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Kyei-Arthur F, Aballo J, Mahama AB, Adu-Afarwuah S. Infant and young child feeding practices among mothers in the pilot Micronutrient Powder Initiative in four geographically and ethnically diverse districts in Ghana. PLoS One 2024; 19:e0307961. [PMID: 39088512 PMCID: PMC11293642 DOI: 10.1371/journal.pone.0307961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 07/15/2024] [Indexed: 08/03/2024] Open
Abstract
In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age. The KIIs and FGDs were audio-taped, transcribed verbatim, and analyzed thematically using NVivo 10. Three themes emerging from the KIIs and FGDs were: level of adherence to IYCF recommendations among mothers and caregivers; IYCF recommendations perceived as the hardest to follow; and perceived motivators, facilitators, and barriers to IYCF practices. Mothers in the four districts generally followed the eight IYCF recommendations. Mothers in the Tolon district demonstrated adherence to IYCF practices, often citing the need for early initiation of breastfeeding, timely introduction of complementary feeding, and feeding children aged 9-23 months 3 times daily in addition to breastfeeding. In contrast, mothers in other districts faced challenges that hindered adherence. Giving children 4 or more food groups and timely introduction of complementary feeding were perceived as the hardest practices to follow. The main facilitators of IYCF practices include midwives and frontline nurses teaching mothers how to breastfeed, and midwives ensuring mothers initiate breastfeeding immediately after delivery. The main barriers to IYCF practices identified were insufficient breastmilk; mothers-in-law giving water to children before six months; resumption of work; and lack of financial means. Mothers in the Ho West district reported more barriers to IYCF practices, followed by mothers in the Tain, Talensi, and Tolon districts. Health practitioners, stakeholders, and policymakers should design targeted interventions that address the contextual barriers to improve IYCF practices in the various districts.
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Affiliation(s)
- Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | | | | | - Seth Adu-Afarwuah
- Department of Nutrition and Food Science, University of Ghana, Legon, Accra, Ghana
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Mgongo M, Ickes SB, Leyaro BJ, Mboya IB, Grounds S, Seiger ER, Hashim TH, Conklin JL, Kimani-Murage EW, Martin SL. Early Infant Feeding Practices among Women Engaged in Paid Work in Africa: A Systematic Scoping Review. Adv Nutr 2024; 15:100179. [PMID: 38246350 PMCID: PMC10877690 DOI: 10.1016/j.advnut.2024.100179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 01/23/2024] Open
Abstract
Around the world, paid work without appropriate structural support is a key barrier to optimal breastfeeding practices. To better protect, promote, and support optimal breastfeeding practices among working women in Africa, this scoping review sought to understand how paid work influences infant feeding practices in the first 6 mo of life and what support women need to manage work and optimal infant feeding practices. We systematically searched PubMed, Scopus, Global Health, and CINAHL Plus, screened 2436 abstracts, and reviewed 322 full-text articles using Covidence for review and charting. We identified 203 articles that met the inclusion criteria. We identified 32 quantitative, 10 qualitative, 3 mixed-methods, and 2 review articles that focused on examining the relationship between work and breastfeeding, and 109 quantitative, 22 qualitative, 21 mixed-methods, and 4 review articles that included work as part of broader breastfeeding research but did not focus on work. Most studies reported a significant negative association between work and exclusive breastfeeding. Three major domains were reported in the qualitative studies: challenges to managing work and infant feeding, receiving support from employers and family members/caregivers, and strategies for feeding infants when the mother is working. Reviewed studies proposed recommendations to increase support for breastfeeding through changes to policies and support within worksites, the health system, and childcare; however, evidence of previously implemented policies or programs is limited. We recommend more consistent definitions and measurement of women's work. Future research is needed on the impact of implementing various strategies and benefits for breastfeeding at workplaces, as well as efforts to support breastfeeding among informal workers.
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Affiliation(s)
- Melina Mgongo
- Institute of Public Health, Department of Community and Global Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Better Health for the African Mother and Child, Moshi, Tanzania.
| | - Scott B Ickes
- Department of Biological and Health Sciences, Wheaton College, Wheaton, IL, United States; Kenya Medical Research Institute, Nairobi, Kenya; Program in Nutritional Sciences, and Department of Health Systems and Population Health, University of Washington, Seattle, WA, United States; Department of Kinesiology and Health Sciences, William and Mary, WIlliamsburg, VA, United States
| | - Beatrice J Leyaro
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Innocent B Mboya
- Institute of Public Health, Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania; Department of Translational Medicine, Lund University, Malmo, Sweden
| | - Samantha Grounds
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Emily R Seiger
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tamara H Hashim
- Institute of Public Health, Department of Community and Global Health, Kilimanjaro Christian Medical University College (KCMUCo), Moshi, Tanzania
| | - Jamie L Conklin
- Health Sciences Library, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | | | - Stephanie L Martin
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Makwela MS, Mashaba RG, Ntimana CB, Seakamela KP, Maimela E. Barriers and enablers to exclusive breastfeeding by mothers in Polokwane, South Africa. Front Glob Womens Health 2024; 5:1209784. [PMID: 38414908 PMCID: PMC10897026 DOI: 10.3389/fgwh.2024.1209784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 01/31/2024] [Indexed: 02/29/2024] Open
Abstract
Background Exclusive breastfeeding (EBF) for six months, with the introduction of appropriate complementary feeding thereafter, and breastfeeding continuing for up to 2 years and beyond, is highly recommended. This could save the lives of up to 1.4 million children each year worldwide. Despite this, breastfeeding rates in South Africa remain sub-optimal, with the recommended target of 50% by the World Health Assembly (WHA) not being achieved. The study aimed to investigate the reasons influencing mothers' practice of exclusive breastfeeding in the Polokwane municipality of Limpopo province in South Africa. Methodology A cross-sectional health facility-based quantitative and descriptive survey was conducted using a validated-structured questionnaire administered to 146 mothers. The data was analyzed using STATA. Chi-square tests were used to determine the relationship between selected demographic variables and their reasons not to breastfeed exclusively. Results Although 94% of the mothers had initiated breastfeeding, at the time of data collection 8% had stopped. Of those who had stopped breastfeeding, 5% did so within one month of starting. Thirty- nine percent of mothers' breastfed exclusively, while 61% practiced mixed feeding. A positive association between exclusive breastfeeding practices and the age of the mother were observed, with older mothers more likely to breastfeed. The reasons mothers stopped breastfeeding were: the mother was ill (45%) or they returned to school or work (27%). Reasons for not breastfeeding were cited as: medical conditions, not enough milk, and infant refusal to breastfeed (33%). Mothers believe that HIV-positive women should breastfeed their infants (57%), and health workers were found to be the main source of HIV information to mothers (77%). Discussion Exclusive breastfeeding during the first six months was less practiced. Infant formula and solid foods were introduced at an early age, usually within the first month of breastfeeding. This study sheds light on factors influencing the early initiation of breastfeeding and the practice of EBF as practiced in Polokwane.
