1
|
Lubbe W, Oosthuizen CS, Dolman RC, Covic N. Stakeholder Attitudes towards Donating and Utilizing Donated Human Breastmilk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101838. [PMID: 31126144 PMCID: PMC6572701 DOI: 10.3390/ijerph16101838] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 11/16/2022]
Abstract
The promotion and support of human milk banks (HMBs) can enhance exclusive breastfeeding rates. The success and sustainability of HMBs depend on the support from relevant healthcare workers and related communities. This study aimed to determine attitudes of key stakeholders, including mothers, healthcare workers and grandmothers, regarding the donation and receipt of human breastmilk. This study was conducted at a public hospital and clinics in the North West Province, South Africa. Eight focus group discussions explored the attitudes regarding donating and receiving human breastmilk: three groups with mothers of infants (n = 13), three with grandmothers (>60 years old) (n = 17) and two with healthcare professionals working with infants (n = 11). Four main themes emerged: perception regarding breast and formula feeding; exposure to the concept of “wet nursing”; breastmilk donation; and utilization and opinions of community members and traditional healers. Specific barriers identified included the processes for donating and receiving milk, safety, human immuno-deficiency virus (HIV) screening and cultural beliefs. Mothers’ fears included having insufficient milk for their own infants, changes in the quality of donated milk during pasteurization and transportation and HIV transmission. Despite barriers towards donations to and the use of HMBs, sufficient information could enhance donations by mothers and breastmilk utilization.
Collapse
Affiliation(s)
- Welma Lubbe
- Quality in Nursing and Midwifery (NuMIQ) research unit, School of Nursing Science, North-West University, Potchefstroom 2520, South Africa.
| | - Charlene S Oosthuizen
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2520, South Africa.
| | - Robin C Dolman
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2520, South Africa.
| | - Namukolo Covic
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2520, South Africa.
| |
Collapse
|
2
|
Facilitators and Barriers to Breastfeeding and Exclusive Breastfeeding in Kilimanjaro Region, Tanzania: A Qualitative Study. Int J Pediatr 2019; 2019:8651010. [PMID: 30853994 PMCID: PMC6378044 DOI: 10.1155/2019/8651010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 01/09/2019] [Indexed: 11/28/2022] Open
Abstract
Background Breastfeeding is the best way to feed infants. It is a simple intervention to improve child health and development. Despite its advantages, there is a low global rate of exclusive breastfeeding (EBF) and, in Kilimanjaro region, Tanzania, EBF is rarely practiced. The aim of this paper is to explore social and cultural factors that might influence the practice of breastfeeding and exclusive breastfeeding in Kilimanjaro region. Methods A qualitative design was used. Three districts in Kilimanjaro region, namely, Same, Moshi Municipal Council, and Rombo, were selected. In each district three focus group discussions (FGDs) were conducted with mothers with infants aged 0-12 months. Results A total of 78 mothers participated in the focus group discussions. A majority of the mothers were positive towards breastfeeding. They believed that it prevents child sickness, creates happiness, and is good for family economy. Despite the positive attitudes, the mothers revealed many perceptions that interfered with breastfeeding and exclusive breastfeeding. These included the following: breast milk is very light and has bad odor, breastfeeding may affect mothers appearance, chango (abdominal pain) has to be treated, there is fear of the evil eye when breastfeeding in public places, breast milk may become unclean, and there is a need of pauses in breastfeeding after the child has burped on the breast. Conclusion There are beliefs that promote the practice of breastfeeding in this setting; these local beliefs could be used to develop breastfeeding messages to improve breastfeeding practices. However, there is also a need to address beliefs that interfere with the practice of exclusive breastfeeding in this setting.
