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BACKGROUND	Community-based peer support has been shown to be effective in improving exclusive breastfeeding rates in a variety of settings .
METHODS	We conducted a cost analysis of a community cluster randomised-controlled trial ( Promise-EBF ) , aimed at promoting exclusive infant feeding in three sites in South Africa .
METHODS	The costs were considered from the perspective of health service providers .
METHODS	Peer supporters in this trial visited women to support exclusive infant feeding , once antenatally and four times postpartum .
RESULTS	The total economic cost of the Promise-EBF intervention was US$ 393 656 , with average costs per woman and per visit of US$ 228 and US$ 52 , respectively .
RESULTS	The average costs per woman and visit in an operational ` non research ' scenario were US$ 137 and US$ 32 per woman and visit , respectively .
RESULTS	Investing in the promotion of exclusive infant feeding requires substantial financial commitment from policy makers .
RESULTS	Extending the tasks of multi-skilled community health workers ( CHWs ) to include promoting exclusive infant feeding is a potential option for reducing these costs .
RESULTS	In order to avoid efficiency losses , we recommend that the time requirements for delivering the promotion of exclusive infant feeding are considered when integrating it within the existing activities of CHWs .
CONCLUSIONS	This paper focuses on interventions for exclusive infant feeding , but its findings more generally illustrate the importance of documenting and quantifying factors that affect the feasibility and sustainability of community-based interventions , which are receiving increased focus in low income settings .