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Affiliation(s)
- Maishataba Solomon Makwela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- Department of Human Nutrition and Dietetics, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - Reneilwe Given Mashaba
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Cairo Bruce Ntimana
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Kagiso Peace Seakamela
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
| | - Eric Maimela
- Department of Public Health, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
- DIMAMO Population Health Research Centre, University of Limpopo, Polokwane, South Africa
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Hassan MS, Hossain MM. Challenges for influencing exclusive breastfeeding practice among lactating mothers with infants aged 0-6 months in Borama District, Somaliland: A cross-sectional study. Health Sci Rep 2023; 6:e1693. [PMID: 37936617 PMCID: PMC10626030 DOI: 10.1002/hsr2.1693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/18/2023] [Accepted: 10/23/2023] [Indexed: 11/09/2023] Open
Abstract
Background and Aims Exclusive breastfeeding (EBF) has been demonstrated to have positive effects on a child's survival, growth, and development, as well as a mother's health and well-being. The authors aim to examine the barriers to EBF among lactating mothers in Borama town, Somaliland, with infants aged <6 months. Methods The authors collected primary data on a sample of 153 lactating mothers in Borama town, Somaliland, for this study. This study used descriptive statistics with frequencies and percentages. Moreover, the multivariable logistic regression model is applied to analyze the data. Results Findings revealed that about 28.1% of mothers pointed out that breastfeeding should be the baby's first meal. Surprisingly, 69.3% of the women were unaware that 6 months of EBF may keep a baby healthy. Results depict that EBF was influenced by lack of education (AOR: 0.013; 95% Cl: 0.001, 0.124), marital status (AOR: 0.40; 95% Cl: 0.004, 0.427), employed mothers (AOR: 0.070; 95% Cl: 0.043, 0.94), mothers perception of milk quantity (AOR: 0.033; 95% Cl: 0.001, 0.124), and perceived rejection to breastfeeding by the baby (AOR: 0.043; 95% Cl: 0.021, 0.134). Mothers who had no formal education or a primary level of education have less chance of practicing EBF than higher-educated mothers. Conclusions It is observed that the educational level of mothers, marital status (widow), employed mother, perceived insufficient milk, and the perceived rejection of breastfeeding by the baby are the major challenges for enhancing the EBF practice. The authors suggested that the Ministry of Health examine how effectively breastfeeding counseling is implemented in medical facilities. Moreover, the authors suggest that the government, nongovernmental organizations (NGOs), and community associations collaboratively plan and carry out suitable programs focusing on vulnerable groups.
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Affiliation(s)
- Mohamed Said Hassan
- Department of Public HealthAmoud UniversityBoramaAwdal RegionSomalia
- Departemnt of Public HealthHorn International UniversityBoramaSomalia
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Abraham M, Lak MA, Gurz D, Nolasco FOM, Kondraju PK, Iqbal J. A Narrative Review of Breastfeeding and Its Correlation With Breast Cancer: Current Understanding and Outcomes. Cureus 2023; 15:e44081. [PMID: 37750138 PMCID: PMC10518059 DOI: 10.7759/cureus.44081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/24/2023] [Indexed: 09/27/2023] Open
Abstract
Breastfeeding has been extensively studied in relation to breast cancer risk. The results of the reviewed studies consistently show a decreased risk of breast cancer associated with breastfeeding, especially for 12 months or longer. This protective effect is attributed to hormonal, immunological, and physiological changes during lactation. Breastfeeding also appears to have a greater impact on reducing breast cancer risk in premenopausal women and specific breast cancer subtypes. Encouraging breastfeeding has dual benefits: benefiting infants and reducing breast cancer risk long-term. Healthcare professionals should provide evidence-based guidance on breastfeeding initiation, duration, and exclusivity, while public health policies should support breastfeeding by creating enabling environments. This review examines the existing literature and analyzes the correlation between breastfeeding and breast cancer risk.
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Affiliation(s)
- Merin Abraham
- Department of Internal Medicine, Kasturba Medical College, Manipal, IND
| | - Muhammad Ali Lak
- Department of Internal Medicine, Combined Military Hospital, Lahore, PAK
| | - Danyel Gurz
- Department of Internal Medicine, Combined Military Hospital, Lahore, PAK
| | | | | | - Javed Iqbal
- Department of Neurosurgery, Mayo Hospital, Lahore, PAK
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Seabela ES, Modjadji P, Mokwena KE. Facilitators and barriers associated with breastfeeding among mothers attending primary healthcare facilities in Mpumalanga, South Africa. Front Nutr 2023; 10:1062817. [PMID: 36998907 PMCID: PMC10043338 DOI: 10.3389/fnut.2023.1062817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/10/2023] [Indexed: 03/15/2023] Open
Abstract
IntroductionDespite the health benefits of breastfeeding for both the mother and the child, early cessation of breastfeeding remains a public health problem in South Africa, attributed to contextual barriers and facilitators. Within the context of Mpumalanga province, which is characterized by low breastfeeding rates and high infant mortality rates in children under 5 years, we explored the facilitators and barriers to breastfeeding among mothers attending the three primary health facilities in Ermelo.MethodsUsing a semi-structured interview guide suggested by the socio-ecological model, three focus group discussions and 12 in-depth interviews were conducted among mothers selected using a purposive sampling. Transcripts from audiotaped and transcribed verbatim interviews were assessed through thematic analysis using NVivo version 10.ResultsMothers were aged between 18 and 42 years and from poor sociodemographic backgrounds. At the individual level, mothers valued breastfeeding facilitated by their commitment, maintaining it, eating healthy foods, and having sufficient breast milk. However, returning to work, insufficient breast milk, misconceptions about breastfeeding, and interference with social life were the barriers for mothers to breastfeed continuously. At the interpersonal level, the family was identified as the main form of support to breastfeeding mothers; however, family interference was also identified as a barrier. At the community level, mothers shared some family beliefs and practices but were still split between societal and cultural norms and traditional beliefs as facilitators or barriers to breastfeeding. At the organizational level, most mothers valued the support provided by healthcare workers on childcare and techniques for breastfeeding at the health facilities. They did however articulate concerns on the miscommunication some healthcare workers offered regarding breastfeeding, which negatively influenced their infant feeding practices.DiscussionIntervention efforts should focus on behaviour change to educate and equip mothers to overcome the barriers that are within their control. Such interventions should further focus on family-centered education and strengthening the proficiency of healthcare workers on advising breastfeeding mothers.
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Affiliation(s)
- Ethel Sekori Seabela
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
| | - Perpetua Modjadji
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
- Non-Communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa
- *Correspondence: Perpetua Modjadji
| | - Kebogile Elizabeth Mokwena
- Department of Public Health, School of Health Care Sciences, Sefako Makgatho Health Sciences University, Ga-Rankuwa, Pretoria, South Africa
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Pereira-Kotze C, Feeley A, Doherty T, Faber M. Maternity protection entitlements for non-standard workers in low-and-middle-income countries and potential implications for breastfeeding practices: a scoping review of research since 2000. Int Breastfeed J 2023; 18:9. [PMID: 36710359 PMCID: PMC9885632 DOI: 10.1186/s13006-023-00542-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/07/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Recommended breastfeeding practices contribute to improved health of infants, young children, and mothers. Access to comprehensive maternity protection would enable working women to breastfeed for longer. Women working in positions of non-standard employment are particularly vulnerable to not accessing maternity protection entitlements. The objective of this scoping review was to determine the current research conducted on maternity protection available and accessible to non-standard workers in low-and-middle-income countries and any potential implications for breastfeeding practices. METHODS Nine databases were searched using search terms related to maternity protection, non-standard employment, and breastfeeding. Documents in English published between January 2000 and May 2021 were included. The approach recommended by the Joanna Briggs Institute was used to select sources, extract, and present data. The types of participants included in the research were female non-standard workers of child-bearing age. The core concept examined by the scoping review was the availability and access to comprehensive maternity protection entitlements of pregnant and breastfeeding women. Research from low-and-middle-income countries was included. The types of evidence sources were limited to primary research. RESULTS Seventeen articles were included for data extraction mainly from research conducted in Africa and Asia. Research on maternity protection for non-standard workers mostly focused on childcare. Components of maternity protection are inconsistently available and often inaccessible to women working in non-standard employment. Inaccessibility of maternity protection was described to disrupt breastfeeding both directly and indirectly, but certain characteristics of non-standard work were found to be supportive of breastfeeding. CONCLUSIONS Published information on maternity protection for non-standard workers is limited. However, the available information indicates that non-standard workers have inadequate and inconsistent access to maternity protection rights. The expansion of comprehensive maternity protection to all women working in positions of non-standard employment could encourage significant social and economic benefits.