Collapse
|
3
|
Does Village Chicken-Keeping Contribute to Young Children's Diets and Growth? A Longitudinal Observational Study in Rural Tanzania. Nutrients 2018; 10:nu10111799. [PMID: 30463264 PMCID: PMC6266779 DOI: 10.3390/nu10111799] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/07/2018] [Accepted: 11/16/2018] [Indexed: 12/11/2022] Open
Abstract
There is substantial current interest in linkages between livestock-keeping and human nutrition in resource-poor settings. These may include benefits of improved diet quality, through animal-source food consumption and nutritious food purchases using livestock-derived income, and hazards of infectious disease or environmental enteric dysfunction associated with exposure to livestock feces. Particular concerns center on free-roaming chickens, given their proximity to children in rural settings, but findings to date have been inconclusive. This longitudinal study of 503 households with a child under 24 months at enrolment was conducted in villages of Manyoni District, Tanzania between May 2014, and May 2016. Questionnaires encompassed demographic characteristics, assets, livestock ownership, chicken housing practices, maternal education, water and sanitation, and dietary diversity. Twice-monthly household visits provided information on chicken numbers, breastfeeding and child diarrhea, and anthropometry was collected six-monthly. Multivariable mixed model analyses evaluated associations between demographic, socioeconomic and livestock-associated variables and (a) maternal and child diets, (b) children’s height-for-age and (c) children’s diarrhea frequency. Alongside modest contributions of chicken-keeping to some improved dietary outcomes, this study importantly (and of substantial practical significance if confirmed) found no indication of a heightened risk of stunting or greater frequency of diarrhea being associated with chicken-keeping or the practice of keeping chickens within human dwellings overnight.
Collapse
|
4
|
de Bruyn J, Thomson PC, Bagnol B, Maulaga W, Rukambile E, Alders RG. The chicken or the egg? Exploring bi-directional associations between Newcastle disease vaccination and village chicken flock size in rural Tanzania. PLoS One 2017; 12:e0188230. [PMID: 29145463 PMCID: PMC5690622 DOI: 10.1371/journal.pone.0188230] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 11/02/2017] [Indexed: 11/18/2022] Open
Abstract
Newcastle disease (ND) is a viral disease of poultry with global importance, responsible for the loss of a potential source of household nutrition and economic livelihood in many low-income food-deficit countries. Periodic outbreaks of this endemic disease result in high mortality amongst free-ranging chicken flocks and may serve as a disincentive for rural households to invest time or resources in poultry-keeping. Sustainable ND control can be achieved through vaccination using a thermotolerant vaccine administered via eyedrop by trained “community vaccinators”. This article evaluates the uptake and outcomes of fee-for-service ND vaccination programs in eight rural villages in the semi-arid central zone of Tanzania. It represents part of an interdisciplinary program seeking to address chronic undernutrition in children through improvements to existing poultry and crop systems. Newcastle disease vaccination uptake was found to vary substantially across communities and seasons, with a significantly higher level of vaccination amongst households participating in a longitudinal study of children’s growth compared with non-participating households (p = 0.009). Two multivariable model analyses were used to explore associations between vaccination and chicken numbers, allowing for clustered data and socioeconomic and cultural variation amongst the population. Results demonstrated that both (a) households that undertook ND vaccination had a significantly larger chicken flock size in the period between that vaccination campaign and the next compared with those that did not vaccinate (p = 0.018); and (b) households with larger chicken flocks at the time of vaccination were significantly more likely to participate in vaccination programs (p < 0.001). Additionally, households vaccinating in all three vaccination campaigns held over 12 months were identified to have significantly larger chicken flocks at the end of this period (p < 0.001). Opportunities to understand causality and complexity through quantitative analyses are limited, and there is a role for qualitative approaches to explore decisions made by poultry-keeping households and the motivations, challenges and priorities of community vaccinators. Evidence of a bi-directional relationship, however, whereby vaccination leads to greater chicken numbers, and larger flocks are more likely to be vaccinated, offers useful insights into the efficacy of fee-for-service animal health programs. This article concludes that attention should be focused on ways of supporting the participation of vulnerable households in ND vaccination campaigns, and encouraging regular vaccination throughout the year, as a pathway to strengthen food security, promote resilience and contribute to improved human nutrition.
