Identifying Effective Health Promotion Strategies to Increase Exclusive Breastfeeding Coverage: Systematic Literature Review

Abstract

Exclusive breastfeeding during the first six months of a baby's life is an important strategy in improving maternal and child health. However, exclusive breastfeeding coverage is still low in various countries, including Indonesia. This study aims to identify effective health promotion strategies in increasing exclusive breastfeeding coverage through the Systematic Literature Review method. Literature searches were conducted through the Scopus database with specific keywords related to breastfeeding promotion, self-efficacy, counseling, and social support. Of the 119 articles identified, 42 met the inclusion criteria and were analyzed thematically. The results showed that the most effective interventions were multifaceted interventions that combined education based on behavioral theory (especially Theory of Planned Behavior), husband and family support, prenatal and postnatal breastfeeding counseling, health worker training, and the use of digital technology. These interventions consistently improve maternal self-efficacy, breastfeeding intention, and exclusive breastfeeding practices. This study concludes that effective breastfeeding health promotion requires an integrated, sustainable, and contextual approach. These findings make an important contribution to the development of exclusive primary and community-based breastfeeding promotion programs, particularly in developing countries such as Indonesia