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Affiliation(s)
| | - Alison Feeley
- grid.11951.3d0000 0004 1937 1135South African Medical Research Council (SAMRC) Developmental Pathways for Health Research Unit (DPHRU), School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Tanya Doherty
- grid.8974.20000 0001 2156 8226School of Public Health, University of the Western Cape (UWC), Cape Town, South Africa ,grid.415021.30000 0000 9155 0024 Health Systems Research Unit, South African Medical Research Council (SAMRC), Cape Town, South Africa
| | - Mieke Faber
- grid.415021.30000 0000 9155 0024 Non-communicable Diseases Research Unit, South African Medical Research Council (SAMRC), Cape Town, South Africa ,grid.8974.20000 0001 2156 8226 Department of Dietetics and Nutrition, University of the Western Cape, Cape Town, South Africa
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Okal JO, Sarna A, Lango D, Matheka J, Owuor D, Kinywa EA, Kalibala S. Client Experiences in a Mobile-Phone Counseling Intervention for Enhancing Access to Prevention of Mother To-Child Transmission (PMTCT) Services in Kenya. Front Glob Womens Health 2022; 3:785194. [PMID: 35720809 PMCID: PMC9204057 DOI: 10.3389/fgwh.2022.785194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 04/12/2022] [Indexed: 11/25/2022] Open
Abstract
Background The prevention of mother-to-child transmission (PMTCT) is considered one of the most successful HIV prevention strategies in detecting and reducing HIV acquisition in utero or at birth. It is anticipated that with the increasing growth of digital technologies mobile phones can be utilized to enhance PMTCT services by improving provider-client interactions, expanding access to counseling services, and assisting in counteracting social and structural barriers to uptake of PMTCT services. Understanding the subjective experiences of women accessing PMTCT services in different settings has the potential to inform the development and promotion of such methods. This paper explores the perspectives of HIV-positive pregnant women attending maternal and neonatal clinic services in Kisumu, Kenya. Methods Data are reported from in-depth interviews with women, following a longitudinal study investigating the impact of a structured, counselor-delivered, mobile phone counseling intervention to promote retention in care and adherence to ARV prophylaxis/treatment, for HIV-positive pregnant women. Thematic content analysis was conducted. Results Discussions indicated that mobile-phone counseling provided useful health-related information, enhanced agency, and assisted mothers access critical PMTCT services across the cascade of care. Similarly, mobile-phone counseling offered personalized one-to-one contact with trained health providers including facilitating discussion of personal issues that likely affect access to services. Findings also identified barriers to the uptake of services, including a lack of partner support, poor health, poverty, facility-related factors, and provider attitudes. Discussion Overall, findings show that mobile-phone counseling is feasible, acceptable, and can enhance access to PMTCT services by overcoming some of the individual and facility-level barriers. Although mobile-phone counseling has not been routinized in most health facilities, future work is needed to assess whether mobile-phone counseling can be scaled-up to aid in the effective use of HIV and PMTCT services, as well as improving other related outcomes for mother and child dyad.
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Affiliation(s)
- Jerry Okoth Okal
- Population Council, Nairobi, Kenya
- *Correspondence: Jerry Okoth Okal
| | | | | | | | | | | | - Sam Kalibala
- Population Council, Washington, DC, United States
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Onwuka C. A cross-sectional study of determinants of exclusive breastfeeding among working mothers in Enugu. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2022; 12:75-80. [PMID: 36213806 PMCID: PMC9536408 DOI: 10.4103/jwas.jwas_102_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022]
Abstract
Introduction: The practice of exclusive breastfeeding (EBF) has remained low despite its benefits. This is worsened when the woman has to combine breastfeeding with work in order to support her family. Objective: The objective was to determine the factors influencing EBF among working mothers in Enugu, South-eastern Nigeria. Materials and Methods: This was a questionnaire-based study of 315 nursing mothers in postpartum period, attending the immunisation centres of the Institute of Child Health of both University of Nigeria Teaching Hospital and Enugu State University Teaching Hospital. The information obtained was analysed using SPSS version 22. A P value of less than 0.05 was considered statistically significant. Results: Although 82.5% (n = 260) of the respondents were aware of EBF recommendation, only 69% (n = 217) practised EBF. A majority of the mothers (87%) initiated breastfeeding within 1 h of delivery. Ninety-nine percent of the mothers did not have workplace facilities (such as breastfeeding rooms, nursery, refrigerator, and privacy) that support breastfeeding practice. The main reasons for not practising EBF were pressure of work (40.8%, n = 40/98) and medical conditions (32.7%, n = 32/98). Low parity (P = 0.018) and registration for antenatal care in the hospital (P = 0.009) were significantly associated with EBF. Conclusion: The prevalence of EBF among working mothers in Enugu South-Eastern Nigeria is still suboptimal; thus there is a need for policy change in order to remove or mitigate associated factors. A multi-institutional national survey on the determinants of EBF among working mothers across the six geopolitical zones of the country may be necessary.
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Kinshella MLW, Prasad S, Hiwa T, Vidler M, Nyondo-Mipando AL, Dube Q, Goldfarb D, Kawaza K. Barriers and facilitators for early and exclusive breastfeeding in health facilities in Sub-Saharan Africa: a systematic review. Glob Health Res Policy 2021; 6:21. [PMID: 34229756 PMCID: PMC8259208 DOI: 10.1186/s41256-021-00206-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 06/10/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Sub-Saharan Africa carries a disproportionate burden of under-five child deaths in the world and appropriate breastfeeding practices can support efforts to reduce child mortality rates. Health facilities are important in the promotion of early and exclusive breastfeeding. The purpose of this review was to examine facility-based barriers and facilitators to early and exclusive breastfeeding in Sub-Saharan Africa. METHODS A systematic search was conducted on Medline, Web of Science, CINAHL, African Journals Online and African Index Medicus from database inception to April 29, 2021 and primary research studies on breastfeeding practices in health facilities in Sub-Saharan Africa were included in the review. We assessed qualitative studies with the Critical Appraisal Skills Programme Qualitative Checklist and quantitative studies using the National Heart, Lung, and Blood Institute tool. The review protocol was registered to Prospero prior to conducting the review (CRD42020167414). RESULTS Of the 56 included studies, relatively few described health facility infrastructure and supplies-related issues (5, 11%) while caregiver factors were frequently described (35, 74%). Facility-based breastfeeding policies and guidelines were frequently available but challenged by implementation gaps, especially at lower health service levels. Facilitators included positive caregiver and health worker attitudes, knowledge and support during the postpartum period. Current studies have focused on caregiver factors, particularly around their knowledge and attitudes, while health facility infrastructure and supplies factors appear to be growing concerns, such as overcrowding and lack of privacy during breastfeeding counselling that lowers the openness and comfort of mothers especially those HIV-positive. CONCLUSION There has been a dramatic rise in rates of facility births in Sub-Saharan Africa, which must be taken into account when considering the capacities of health facilities to support breastfeeding practices. As the number of facility births rise in Sub-Saharan Africa, so does the responsibility of skilled healthcare workers to provide the necessary breastfeeding support and advice to caregivers. Our review highlighted that health facility infrastructure, supplies and staffing appears to be a neglected area in breastfeeding promotion and a need to strengthen respectful maternity care in the delivery of breastfeeding counselling, particularly in supporting HIV-positive mothers within the context of Sub-Saharan Africa.