Collapse
Affiliation(s)
- Julia de Bruyn
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Peter C. Thomson
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
| | - Brigitte Bagnol
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- International Rural Poultry Centre, KYEEMA Foundation, Brisbane, QLD, Australia
- Department of Anthropology, University of Witswatersrand, Johannesburg, South Africa
| | - Wende Maulaga
- Central Veterinary Laboratory, Tanzania Veterinary Laboratory Agency, Dar es Salaam, Tanzania
| | - Elpidius Rukambile
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
- Central Veterinary Laboratory, Tanzania Veterinary Laboratory Agency, Dar es Salaam, Tanzania
| | - Robyn G. Alders
- School of Life and Environmental Sciences, University of Sydney, Sydney, NSW, Australia
- Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
- International Rural Poultry Centre, KYEEMA Foundation, Brisbane, QLD, Australia
| |
Collapse
|
5
|
Colvin CJ, Smith HJ, Swartz A, Ahs JW, de Heer J, Opiyo N, Kim JC, Marraccini T, George A. Understanding careseeking for child illness in sub-Saharan Africa: a systematic review and conceptual framework based on qualitative research of household recognition and response to child diarrhoea, pneumonia and malaria. Soc Sci Med 2013; 86:66-78. [PMID: 23608095 DOI: 10.1016/j.socscimed.2013.02.031] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Revised: 02/18/2013] [Accepted: 02/18/2013] [Indexed: 01/31/2023]
Abstract
Diarrhoea, pneumonia and malaria are the largest contributors to childhood mortality in sub-Saharan Africa. While supply side efforts to deliver effective and affordable interventions are being scaled up, ensuring timely and appropriate use by caregivers remains a challenge. This systematic review synthesises qualitative evidence on the factors that underpin household recognition and response to child diarrhoea, pneumonia and malaria in sub-Saharan Africa. For this review, we searched six electronic databases, hand searched 12 journals from 1980 to 2010 using key search terms, and solicited expert review. We identified 5104 possible studies and included 112. Study quality was appraised using the Critical Appraisal Skills Program (CASP) tool. We followed a meta-ethnographic approach to synthesise findings according to three main themes: how households understand these illnesses, how social relationships affect recognition and response, and how households act to prevent and treat these illnesses. We synthesise these findings into a conceptual model for understanding household pathways to care and decision making. Factors that influence household careseeking include: cultural beliefs and illness perceptions; perceived illness severity and efficacy of treatment; rural location, gender, household income and cost of treatment. Several studies also emphasise the importance of experimentation, previous experience with health services and habit in shaping household choices. Moving beyond well-known barriers to careseeking and linear models of pathways to care, the review suggests that treatment decision making is a dynamic process characterised by uncertainty and debate, experimentation with multiple and simultaneous treatments, and shifting interpretations of the illness and treatment options, with household decision making hinging on social negotiations with a broad variety of actors and influenced by control over financial resources. The review concludes with research recommendations for tackling remaining gaps in knowledge.
Collapse
Affiliation(s)
- Christopher J Colvin
- Centre for Infectious Disease Epidemiology and Research, Falmouth 5.49, School of Public Health and Family Medicine, University of Cape Town, Observatory 7925, Cape Town, South Africa.
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Glover M, Waldon J, Manaena-Biddle H, Holdaway M, Cunningham C. Barriers to best outcomes in breastfeeding for Māori: mothers' perceptions, whānau perceptions, and services. J Hum Lact 2009; 25:307-16. [PMID: 19286841 DOI: 10.1177/0890334409332436] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This research explores the perceptions of New Zealand Māori women and their whānau (customary Māori extended family) toward barriers to achieving best outcomes in infant feeding: exclusively breastfed infants at 6 months. Interviews are undertaken with 59 Māori women who have given birth in the previous 3 years and 27 whānau members. Although mothers and whānau members feel positively toward breastfeeding and generally expect to breastfeed exclusively, these expectations are unmet in many cases because of lack of support when establishing breastfeeding; lack of support when life circumstances change; lack of timely, culturally relevant, and comprehensible information; confusion about smoking while breastfeeding; uncertainty about the safety of bed-sharing, and perceived lack of acceptability of breastfeeding in public. The relatively high rates of tobacco use by Māori create a tension for breastfeeding mothers, cited by some as a reason for ending breastfeeding prematurely.
