Mama Breastfeeding

How a nurse in Tanzania promotes breastfeeding in her community

Nurse Isabella Hwinzela Bigendako stands outside the health facility where she works in Morogoro, Tanzania. / Stephanie Mork, USAID

To strangers, Isabella goes by Isabella Hwinzela Bigendako or Nurse Isabella. But to family, friends, and colleagues, she answers to a different name: ‘Mama Breastfeeding.’

She earned the nickname after dedicating her life to educating others on the importance of exclusive breastfeeding for infants and young children.

Isabella has been a nurse in Morogoro, Tanzania for nine years. As a child, she looked up to the nurses in her neighborhood and was inspired to become one when she saw these nurses bring very sick children back to health.

“When I was a child, my neighbor was a nurse, and I could see her taking care of children in the neighborhood. I saw from her how you have to care for children so they don’t lose their life.” — Isabella

While there has been progress to increase the rate of exclusive breastfeeding in Tanzania in the past decade, nearly 40 percent of children under 5 are malnourished, and less than 60 percent of infants under 6 months are exclusively breastfed.

A nurse gives an educational session on the importance of breastfeeding to a group of local women in Morogoro, Tanzania. / Stephanie Mork, USAID

Yet the benefits of breastfeeding on nutrition and child health are substantial.

Breastfeeding is one of the most cost-effective health interventions, with every dollar invested leading to an estimated $35 in economic gains. Children who are breastfed receive optimal nutrition for proper growth and development and are sick less often, which contributes to better economic opportunities later in life.

Infants that are exclusively breastfed are also 14 times less likely to die within their first six months of life, compared to infants that are not exclusively breastfed. Breastfeeding also reduces deaths due to respiratory tract infections and diarrhea, which are two of the main causes of death for children in Tanzania.

Isabella with two of the nurses that she mentors and her supervisor (right). / Stephanie Mork, USAID

USAID supports breastfeeding in Tanzania by increasing breastfeeding education among communities, and helping mothers and families address breastfeeding challenges.

In addition, USAID trains nurses, a critical part of the global health workforce in Tanzania, to promote exclusive and early initiation of breastfeeding to pregnant women and caregivers to provide infants with optimal nourishment for a healthy start.

Isabella participated in a USAID-supported mentorship training for community-level healthcare providers to learn best practices for maternal and child health, including building the skills of other health workers to provide proper breastfeeding counseling and support to pregnant women and new families.

Teaching from Experience

Through this training, Isabella learned the importance of exclusive breastfeeding and is now a passionate community advocate. She provides mentorship to three other nurses at her health facility, and counsels her friends and family members on the importance of exclusively breastfeeding for six months.

After having her own child and practicing exclusive breastfeeding, Isabella uses her experience to encourage others to do the same.

“I breastfed my own baby for six months, and the baby was very healthy. I use that to testify to other mothers to say, ‘It is possible, I have done it myself.’ ” — Isabella

Promoting breastfeeding is crucial in the context of the COVID-19 pandemic to provide infants with the nutrients and immune support they need to better fight off infections.

New mother, Agness Jumanne, 20, breastfeeding her infant in Tanzania. / Frank Kimaro, Jhpiego

In Tanzania, USAID has continued to support breastfeeding alongside efforts to respond to the pandemic, such as ensuring health facilities are following recommendations to limit the spread of COVID-19. When pregnant and lactating women visit health facilities for a health checkup, they also learn about the importance of social distancing, increased hand washing, and use of face coverings to limit the spread of COVID-19, especially while breastfeeding.

Over the past five years, USAID investments like these have contributed to a 41 percent increase in the number of infants being exclusively breastfed in Tanzania. By strengthening the local capacity of health care providers like Isabella and equipping them with the skills and knowledge to better support their communities, USAID is supporting Tanzania on its journey to self-reliance.

About the Author

Stephanie Mork is a Nutrition Communications Intern in USAID’s Bureau for Global Health.