Pathways linking social support, self-efficacy, and exclusive breastfeeding among women in northern Uganda

Social realities in remote villages: Infant and young child feeding in Kirewa, Uganda

Understanding infant and young child feeding (IYCF) practices in Africa requires an examination of the social context. Social relationships influence people through mechanisms such as social support, social influence, social engagement, access to resources and negative social interactions. This study explores how these mechanisms manifest in IYCF in remote villages in Uganda. In 2018, we conducted two focus group discussions each with mothers, fathers and grandparents, ande interviews with two clan leaders, six village health teamers (VHT) and four healthcare workers (HCW). We deductively searched the data for any indications of elements that could influence child feeding and health using the psychosocial mechanisms of social support, social influence, social engagement, access to resources and negative social interactions as the broader themes. The manifestation of social support involved practical help from mothers-in-law (MIL), financial contributions from fathers, and informational, instrumental, emotional and appraisal support from VHTs. Social influence by MILs mainly concerned the transmission of food-related beliefs and pressure to have many children. The social engagement of young mothers was restricted. Access to resources was stratified and affected by poverty, patriarchy, and knowledge of HCWs and VHTs. Negative social interactions included physical abuse, alcoholism, and fear-based relationships. We found the different psychosocial mechanisms to construct a useful framework for describing the social reality surrounding IYCF. Changing attitudes towards family planning, involving fathers in IYCF, and strengthening the position of VHTs as family advisers can potentially improve IYCF in rural Uganda.

A Scoping Review of Instruments Used in Measuring Social Support among Refugees in Resettlement

This study aimed to systematically review current research on the application of existing social support scales in research with refugees in resettlement, assess their quality, and identify gaps in measurement to enhance research and practice. A scoping review was conducted on the extant literature published until March 2023. A team of researchers conducted search, sorting, and data extraction processes following best practices for scale development and validation. Of the 1185 studies collected from the search process, 41 articles were retained in the final analysis, from which 17 distinct social support instruments used in research with resettled refugees were identified. An assessment of all 17 instruments showed the presence of one or more limitations associated with construct, criterion, convergent, and/or discriminant validity. Test of reliability was assessed in all studies, with a range of 0.80 to 0.90. Our findings show that most of the research evaluating social support among resettled refugees is conducted without measurement instruments adequately validated in the resettlement context. This analysis highlights the need for rigorously developed social support scales that reflect the lived experiences, needs, and priorities of resettled refugees.

Mother's milk-mother's gift: Mobile-based training to increase self-efficacy of nursing women during postpartum and puerperium: A quasi-experimental study

BACKGROUND

The World Health Organization recommends exclusive breastfeeding for 6 months followed by continued breastfeeding with complementary food up to 2 years of age or beyond. This study aimed to investigate the effect of mobile -based education on the self-efficacy of lactating women in the postpartum period.

METHODS

A quasi-experimental study was carried out in 2018 in Shirvan, Iran among 69 postpartum women. Participants were assigned to intervention (n = 33) and control (n = 36) groups on the first day after delivery by random allocation. Intervention group received the mobile-based training for 4 weeks in the form of text messages, photos, video clips, and audio files. The control group received routine hospital care and training. Data were collected on demographic characteristics, delivery information, and the breastfeeding self-efficacy. Self-efficacy was measured in two groups at three time points; the first day after delivery, 4 weeks after delivery and 8 weeks after delivery.

FINDINGS

The mean and standard deviation of breastfeeding self-efficacy score was higher in the intervention than control group 4 weeks (155.30 ± 10.93 vs 132.52 ± 19.70, P < 0.001) and 8 weeks after delivery (160.18 ± 11.33 vs 132.30 ± 24.09, P < 0.001). Compared to the control group, the rate of exclusive breastfeeding in the intervention group was significantly higher 4 and 8 weeks after the delivery (Pall < 0.05).

DISCUSSION

The findings from this study showed a substantial increase in breastfeeding self-efficacy and exclusive breastfeeding in the group who received training through mobile-based education compared to the group that received routine care.

APPLICATION TO PRACTICE

Mobile-based breastfeeding education might be a promising strategy to increase breastfeeding self-efficacy. It is suggested that midwives include the design of mobile-based educational programs as part of their educational strategies and use the advantages of this educational method during pregnancy and after childbirth.

TRAIL REGISTRATION

This article has been registered in Iran's Clinical Trial Center with the code: 2 N20171024036972 IRCT.

Breastfeeding experience of postnatal mothers separated from preterm infants after discharge: a phenomenology qualitative approach

BACKGROUND

Breastfeeding practices are influenced by the maternal-infant bond relationship. Mothers of preterm infants in the puerperium face many challenges and support is needed to maintain breastfeeding after hospital discharge. This study explored the breastfeeding experiences among mothers of preterm infants and challenges that influenced their breastfeeding practices.

METHODS

A qualitative phenomenological approach was used involving the mothers of preterm infants during the puerperium in Shanghai who fulfilled the inclusion criteria and consented to participate in the study. The mothers were recruited using purposive sampling. Eighteen participants were interviewed using semi-structured in-depth interviews. All interviews were recorded in digital audio, transcribed verbatim, and analyzed using thematic analysis.

FINDINGS

The breastfeeding experience among mothers of preterm infants included four themes: breastfeeding motivation, breastfeeding challenges, breastfeeding support and education, and response to parental stress. Breastfeeding challenges included perceived insufficient milk, bottle preference, and maternal-infant separation. Two sub-themes of breastfeeding support included breastfeeding knowledge and approach.

CONCLUSION

To overcome breastfeeding challenges and improve the breastfeeding rate of preterm infants after discharge, medical professionals must develop individualized breastfeeding plans based on a comprehensive assessment of the needs of mothers who delivered a preterm infant.