Suboptimal Breastfeeding Practices for Children under two and Associated Factors among Mothers Attending Yeka Sub City Public Health Facilities

Thesis Proposal

Texto Academico , 2022 , 30 Páginas , Calificación: 3.2

Salud - Salud pública

The objective of this study is to assess suboptimal breastfeeding practice for under two-year-old children and associated factors among mothers attending Yeka sub city public health facilities, Addis Ababa, Ethiopia from March to April 2022. This study will be an institutional based quantitative cross-sectional study.

Breastmilk provides the best nutrition for infants, as it has an almost perfect mixture of vitamins, protein, fat and essential nutrients for the child to grow. In Ethiopia, recent studies showed that 58% of infants less than 6 months old are exclusively breastfed. 5 % of infants under the age of 6 months are not breastfed at all. Infants who are not breastfed are 6 to 10 times more likely to die in the first month of life than infants who were breastfed. Diarrhea and pneumonia are more common and more severe in children who are artificially fed, and are responsible for many of these deaths. It is estimated that suboptimal breastfeeding, especially non-exclusive breastfeeding in the first 6 months of life, results in 1.4 million deaths and 10% of the disease burden in children less than two years.

Table of Contents

SUMMARY

1. INTRODUCTION
1.1. Back ground of the study
1.2. Statement of the problem
1.3 Significance of the study

2. Literature review
2.1 Sub -optimal Breast- feeding Practice
2.2. Late initiation of breast- feeding
2.3. Non- exclusive breast-feeding
2.4 Factors influencing sub optimal breast- feeding
2.4.1 Socio demographic and economic factors
2.4.2. Obstetric factors
2.4.3. Health services related factors
2.5 Conceptual frame work

3. OBJECTIVE OF THE STUDY
3.1 General objective
3.2 Specific objectives

4. METHODS AND MATERIALS
4.1 Study area and period
4.2. Study Design
4.3 Source Of Population
4.3.1. Study population
4.3.2. Study unit
4.4. Eligible criteria
4.4.1. Inclusion Criteria
4.4.2. Exclusion Criteria
4.5. Sampling Size Determination/calculation
4.6. Study variables
4.6.1. Dependent Variable:
4.6.2. Independent Variables:
4.7. Operational definitions
4.9. Data Collection Procedure
4.10. Data Quality Assurance
4.11. Data processing and analysis
4.12. Ethical consideration
4.13. Plan for Dissemination and Utilization of results
4.14. WORK PLAN

5. Estimated cost of the research project

6. REFERENCES

10. ANNEX

Annex 1. Consent form

Annex 2. Questionnaires

ACKNOWLEDGMENT

First of all, I would like to thank the almighty God for giving me courageous throughout my work. Next my acknowledgment goes Abichu campus, Rift Valley University for variety support in the accomplishment of this study.

LIST OF ACRONYMS

Abbildung in dieser Leseprobe nicht enthalten

SUMMARY

Background:Breast milk provides the best nutrition for infants that have an almost perfect mixture of vitamins, protein; fat and essential nutrient for the child must grow. In Ethiopia resent study showed 58 percent of infants less than 6 months are exclusively breastfed. 5% of infants under age 6 months are not breastfed at all[12]. Infants who are not breastfed are 6 to 10 times more likely to die in the first month of life than infants who were breastfed. Diarrhea and pneumonia are more common and more severe in children who are artificially fed, and are responsible for many of these deaths. It is estimated that sub-optimal breast-feeding, especially non-exclusive breast-feeding in the first 6 months of life, results in 1.4 million deaths and 10% of the disease burden in children less than two years[4].

Objective: To assess suboptimal breastfeeding practice for under two years children and associated factors among mothers attending Yeka sub city public health facilities, Addis Ababa, Ethiopia from March to April 2022.

Methods:Institutional based quantitative cross-sectional study. The study population all mothers who have children less than two years of age attending in randomly selected in yeka sub city.

Timeframe:The study will be conducted for one month from March 1 to 30, 2022.

Estimated Budget:The study is estimated to cost a total of 16.385 Ethiopian Birr (ETB).

1. INTRODUCTION

1.1. Background of the study

Breast milk provides the best nutrition for infants that have an almost perfect mixture of vitamins, protein; fat and essential nutrient for the child must grow. It contains antibodies that facilitate the child to fight down viruses and microorganisms. It has been linked to higher intelligent quotient scores in later childhood and to gain the right amount of weight as they grow rather than become overweight children and lower the risk of diabetes, obesity, and certain cancers[1]

Sub- optimal breast-feeding is the late initiation of breast-feeding within 1 hour of birth, non­exclusive breast-feeding for the first 6 months of life, and not continued breast-feeding for up to 2 years or beyond with appropriate complementary feeding beginning at 6 months WHO recommendations[2].