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Affiliation(s)
- Mai-Lei Woo Kinshella
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Sarina Prasad
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Tamanda Hiwa
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Marianne Vidler
- Department of Obstetrics and Gynaecology, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Alinane Linda Nyondo-Mipando
- School of Public Health and Family Medicine, Department of Health Systems and Policy, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Queen Dube
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi
- Queen Elizabeth Central Hospital, Pediatrics, Blantyre, Malawi
| | - David Goldfarb
- Department of Pathology and Laboratory Medicine, BC Children's and Women's Hospital and University of British Columbia, Vancouver, Canada
| | - Kondwani Kawaza
- Department of Pediatrics and Child Health, College of Medicine, University of Malawi, Blantyre, Malawi.
- Queen Elizabeth Central Hospital, Pediatrics, Blantyre, Malawi.
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Moshi FV, Akyoo EE, Seif SA. Prevalence and Predictor of Exclusive Breastfeeding among Mothers of 0 to 6 months Infants from Pastoralists and Hunters' Community in Tanzania; A Community Based Cross-Sectional Study. East Afr Health Res J 2021; 5:82-90. [PMID: 34308249 PMCID: PMC8291207 DOI: 10.24248/eahrj.v5i1.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/04/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Initiating breastfeeding during the first hour after birth and continuing breastfeeding exclusively for 6 months prevents childhood infections such as diarrhoea. Exclusive breastfeeding (EBF) for the first 6 months of life of the baby is recognised globally as the best and the most effective intervention to ensure the survival of babies. The aim of this study was to determine the prevalence of EBF and its predictors among mothers of 0 to 6 months infants from pastoralists and hunters' community in Manyara region-Tanzania. METHODS This was a community-based analytical cross-sectional study that involved 342 mothers of 0 to 6 months infants who were randomly selected through 4 stage multistage sampling technique. Data was collected using an interviewer-administered questionnaire. Collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20. Binary Logistic Regression analysis was used to establish factors associated with EBF practices. RESULTS The prevalence of EBF among postnatal women from hunters and pastoralists societies was 47.1% at 95% CI=41.7%-52.5%. After adjusted for confounders, the predictors of EBF practice were age of infants (0-1 months, AOR = 2.838 at 95% CI = 1.326-6.075, p=.007), age of mothers (26-35 years, AOR=1.851 at 95% CI= 1.059-3.234, p=.031), Level of education of infants' mothers (primary education, AOR= 2.374 at 95% CI= 1.321-4.265, p=.004) and knowledge on exclusive breast feeding, AOR=2.51 at 95% CI= 1.435-4.393, p=.001. CONCLUSION Majority of mothers from pastoralists' and hunters' societies were not practising EBF. Predictors of EBF practice were; the age of infants, maternal age, level of education of the mother and knowledge on exclusive breastfeeding. Poor EBF practice was mainly contributed to low level of knowledge about the EBF. The low level of knowledge could have been contributed by poor access to maternal services. Nature of living (lack of permanent settlement) of the study population could have contributed to low access to maternal services. An innovative interventional study is highly recommended to come up with strategies that will improve knowledge on EBF and practice of EBF.
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Affiliation(s)
- Fabiola Vincent Moshi
- Department of Nursing Management and Education, School of Nursing and Public Health of University of Dodoma, Tanzania
| | - Esther E. Akyoo
- Department of Clinical Nursing, School of Nursing and Public Health of University of Dodoma
| | - Saada Ally Seif
- Department of Nursing Management and Education, School of Nursing and Public Health of University of Dodoma, Tanzania
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Kyei-Arthur F, Agyekum MW, Afrifa-Anane GF. The association between paternal characteristics and exclusive breastfeeding in Ghana. PLoS One 2021; 16:e0252517. [PMID: 34081726 PMCID: PMC8174696 DOI: 10.1371/journal.pone.0252517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/17/2021] [Indexed: 12/29/2022] Open
Abstract
Background Studies have shown that partners play an influential role in exclusive breastfeeding practice and that they can act as either deterrents or supporters to breastfeeding. However, there are limited studies on the influence of partners’ characteristics on exclusive breastfeeding in Ghana. This study examined the association between partners’ characteristics and exclusive breastfeeding in Ghana. Methods This cross-sectional study used data from the 2014 Ghana Demographic and Health Survey. Infants less than 6 months old (exclusively breastfed or not) with maternal and paternal characteristics were included in the study. A total of 180 participants were used for the study. A binary logistic regression was used to examine the influence of partners’ characteristics on exclusive breastfeeding. Results Partners’ characteristics such as education, desire for children, religion, and children ever born were associated with exclusive breastfeeding. Mothers whose partners had primary education (AOR = 0.12; CI 95%: 0.02–0.93; p = 0.04) were less likely to practice exclusive breastfeeding compared to those whose partners had no formal education. Also, mothers whose partners desired more children (AOR = 0.20; CI 95%: 0.06–0.70; p = 0.01) were less likely to practice exclusive breastfeeding compared to those whose partners desire fewer children. Conclusion Improving EBF requires the involvement of partners in exclusive breastfeeding campaigns/programmes. A more couple-oriented approach is required by health practitioners to educate and counsel both mothers and partners on the importance of exclusive breastfeeding in Ghana.
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Affiliation(s)
- Frank Kyei-Arthur
- Regional Institute for Population Studies, University of Ghana, Legon, Accra, Ghana
- * E-mail:
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13
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Shi H, Yang Y, Yin X, Li J, Fang J, Wang X. Determinants of exclusive breastfeeding for the first six months in China: a cross-sectional study. Int Breastfeed J 2021; 16:40. [PMID: 34001155 PMCID: PMC8130252 DOI: 10.1186/s13006-021-00388-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 05/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background Breast milk is the best source of essential nutrients and bioactive components for infants under 6 months. However, little is known about what affects breastfeeding intentions and practices of Chinese mothers. With measures of individual, setting, and sociocultural factors, this study examined determinants of exclusive breastfeeding in the first 6 months of infancy in China. Methods Data were obtained from a national cross-sectional survey in China in 2018 that included 5237 infants under 6 months with available measurements of breastfeeding. A 24-h reported food recall method was applied to assess breastfeeding and complementary food intake in the past 24 h. Potential breastfeeding determinants categorized into six aspects were measured: (1) infant health, (2) maternal sociodemographic characteristics, (3) maternal health, (4) breastfeeding support from family, friends, and workplace, (5) social support for breastfeeding, and (6) maternal breastfeeding experiences and knowledge. Reasons for non-commencement or early cessation of breastfeeding were evaluated for non-breastfed infants. For breastfed infants, multivariate logistic regression was used to explore the determinants of exclusive breastfeeding. Results About 30 % (29.5%) of infants under 6 months were exclusively breastfed; 2.3% (2.3%) had never been breastfed and 3.2% had ceased breastfeeding. No breast milk (60.7%), maternal illness (13.9%), and infant illness (13.1%) were the top three reasons for non-commencement of breastfeeding. Insufficient breast milk was the reason given for ceasing breastfeeding early by almost two thirds of caregivers who had stopped breastfeeding. The following factors were associated with exclusive breastfeeding: maternal higher education, formal employment with ≥6 months of paid maternity leave, support of the husband and best friends for breastfeeding, a breastfeeding-supportive society, and better breastfeeding knowledge and experiences (a previous successful breastfeeding experience ≥6 months and early initiation of breastfeeding). Maternal age of ≥40 years, caesarean delivery, and infant disease history were associated with non-exclusive breastfeeding. Conclusions The exclusive breastfeeding rate is still very low in China. Multidimensional barriers contribute to this situation. A comprehensive intervention framework is needed to increase optimal breastfeeding and achieve substantial public health gains.