Collapse
Affiliation(s)
- Marewa Glover
- Auckland Tobacco Control Research Centre, Social & Community Health, School of Population Health, University of Auckland, Auckland, New Zealand.
| | | | | | | | | |
Collapse
|
7
|
Simondon KB. Early breast-feeding cessation and infant mortality in low-income countries: workshop summary. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2008; 639:319-29. [PMID: 19227552 DOI: 10.1007/978-1-4020-8749-3_23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- K B Simondon
- Epidemiology and Prevention Research Unit, Institut de Recherche pour le Diveloppement, 911, Avenue Agropolis, BP 64501, 34394 Montpellier, France.
| |
Collapse
|
8
|
Pelto GH, Levitt E, Thairu L. Improving feeding practices: current patterns, common constraints, and the design of interventions. Food Nutr Bull 2003; 24:45-82. [PMID: 12664527 DOI: 10.1177/156482650302400104] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We propose a set of "best-practice complementary feeding behaviors," which were derived by combining principles of psychosocial care with current knowledge in nutritional sciences. We provide a theoretical rationale for assessing and describing complementary feeding practices in terms of what is fed, how food is prepared and given, who feeds the child, when food is fed (frequency and scheduling), and the feeding environment (where). We also discuss the significance of selected sociocultural determinants of these practices for the design of interventions. We then review 18 case studies in relation to these practices and their determinants. The exercise, in which we abstracted data from ethnographic reports, revealed areas of congruence and deviations from best-practice behaviors. The data on feeding practices are described with a common framework to facilitate comparison across sites. Key themes emerging from the studies include the significance of the larger family, the effects of competing maternal time demands, and the importance of parental perceptions and cultural constructs in affecting complementary feeding practices. Finally, we discuss the implications of the findings for future interventions.
Collapse
Affiliation(s)
- Gretel H Pelto
- Division of Nutritional Sciences, Cornell University, Ithaca, New York, USA
| | | | | |
Collapse
|
9
|
Mabilia M. Beliefs and practices in infant feeding among the Wagogo of Chigongwe (Dodoma rural district), Tanzania. II. Weaning. Ecol Food Nutr 2002; 35:209-17. [PMID: 12321374 DOI: 10.1080/03670244.1996.9991490] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
10
|
Sellen DW. Anthropological Approaches to Understanding the Causes of Variation in Breastfeeding and Promotion of “Baby Friendly” Communities. ACTA ACUST UNITED AC 2002. [DOI: 10.1525/nua.2002.25.1.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
11
|
Sellen DW. Comparison of infant feeding patterns reported for nonindustrial populations with current recommendations. J Nutr 2001; 131:2707-15. [PMID: 11584094 DOI: 10.1093/jn/131.10.2707] [Citation(s) in RCA: 85] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The observation that young child-feeding practices rarely conform to current global recommendations is of major public health nutrition policy concern and raises questions about whether near-universal compliance with recommendations is feasible in any population. This analysis uses indicators of age at introduction of complementary foods and termination of breastfeeding available from ethnographic and demographic reports published between 1873 and 1998 to test the hypothesis that recent and contemporary nonindustrial societies practice patterns of infant feeding concordant with current global recommendations. Results suggest that ethnographically reported average ages at introduction of nonbreast milk liquids (4.5 +/- 6.0 mo) and solids (5.0 +/- 4.0 mo) and the duration of breastfeeding (29.0 +/- 10.0 mo) among a sample of 113 such populations concord with those at which key weaning transitions are biologically optimal for most normal healthy children. However, wide variation in estimates across populations remains unexplained and serious limitations in the available data preclude proper assessment of the underlying distribution of the timing of weaning transitions within populations.
Collapse
Affiliation(s)
- D W Sellen
- Department of Anthropology and International Health, Emory University, Atlanta, GA 30322, USA.
| |
Collapse
|
12
|
Sellen DW, Smay DB. Relationship between subsistence and age at weaning in “preindustrial” societies. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2001; 12:47-87. [DOI: 10.1007/s12110-001-1013-y] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/1999] [Accepted: 02/11/2000] [Indexed: 10/23/2022]
|
13
|
|