Optimal breast-feeding practices play a key role in improving the health and development of children less than two years, and have been shown to be associated with decreased risk of childhood diarrhea and respiratory tract infections as well as reductions in childhood mortality. It is estimated that, globally, 11.6 percent of deaths of children less than two years of age [800,000] are attributable to sub-optimal breast-feeding practices. In addition, breast-feeding is associated with a reduced risk of child non-communicable diseases later in life, It is also associated with improved cognition and higher performance on intelligence tests, influenza, meningitis, lower mean blood pressure ,total serum cholesterol and with a lower prevalence of type-2 diabetes overweight and obesity during adolescence and adult life [3, 4].

1.2. Statement of the problem

To improve infant and child health, optimal breast feeding is the first priority and highly cost effective preventive intervention. Every year, optimal breast feeding has the potential of preventing 1.4 million deaths of less than five-year children and reduces acute respiratory tract infections and diarrheal deaths by 50-95% [4, 5]. It increases the effectiveness of immunization, reduces the need for oral rehydration by 50% and significantly increases intelligence and readiness to learn [4,5]. Exclusive breast feeding is the practice of only giving infant breast milk for the first six month[6].

Resent data showed that globally 60% of mothers do not breast-feed and breast- feeding practice durations influenced by many factors like issues with lactation and latching, concerns about infant nutrition and weight, mother's concern about taking medications while breast-feeding[7], unsupportive work policies and lack of parental leave , cultural norms and/or lack of family support[8], unsupportive hospital practices and policies in American Academy of Pediatrics[9].

In Ethiopia resent study showed 58 percent of infants under 6 months are exclusively breastfed. 5% of infants under age 6 months are not breastfed at all[12]. Infants who are not breastfed are 6 to 10 times more likely to die in the first month of life than infants who were breastfed. Diarrhea and pneumonia are more common and more severe in children who are artificially fed, and are responsible for many of these deaths. It is estimated that sub-optimal breast-feeding, especially non-exclusive breast-feeding in the first 6 months of life, results in 1.4 million deaths and 10% of the disease burden in children less than two years[4].

Sub-optimal breast feeding contributes 45% of neonatal infection death 30% of diarrheal death and 18% of acute respiratory deaths among under -five children in developing countries[11].it also accounts for 10% of the disease burden in children less than 2 years old[12]. Sub-optimal breast feeding practices contributed to70,000 infant's death, which accounted for 24% of the total annual infant's death [13,14]. Even though, the federal ministry of health has been working to improve the optimal breast feeding practice through providing training and developing implementation guidelines its practice remained far from global recommendation [15 16]. The prevalence and its associated factors of sub optimal breast feeding practice are not well acknowledged in the study area of Yeka sub city. while facilitating training sessions in PMTC ,FP and other post-natal service issues and during supervising trainers in health institutions, the researcher have identified gaps in the breast feeding practice of mother .Even if it is recommended ,feeding practice for infants and children less than two years worldwide are not optimal. Therefore, this study aims to assess the prevalence and its associated factors of sub- optimal breast-feeding practices of mother with children of less than two years old in Yeka sub city.

1.3 Significance of the study

Ethiopia is one of the countries, which is sub-optimal breast-feeding practice with not good breast feeding practice due to traditional, cultural beliefs, low education level and poor maternal knowledge. The report of sub-optimal breast feeding on the community in the other study area has high prevalence.

I have identified gaps on the breast feeding practice of mothers. So this drove me to assess the magnitude of the problem and possible contributing factors. There is no previous studies that acknowledge the prevalence and its associated factors of sub-optimal breast-feeding practice in the study area even if breast-feeding practice is a vital component of the primary health care unit. Hence, there is a need to carry out research to come up with the prevalence and its associated factors of sub-optimal breast-feeding practice in the study area.

Therefore, this study will be it is an input and strength the help of regional health bureau, district health office, , and non-governmental organizations [NGOs] that intervene on maternal and child health by providing important information for upcoming plans and interventions of proper strategies to promote and maintain optimal breast-feeding practices for up to two years of life. It will also help health care workers as a result, the study can be used as a mention for nurse educators, health care professionals' especially pediatrics nurses, and for others who are interested in carrying out further studies with this regard.

2. Literature review

2.1 Sub -optimal Breast- feeding Practice

Sub-optimal breast-feeding practices for infants and young children worldwide were 39% late initiation within one hour of birth, 63% of infants less than six months of age are non-exclusively breastfed in 2008. More than 10 million children under the age of five die each year; 41% of these deaths occur in sub-Saharan Africa and another 34% in South Asia and the major contributor to their death is poor breast-feeding practices[4].

Globally in 2017, UNICEF and WHO report, 58% of the breast- feeding doesn't start within an hour of birth, leaving an estimated 78 million new-borns to wait over 1 hour to be put to the breast, the majority born in low-income and middle-income countries[17].