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Affiliation(s)
- Huifeng Shi
- Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China
| | - Yumei Yang
- School of Economics and Management, Beijing Forestry University, Beijing, China
| | - Xiaohan Yin
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China
| | - Jia Li
- China Development Research Foundation, Beijing, China
| | - Jin Fang
- China Development Research Foundation, Beijing, China.
| | - Xiaoli Wang
- Department of Maternal and Child Health, Peking University School of Public Health, Beijing, China. .,National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
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14
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Patil DS, Pundir P, Dhyani VS, Krishnan JB, Parsekar SS, D'Souza SM, Ravishankar N, Renjith V. A mixed-methods systematic review on barriers to exclusive breastfeeding. Nutr Health 2020; 26:323-346. [PMID: 33000699 DOI: 10.1177/0260106020942967] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The World Health Organization recommends exclusive breastfeeding for every newborn during the first 6 months of life, yet women come across various challenges to continuing it. AIM This systematic review was intended to identify barriers to exclusive breastfeeding among mothers. METHODS MEDLINE, Cumulative Index to Nursing and Allied health literature, ProQuest, Web of Science and Scopus databases were searched from January 1990 to October 2017. The systematic review included quantitative, qualitative and mixed-methods studies to identify barriers to exclusive breastfeeding among mothers of reproductive age with an infant aged between 0 and 12 months. All studies were screened based on titles, abstracts and full text by two reviewers independently. The methodological quality of included studies was assessed using appropriate tools. Of the 9737 eligible records, 44 studies were included for analysis. Classification of barriers to exclusive breastfeeding was adopted from the conceptual framework of factors affecting breastfeeding practices given by Hector and colleagues. RESULTS In total 32 barriers were grouped under individual, group and society level factors. Meta-analysis indicated that mothers who smoked had 2.49 times more odds of not exclusively breastfeeding than non-smoking mothers and mothers who had undergone caesarean section had 1.69 times more risk of cessation of exclusive breastfeeding than mothers who have had a vaginal childbirth. CONCLUSION The systematic review revealed a complex interplay of various barriers related to exclusive breastfeeding. It is recommended that context-specific strategies should be designed in accordance with barriers existing in a region or country.
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Affiliation(s)
| | - Prachi Pundir
- Public Health Evidence South Asia, Prasanna School of Public Health, India
| | - Vijay Shree Dhyani
- Public Health Evidence South Asia, Prasanna School of Public Health, India
| | - Jisha B Krishnan
- Public Health Evidence South Asia, Prasanna School of Public Health, India
| | - Shradha S Parsekar
- Public Health Evidence South Asia, Prasanna School of Public Health, India.,Department of Community Medicine, Kasturba Medical College, India
| | | | - N Ravishankar
- Department of Statistics, Prasanna School of Public Health, India
| | - Vishnu Renjith
- Department of Neurology, 123320Sree Chitra Tirunal Institute for Medical Sciences and Technology, India
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15
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Ganle JK, Bedwei-Majdoub VM. Discontinuation of Exclusive Breastfeeding in Ghana: A Longitudinal, One-Group Observational Study of Postnatal Mothers With Children 0-6 Months old. J Hum Lact 2020; 36:461-470. [PMID: 31465696 DOI: 10.1177/0890334419871012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although exclusive breastfeeding of infants has several benefits, in Ghana only 52% of children under 6 months old are breastfed exclusively. However, researchers have not conducted longitudinal observational studies to examine exclusive breastfeeding discontinuation and determine risk factors. RESEARCH AIMS (1) To determine exclusive breastfeeding discontinuation, and (2) to examine those factors linked to discontinued exclusive breastfeeding. METHODS A longitudinal, one-group observational study was conducted. A total of 322 mothers who had normal and full-term delivery at a district level referral hospital from January to December 2017 were recruited, followed-up every month, and subsequently interviewed after 6 months postpartum. Data were collected using validated questionnaires. Binary and multivariable Poisson regression analyses were the statistical analytical methods used. RESULTS Respondents' mean age was 29.78 years (SD = 5.20). Among the 322 mothers who initiated breastfeeding with human milk at birth, 108 (34%) discontinued exclusive breastfeeding before 6 months postpartum. After controlling for possible covariates, attending antenatal care 4 or less times during pregnancy (aRR = 6.54; 95% CI [1.77-24.22]; p = .005); lack of support from family to breastfeed exclusively (aRR = 2.41; 95% CI [1.23-4.71]; p = .010), outside pressure to provide other food to the baby < 6 months postpartum (aRR = 1.87; 95% CI [1.01-3.46]; p = .045), and living in an urban area (aRR = 2.10; 95% CI [1.17-3.75]; p = .013) significantly increased the risks of discontinuing exclusive breastfeeding. CONCLUSION Universal exclusive breastfeeding may not be achieved without tackling the key determinants of discontinuation of exclusive breastfeeding. Health facility and community-based exclusive breastfeeding promotion interventions are therefore needed.
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Affiliation(s)
- John Kuumuori Ganle
- 260088 Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.,58835 Stellenbosch Institute for Advanced Study (STIAS), Wellenberg Research Centre at Stellenbosch University, Stellenbosch 7600, South Africa
| | - Vanessa-Marie Bedwei-Majdoub
- 260088 Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Social and Bio-Medical Predictors of Exclusive Breastfeeding Among Nursing Mothers in Lagos and Taraba States, Nigeria. J Pediatr Nurs 2020; 52:e96-e102. [PMID: 31864803 DOI: 10.1016/j.pedn.2019.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 12/01/2019] [Accepted: 12/01/2019] [Indexed: 11/23/2022]
Abstract
PURPOSE Although exclusive breastfeeding (EBF) is known to have positive consequences for mothers and infants, EBF rate in Nigeria is <25%. This study investigated if social factors were stronger predictors of EBF than bio-medical factors in the metropolitan areas of Lagos and Taraba States. Social factors included mother's education, infant sex, place of birth, and nature of mother's employment, while bio-medical factors included nature of birth (whether vaginal or caesarean section), problems with breast/nipple, breast milk insufficiency, and mother's age. DESIGN AND METHODS The study adopted a cross-sectional survey design and mixed method of data collection. From the two states, 500 mothers with babies between 7 and 12 months of age completed a structured questionnaire. Twenty respondents from each state were interviewed using an in-depth interview guide. RESULTS Education (β = 1.743; p < 0.001), infant sex (β = -0.454; p < 0.05), and place of delivery (β = -1.552; p < 0.001) were significant social predictors. Breast milk insufficiency (β = -1.851; p < 0.001) and mother's age (β = 0.064; p < 0.001) were significant bio-medical predictors. When all the eight factors were considered, only two of the three social factors, namely, education and infants' sex, remained significant, while three bio-medical factors, namely, breast milk insufficiency, mother's age, and nature of delivery, were significant. CONCLUSIONS Social and bio-medical factors co-determine the practice of EBF and must not be considered dichotomous. PRACTICAL IMPLICATIONS Interventions to encourage EBF among Nigerian mothers must focus on education regarding its benefits and correction of misconceptions that breast milk alone is insufficient as an infant's diet.
