In line with our study, comprehensive and integrated counselling strategies have been described as very successful in changing behaviour and health outcomes, as was the case from a large trial in Haryana, India [37,38]. Further, subjective intrinsic factors determining behaviour change are deeply embedded in cultural norms and traditions, thus understanding context of relevant barriers related to self-efficacy, beliefs and attitudes is key to meet and counsel the women in a meaningful way [38,39]. Our study group addressed some of these factors in formative research identifying poverty and limited access to health systems facilities, water, sanitation and fear of stigma and rejection as key factors why not breastfeeding is considered a non-option in Burkina Faso and Uganda [33,40].