In resent a study done like Asia and, North Africa, more than 40% in Latin America, sub-Sahara Africa about 20% of infants are exclusively breast-feeding for the 1st 6 months[10]. In sub­Saharan countries, including Ethiopia breast-feeding practices gap is highly increasing with the early and rapid cessation of breast-feeding followed by an introduction of unclean , unsafe artificial feeding of infants with very dilute milk products are common[11].

The prevalence rate of late initiation of Breast- feeding [LIBF] varies widely across regions from 35% in the Middle East and North Africa to 65% in Eastern and Southern Africa. Another report also shows that only three in five infants <6 months of age are non- exclusively breast-feed[18]. Based on meta-analysis done in 2018, the prevalence of LIBF and non- exclusive breast­feeding in Ethiopia is 33.5% and 39.9% respectively.

2.2. Late initiation of breast- feeding

A study done at Croatia in Europe indicates that 99.9% of women initiation of breast- feeding whilst in hospital and at discharge about 97.8% non- exclusively breast-feed their infants and the Proportion of women that doesn't breast-feed at 3 months was 39.4%, increased to 95.9 % at 24 months[24]. The Ethiopian demographic health survey (EDHS) 2016 shows that the prevalence of late initiation of breast- feeding at the national level was 73% and 66% in Amhara region[23].

2.3. Non- exclusive breast-feeding

Study conducted in East-Central Ethiopia and Kilimanjaro region, Northern Tanzania reported the prevalence of non-exclusive breast- feeding as 43 %[27]and 77.3%[28]respectively. The prevalence of non- exclusive breast-feeding for infants was 86.5% in Nigeria[29]. A study conducted in Gozamen district, northwest Ethiopia and rural mothers in East Ethiopia the prevalence of non-exclusive breastfeeding was (24.9%)[30], (28.3%)[31]respectively Another study conducted in Hula districts southern Ethiopia the prevalence of non-exclusive breastfeeding was (13.4%)[15].

Sub-optimal breast-feeding is 75.4%, around Jimma in Ethiopia, less than half of mothers 37.4% not initiated breast-feeding within the first hour of delivery, 72.5% gave colostrum to their infants, and 43.3% of mothers provided butter. Non- exclusive breast-feeding was 52.09% and it increased to 62.1% at the end of the first month, which elevated to 90.1% at the age of 6 months. less than half of mothers 42.78% had breastfeed less than 8 times per day[31]. Study showed that in DebreBerhan stated late initiation of breast- feeding is 17.5%, not exclusively breast­feeding 49.8% and early cessation of breast- feeding were, 12.8%[26]

2.4. Early cessation of breast-feeding

2.4 Factors influencing sub optimal breast- feeding

2.4.1 Socio demographic and economic factors

The study also indicates that non-exclusive breast- feeding is associated with household food security, access to health facilities, maternal knowledge of child feeding practices and marital status[31]. Not exclusively breast-feeding was related to with no antenatal care and lack of recommendation. Illiteracy, no antenatal care, age, received advice about breast- feeding, and Para one were significantly associated with early cessation of breast-feeding[26].

A study in India, Tanzania, and Nigeria showed that occupation and income affect the early initiation of breast- feeding, occupation affected exclusive breast-feeding, and income affected exclusive breastfeeding respectively[25],[28],[29].

Study conducted in Tanzania mentioned education, maternal age of the infant and sex of the child affected exclusive breast- feeding, and infant age as one of the factors of for exclusive breastfeeding practice respectively[28].

2.4.2. Obstetric factors

Study in India showed that ANC attendance affect early initiation of breast- feeding[25]. A study conducted in Tanzania said that ANC attendance, PNC attendance and parity affected exclusive breastfeeding[28].

A study conducted in Debre Berhan showed that ANC attendance, PNC attendance and Parity affected initiation of breast- feeding[18].

2.4.3. Health services related factors

Study in India showed that breast-feeding and place of delivery affect early initiation of breast­feeding[33]. Another study conducted in Tanzania showed that breast- feeding advice and mode of delivery affect exclusive breast- feeding[28].

In DebreBerhan town one study identified the place of delivery, mode of delivery, breast­feeding advice and birth attendant affected in initiation of breast the feeding .Birth at home was significantly associated with late initiation of breast-feeding no advice during antenatal care was a predictor of not exclusively breast-feeding. Being illiterate and no advice during antenatal care about breast-feeding were significantly associated with early cessation of breast-feeding[26].

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• Universidad: Rift Valley Institute Of Science And Technology
• Calificación: 3.2
• Año de publicación: 2022
• Páginas: 30
• No. de catálogo: V1351687
• ISBN (PDF): 9783346858306
• Idioma: Inglés
• Etiqueta: research, public health, project, Breastfeeding Practices, Suboptimal Breastfeeding, Health research, Children under two