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Kebede T, Woldemichael K, Jarso H, Bekele BB. Exclusive breastfeeding cessation and associated factors among employed mothers in Dukem town, Central Ethiopia. Int Breastfeed J 2020; 15:6. [PMID: 32019563 PMCID: PMC7001375 DOI: 10.1186/s13006-019-0250-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 12/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Employed women tend to exclusively breastfeed less than non-employed women. Early returning to work has been major reason why employed women stop exclusive breastfeeding. The aim of this study was to investigate exclusive breastfeeding (EBF) cessation and associated factors among employed mothers in Dukem town, Central Ethiopia. METHODS A cross-sectional study was conducted from February to March 2015 using total sample of 313 randomly selected permanently employed women. Information regarding participants' work-related factors, health service and sociodemographic factors were collected by face to face interview using structured questionnaire. Data were checked for completeness, entered and analyzed by SPSS version 20. Binary logistic regression was done to identify factors associated with exclusive breastfeeding cessation. The strength of association was measured using odds ratio with 95% confidence intervals. RESULTS Prevalence of exclusive breastfeeding cessation was 75.7% (95% CI 71.0, 80.5%). Having a short duration of maternity leave (AOR 9.3; 95% CI 3.8, 23), being a full time employee (AOR 3.5; 95% CI 1.7, 11), being private organization employee (AOR=2.1, 95% CI(1, 4.3)), lack of flexible work time (AOR 3.0; 95% CI 1.2, 7.5), not pumping breast milk (AOR 4.3; 95% CI 1.7, 11), lack of a lactation break (AOR 6.7; 95% CI 3,14.5) and work place far away from her child (AOR 3.1; 95% CI 3.1, 6.3), were significantly associated with cessation of EBF among employed mothers. CONCLUSION Prevalence of exclusive breastfeeding cessation was much higher than the international and national expectation. The concerned governmental bodies should consider improving the legislation of the 3 months postpartum maternity leave to reduce employed mother's exclusive breastfeeding cessation.
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Affiliation(s)
- Tolossa Kebede
- Public Health Emergency Management and Health Research Office, Oromia Regional Health Bureau Addis Ababa, Addis Ababa, Ethiopia
| | - Kifle Woldemichael
- Department of Epidemiology, Institute of Health Sciences, Jimma University, 378, Jireen Street, Jimma, Ethiopia
| | - Habtemu Jarso
- Department of Epidemiology, Institute of Health Sciences, Jimma University, 378, Jireen Street, Jimma, Ethiopia
| | - Bayu Begashaw Bekele
- Department of Public Health, College of Health Sciences, Mizan Tepi University, Mizan Aman Street, 260,, Mizan Aman, Ethiopia.
- Doctoral School of Health Sciences, University of Debrecen, Debrecen, 4028, Hungary.
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Abstract
BACKGROUND Working mothers face unique barriers to breastfeeding, despite the compelling evidence of its benefits. The aim of this study was to describe exclusive breastfeeding (EBF) rate of working mothers and associated factors. METHODS Cross-sectional study was carried out in Mansoura District, Egypt from 1 July to 31 December 2017 among working mothers attending health care facilities for vaccinating their infants aged 6 months. Data were collected using a questionnaire covering sociodemographic and occupational data; breastfeeding supportive workplace facilities; antenatal and natal care; infant's data; and EBF practice. RESULTS EBF rate was 14.1%. Independent predictors were being still on work leave, return to work 4 months after childbirth, working as farmer/manual worker and in trades and business, and being self/family employed. CONCLUSIONS EBF rate is low among working mothers. There is a need to extend maternity leave and provide promoting workplace facilities.
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Affiliation(s)
- Hala Samir Abou-ElWafa
- Occupational Health and Industrial Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Abdel-Hady El-Gilany
- Public Health and Community Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.,Public Health and Preventive Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Tampah-Naah AM, Kumi-Kyereme A, Amo-Adjei J. Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana. PLoS One 2019; 14:e0215285. [PMID: 31048865 PMCID: PMC6497241 DOI: 10.1371/journal.pone.0215285] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 03/30/2019] [Indexed: 11/18/2022] Open
Abstract
Mothers are recommended to exclusively breastfeed their infants for the first six months of their lives. Also, after the sixth month, breastfeeding should continue with added complementary foods to the diets of children. Studies designed to sought the views of mothers on breastfeeding practices are limited. The aim of this study was to explore challenges to breastfeeding practices by considering spatial, societal and maternal characteristics in Ghana. Twenty mothers aged 15–49 years were interviewed purposively in selected communities within two regions of the country. Thematic content analytical procedures were applied to interpret and present findings. Challenges (to both exclusive breastfeeding and complementary feeding) spanned across spatial (home and work places), societal, and maternal characteristics. Key themes identified were in relation to household chores, work schedules, family influence, low breast milk production, swollen breasts or sore nipples, access to food items and preparation or giving foods. Addressing these challenges would require co-creation of supportive environments between couples and significant others as well as tackling institutional barriers that obstruct adequate breastfeeding among mothers. On complementary feeding, there is the need to form community health volunteers help educate mothers more on how to appropriately use local foods to feed their children.
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Affiliation(s)
- Anthony Mwinilanaa Tampah-Naah
- Department of Environment and Resource Studies, Faculty of Integrated Development Studies, Wa Campus, University for Development Studies, Tamale, Ghana
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
- * E-mail:
| | - Akwasi Kumi-Kyereme
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Joshua Amo-Adjei
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
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20
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The experiences of breastfeeding mothers returning to work as hospital nurses in Pakistan: A qualitative study. Women Birth 2019; 32:e252-e258. [DOI: 10.1016/j.wombi.2018.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/19/2018] [Accepted: 06/27/2018] [Indexed: 11/23/2022]
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Schuler C, Ntow GE, Agbozo F. Mothers' Experiences with Neonatal Care for Low Birth Weight Infants at Home; A Qualitative Study in the Hohoe Municipality, Ghana. J Pediatr Nurs 2019; 45:e44-e52. [PMID: 30660426 DOI: 10.1016/j.pedn.2018.12.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 12/31/2018] [Accepted: 12/31/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To explore knowledge and beliefs of mothers on low birth weight (LBW), examine care provision at home and societal perceptions of LBW infants. DESIGN AND METHODS This qualitative study was conducted using hermeneutic phenomenological approach. Data of mothers who delivered LBW infants within 2 years preceding the study were purposively extracted from the medical records of the Hohoe Municipality Hospital in Ghana. Twenty semi-structured interviews and three focus group discussions were conducted. A thematic analysis approach was performed using Atlas.ti. RESULTS Mothers identified and described LBW babies based on frailty, size and activity levels. LBW recognition was easier for multiparous mothers by comparing with previous deliveries. LBW was linked to poor maternal diet, diseases during pregnancy and heavy workload. Although most mothers perceived their LBW babies as healthy irrespective of the size a few home-care practises differed. Smaller LBW infants were less likely to be socially accepted. In the first few weeks after birth the care of LBW infants is the core responsibility of grandmothers. Primiparous mothers and those whose infants were smaller (<2 kg) quested for more information and support on LBW newborn care at home. CONCLUSION There is a need to increase knowledge on risk factors and tackle lapses in the recognition and care of LBW infants. Counselling on recommended neonatal care should begin during antenatal care and reiterated during postnatal care. PRACTICAL IMPLICATION Tailored in-depth and culturally-adapted counselling, discharge instructions and home-based postnatal visits targeted at LBW infants and their primary caregivers could improve care.
