{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:53:30Z","timestamp":1793642010541,"version":"4.5.1"},"reference-count":49,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Maternal &amp;amp; Child Nutrition"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Timely support given to breastfeeding mothers can result in life\u2010saving benefits for both mothers and infants. Progress in achieving results from existing efforts to improve breastfeeding practices can be accelerated with adequate investments in effective interventions. We aimed to document expenditures incurred by three diverse programs in Bangladesh, Ethiopia, and Vietnam that demonstrated improved breastfeeding outcomes. Based on expenditure records, we retrospectively calculated annual and per participant expenditures. The results represent the incremental financial needs of strengthening existing efforts in low\u2010 and middle\u2010income countries to inform budget planning. The programs reached between 400,000 to 1.2 million pregnant women, infants, and mothers annually at an average expenditure of USD 0.55 to 1.90 per woman and infant. The largest proportion of expenditures were incurred for training frontline workers and delivering interpersonal communication or counseling. These ranged from 73.4% of total expenditures in Bangladesh to 63.9% in Ethiopia and 55.1% in Vietnam. Management and administration expenditures ranged from 13.3% and 19.6% across countries; the range in expenditures for planning and strategy development was 2.5%\u20139.9%; for materials development and production was 1.1%\u201315.1%; and for monitoring was 1.7%\u201318.7%. The results show that existing cadres of facility and community workers can deliver effective breastfeeding counseling on a large scale with substantial economies of scale. Budgetary needs will differ by country due to delivery system strengths and weaknesses, pre\u2010existing coverage, and demand for counseling services. The study provides a basis for realistic budget estimates for strengthening breastfeeding counseling in large\u2010scale programs.<\/jats:p>","DOI":"10.1111\/mcn.70031","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T11:20:14Z","timestamp":1743852014000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Expenditures on Strengthening Large Scale Breastfeeding Counseling Programs in Bangladesh, Ethiopia, and Vietnam"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0159-734X","authenticated-orcid":false,"given":"Tina G.","family":"Sanghvi","sequence":"first","affiliation":[{"name":"Alive &amp; Thrive initiative, FHI 360, Family Health International, Washington DC and Durham  North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9827-9238","authenticated-orcid":false,"given":"Rick","family":"Homan","sequence":"additional","affiliation":[{"name":"FHI 360, Health Services Research, Global Health and Population Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0737-430X","authenticated-orcid":false,"given":"Tuan","family":"Nguyen","sequence":"additional","affiliation":[{"name":"FHI 360, Alive &amp; Thrive Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeba","family":"Mahmud","sequence":"additional","affiliation":[{"name":"FHI 360, Alive &amp; Thrive Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Nersesyan","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive initiative, FHI 360, Family Health International, Washington DC and Durham  North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Preware","sequence":"additional","affiliation":[{"name":"Alive &amp; Thrive initiative, FHI 360, Family Health International, Washington DC and Durham  North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8265-9815","authenticated-orcid":false,"given":"Edward A.","family":"Frongillo","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Education, and Behavior University of South Carolina Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4475-8716","authenticated-orcid":false,"given":"Roger","family":"Mathisen","sequence":"additional","affiliation":[{"name":"FHI 360, Alive &amp; Thrive Hanoi Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,4]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"A&T.2012.Timed and Age\u2010Appropriate IYCF Messaging for Frontline Workers.https:\/\/www.aliveandthrive.org\/en\/resources."},{"key":"e_1_2_9_3_1","unstructured":"A&T.2013.Infant and Young Child Feeding Services Toolkit: A Social Franchise Model.https:\/\/www.aliveandthrive.org\/en\/resources."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0273179"},{"key":"e_1_2_9_5_1","volume-title":"World Bank Institute Development Studies","author":"Belli P.","year":"2001"},{"key":"e_1_2_9_6_1","unstructured":"BRAC.2013.Alive and Thrive Implementation Manual for BRAC's Community\u2010Based IYCF Program in Bangladesh.https:\/\/www.fhi360.org\/sites\/defaultfiles\/media\/docs\/alive-thrive-getting."},{"key":"e_1_2_9_7_1","volume-title":"Ecological Systems Theory","author":"Bronfenbrenner U.","year":"1992"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czaa005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmy041"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13102"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15214541"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0002454"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049731509358424"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nyas.13679"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10071141"},{"issue":"2","key":"e_1_2_9_16_1","first-page":"89","article-title":"Generalised Cost\u2010Effectiveness Analysis: An Aid to Decision Making In Health","volume":"1","author":"Hutubessy R. 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