nutrition (MIYCN) practices in Kenya. METHODS: Data on the impact of the pandemic on the BFCI activities, provision and access to MCH services and MIYCN practices were collected using key informant interviews (n = 57), in-depth interviews (n = 31), and focus group discussions (n = 15) with government officials, civil society organizations and community members in BFCI implementing and non-implementing urban and rural areas. RESULTS: Our study found that BFCI activities, such as home visits, support group meetings and MCH services such as nutrition counselling, growth monitoring and vaccination were interrupted by the pandemic due to fear of contracting the virus, lack of personal protective equipment (PPEs) and movement restrictions. This meant that mothers did not have access to basic community and health services. Food insecurity attributed to financial difficulties resulted in coping strategies such as skipping meals and negatively affected MIYCN practices. Positive measures to prevent COVID-19 spread such as remote working enabled some mothers to adequately feed their children because they were better able to balance working and the demands of feeding young children from home. CONCLUSION: On balance, the pandemic negatively impacted the BFCI, MCH services and MIYCN practices in Kenya. In such a context, there is a need for innovative approaches to ensure continued provision of and access to facilities and community health services in the future if the country finds itself in a similar position with the challenges of a pandemic. The pandemic revealed that remote working support policies could have the potential to improve breastfeeding and complementary feeding for working women but further evidence is needed to fully evaluate this.