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Affiliation(s)
- Christina Schuler
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana; Ghana Health and Education Initiative, Sefwi Bekwai, Ghana.
| | - George Edward Ntow
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Faith Agbozo
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana; Institute of Public Health, Medical Faculty, University of Heidelberg, Germany
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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.
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Haile ZT, Sarfo B, Francescon J, Chertok IR, Teweldeberhan AK, Chavan B. The Moderating Effect of Urban Versus Rural Residence on the Relationship Between Type of Birth Attendant and Early Initiation of Breastfeeding in Ghana. J Hum Lact 2018; 34:810-820. [PMID: 29186666 DOI: 10.1177/0890334417741881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Early initiation of breastfeeding increases the likelihood of longer duration of breastfeeding. Factors associated with breastfeeding include maternal sociodemographic, behavioral and health-related characteristics, infant health characteristics, and perinatal factors. Research aim: This study aimed to determine the association between type of birth attendant and early initiation of breastfeeding among women in Ghana. METHODS A cross-sectional study was conducted using women ( N = 3,087) who participated in the 2014 Ghana Demographic and Health Survey. The main outcome of interest was early initiation of breastfeeding, defined as provision of mother's milk to the infant within 1 hr of birth. Chi-square tests and multivariable logistic regression modeling were performed. RESULTS Breastfeeding was initiated within 1 hr of birth by 58.3% of women. In the multivariable model, there was a significant interaction between type of birth attendant and place of residence on early initiation of breastfeeding. For rural areas, compared with women who had a nurse or midwife as their birth attendant, the multivariable odds ratios [95% confidence intervals] for early initiation of breastfeeding were lower among women whose birth attendant was a relative or other, 0.20 [0.07, 0.55], p = .002; village health volunteer or traditional health practitioner, 0.21 [0.07, 0.62], p = .005; none, 0.34 [0.12, 0.93], p = .035; community health officer, 0.42 [0.21, 0.85], p = .016; and doctor, 0.48 [0.24, 0.96], p = .037. For urban areas, no significant association was detected between type of birth attendant and early initiation of breastfeeding. CONCLUSION Findings from the study highlight the need for focused, context-specific, early initiation of breastfeeding promotion and intervention, especially for women and their birth attendants in rural areas.
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Affiliation(s)
- Zelalem T Haile
- 1 Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Bismark Sarfo
- 2 Department of Epidemiology and Disease Control, School of Public Health, University of Ghana, Legon-Accra, Ghana
| | - John Francescon
- 3 Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
| | - Ilana R Chertok
- 4 Department of Nursing, Ohio University College of Health Sciences and Professions, Athens, OH, USA
| | | | - Bhakti Chavan
- 1 Department of Social Medicine, Ohio University Heritage College of Osteopathic Medicine, Dublin, OH, USA
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Alebel A, Tesma C, Temesgen B, Ferede A, Kibret GD. Exclusive breastfeeding practice in Ethiopia and its association with antenatal care and institutional delivery: a systematic review and meta-analysis. Int Breastfeed J 2018; 13:31. [PMID: 30026786 PMCID: PMC6048887 DOI: 10.1186/s13006-018-0173-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 07/05/2018] [Indexed: 11/10/2022] Open
Abstract
Background Despite the World Health Organization recommendation of exclusive breastfeeding (EBF) for the first six months of life, the rate remains low both in developed and developing countries. In Ethiopia, findings regarding the prevalence of EBF have been highly variable. Antenatal care and institutional delivery are the most important factors contributing to the practice of EBF however; their effect has not been investigated in Ethiopia. Methods In this systematic review and meta-analysis, international databases were systematically searched. All observational studies reporting the prevalence of EBF and its association with antenatal care and institutional delivery in Ethiopia were considered. Two authors independently extracted all necessary data using a standardized data extraction format. A random effects meta-analysis model was computed to estimate the pooled prevalence of exclusive breastfeeding. Moreover, the association of antenatal care and institutional delivery with EBF was determined. Results After reviewing 619 studies, 32 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of EBF in Ethiopia was 59.3% (95% Confidence Interval [CI] 53.8, 64.8). The subgroup analysis indicated that the highest prevalence was observed in Afar region (65.6%), followed by SNNP (63.8%), and then by Oromia (61.8%). Additionally, mothers who attended antenatal visits were 2.1 times more likely to practice EBF compared to their counterparts (Odds Ratio [OR] 2.1; 95% CI 1.5, 2.8). Moreover, mothers who gave birth at a health institution were 2.2 times more likely to practice EBF compared to mothers who gave birth at home (OR 2.2; 95% CI 1.3, 3.5). Conclusions Exclusive breastfeeding in Ethiopia was significantly lower than the global recommendations. There was evidence that mothers who attended antenatal visits and who gave birth at health institutions had better EBF practices. Based on our findings, we strongly recommended that the utilization of antenatal care and institutional delivery should be improved through health extension workers.
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Affiliation(s)
- Animut Alebel
- 1Department of Nursing, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Cheru Tesma
- 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | | | - Aster Ferede
- 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getiye Dejenu Kibret
- 2Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Khan GN, Ariff S, Khan U, Habib A, Umer M, Suhag Z, Hussain I, Bhatti Z, Ullah A, Turab A, Khan AA, Garzon AC, Khan MI, Soofi S. Determinants of infant and young child feeding practices by mothers in two rural districts of Sindh, Pakistan: a cross-sectional survey. Int Breastfeed J 2017; 12:40. [PMID: 28936229 PMCID: PMC5603092 DOI: 10.1186/s13006-017-0131-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 09/10/2017] [Indexed: 11/15/2022] Open
Abstract
Background Infant and young child feeding (IYCF) practices during the first two years of life are important for the growth and development of a child. The aim of this study was to assess IYCF practices and its associated factors in two rural districts of Pakistan. Methods A cross-sectional study was conducted in two rural districts of Sindh province, Pakistan as part of a stunting prevention project between May and August 2014. A standard questionnaire on IYCF practices recommended by World Health Organization was used to collect information from 2013 mothers who had a child aged between 0 and 23 months. Results Only 49% of mothers initiated breastfeeding within one hour of birth. Thirty-seven percent of mothers exclusively breastfed their infants for six months. Seventy-percent mothers introduced complementary feeding at 6–8 months of age. Eighty-two percent of mothers continued breastfeeding for at least one year and 75% for at least two years of age. IYCF practices were not significantly different for boys and girls in the study area. Being an employed mother (AOR 2.14; 95% CI 1.02, 4.51) was positively associated with the early initiation of breastfeeding. Children who were born at a health facility (AOR 0.65; 95% CI 0.50, 0.84) and were aged six to eleven months (AOR 0.70; 95% CI 0.54, 0.90) were less likely to be have an early initiation of breastfeeding. Mothers aged 25 to 29 years (AOR 1.83; 95% CI 1.05, 3.18), being literate (AOR 1.79; 95% CI 1.15, 2.78), and higher income (AOR 10.6; 95% CI 4.40, 25.30) were more likely to have an improved dietary diversity. Being an employed mother (AOR 2.18; 95% CI 1.77, 4.03) and higher income were more likely to have minimum acceptable diet (AOR 9.7; 95% CI 4.33, 21.71). Conclusion IYCF practices were below the acceptable level and associated with maternal age, maternal illiteracy, unemployment, and poor household wealth status. Emphasis should be given to improve maternal literacy and reduction in poverty to improve IYCF practices.
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Affiliation(s)
- Gul Nawaz Khan
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Shabina Ariff
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ubaidullah Khan
- Department of Paediatrics, King Edward Medical University, Lahore, Pakistan
| | - Atif Habib
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Umer
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Zamir Suhag
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Imtiaz Hussain
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Zaid Bhatti
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Asmat Ullah
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Ali Turab
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
| | | | | | - Mohammad Imran Khan
- Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan
| | - Sajid Soofi
- Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan
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Nabwera HM, Jepkosgei J, Muraya KW, Hassan AS, Molyneux CS, Ali R, Prentice AM, Berkley JA, Mwangome MK. What influences feeding decisions for HIV-exposed infants in rural Kenya? Int Breastfeed J 2017; 12:31. [PMID: 28717383 PMCID: PMC5508793 DOI: 10.1186/s13006-017-0125-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 07/05/2017] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Infant feeding in the context of human immunodeficiency virus (HIV) poses unique challenges to mothers and healthcare workers in balancing the perceived risks of HIV transmission and nutritional requirements. We aimed to describe the decision-making processes around infant feeding at a rural HIV clinic in Kenya. METHODS We used a qualitative study design. Between March and August 2011, we conducted in-depth interviews (n = 9) and focus group discussions (n = 10) with purposively selected hospital and community respondents at Kilifi County Hospital, Kenya. These respondents had all experienced of infant feeding in the context of HIV. These interviews were informed by prior structured observations of health care worker interactions with carers during infant feeding counselling sessions. RESULTS Overall, women living with HIV found it difficult to adhere to the HIV infant feeding guidance. There were three dominant factors that influenced decision making processes: 1) Exclusive breastfeeding was not the cultural norm, therefore practising it raised questions within the family and community about a mother's parenting capabilities and HIV status. 2) Women living with HIV lacked autonomy in decision-making on infant feeding due to socio-cultural factors. 3) Non-disclosure of HIV status to close members due to the stigma. CONCLUSION Infant feeding decision-making by women living with HIV in rural Kenya is constrained by a lack of autonomy, stigma and poverty. There is an urgent need to address these challenges through scaling up psycho-social and gender empowerment strategies for women, and introducing initiatives that promote the integration of HIV infant feeding strategies into other child health services.
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Affiliation(s)
- Helen M. Nabwera
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Joyline Jepkosgei
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Kelly W. Muraya
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition (CHAIN) Network, PO Box 43640-00100, Nairobi, Kenya
| | - Amin S. Hassan
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Catherine S. Molyneux
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition (CHAIN) Network, PO Box 43640-00100, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF UK
| | - Rehema Ali
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
| | - Andrew M. Prentice
- MRC Unit, The Gambia, PO Box 273, Banjul, The Gambia
- MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - James A. Berkley
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition (CHAIN) Network, PO Box 43640-00100, Nairobi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF UK
| | - Martha K. Mwangome
- KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230-80108, Kilifi, Kenya
- The Childhood Acute Illness & Nutrition (CHAIN) Network, PO Box 43640-00100, Nairobi, Kenya
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Haddad M, Ebada ME. Demographic and Socioeconomic Characteristics of Outpatients Could Modify Their Attitude Towards Misusing Medications in Northern Jordan. J Public Health Res 2017; 6:818. [PMID: 28480175 PMCID: PMC5402186 DOI: 10.4081/jphr.2017.818] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 04/12/2017] [Indexed: 11/25/2022] Open
Abstract
Background Potentially inappropriate drug use, including prescribed and over-the-counter medications, is associated with increased morbidity and mortality. It also contributes to unnecessary expenditure on health services. This survey was undertaken to investigate the incidence of drug misuse and associated socioeconomic/demographic characteristics in Irbid, Jordan. Design and Methods The present cross section study was conducted using a validated 5-point Likert scale questionnaire to be self-reported by 480 outpatients visiting clinics in three major medical centres in Irbid, Jordan between 20th October 2015 and 27th November 2015. Descriptive analysis, chi-square tests and ordinal logistic regression models were performed. Results Patients demonstrated distinctive attitudes towards medication misuse (P<0.001). Whereas around 40% of patients sometimes stopped taking medications earlier than prescribed or doubled the dose in case of missing a dose, three quarters and two fifth of participants neither used expired drugs nor continued to take a drug when adverse drug reactions occurred, respectively. Also, there were significant associations (P<0.05) between patients’ attitudes towards misusing medications and characteristics like age, gender, income and marital status. For instance, senior patients (>45 years) tended to double a medication’s dose in case of no improvement, and to use others’ leftover drugs without medical supervision. Further, male and female patients exhibited different attitude towards misusing medications. Unemployment and little earnings increased the risk for not using drugs properly. Furthermore, married patients were less likely to misuse medications. In particular, the educational level of patients was found to play a major role in modifying patients’ attitudes towards potentially inappropriate drug use. Patients holding one or more university degrees were at lower risk for using medications inappropriately. Conclusions This survey indicated that northern Jordanians inappropriately used medications to a great extent, suggesting that the current policies should be revised, and emphasising the importance of running public antidrug misuse awareness campaigns and establishing advanced educational/training events targeting healthcare professionals. Significance for public health Evaluating and reducing potentially inappropriate drug use are two important approaches towards improving the therapeutic outcome and patient compliance. It is speculated that the prevalence of inappropriate drug use among hospitalised patients is relatively low providing that healthcare and direct observation by professional staff limit its incidence. On the other hand, outpatients seem to be the most sufferers from misusing prescribed and non-prescribed drugs and therefore clearly informing them about the dispensed medications especially by the community/hospital pharmacists could probably encourage them to follow the standard and approved instructions to avoid negative consequences. This survey also points out that patients could play a role in developing better health policies and improved health services by assessing their habits and compliance with regard to the use of prescribed and over-the-counter medications.
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Affiliation(s)
- Mansour Haddad
- Department of Clinical Sciences, Faculty of Pharmacy, Philadelphia University, Amman, Jordan
| | - Mohamed Elsaed Ebada
- Department of Pharmacology, National Organization for Drug Control and Research (NODCAR), Agouza, Giza, Egypt
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Views of First-Time Expectant Mothers on Breastfeeding: A Study in Three Health Facilities in Accra, Ghana. ADVANCES IN PUBLIC HEALTH 2017. [DOI: 10.1155/2017/4894026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to evaluate the views of first-time expectant mothers on breastfeeding. A qualitative study approach using focus group discussions was used to solicit the views of 25 expectant first-time mothers. The results indicated the intention to breastfeed, though some were willing to opt for formula feeding when the need arises. Knowledge on breastfeeding issues was minimal among this group. Common sources of information on breastfeeding issues were obtained from home (relatives), hospital, and television. The need to support and provide adequate education on breastfeeding issues is critical among this category of women.
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