Faculty of Human Medicine and Health Sciences

An-Najah National University

Supervised by: Dr.Zaher Nazzal

Dr.Ameera Alhindi Prepared by:

Community medicine group

Evaluation of Breastfeeding Promotion

among Health Care System in Nablus

Governorate

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Introduction & Background

Exclusive breast feeding(EBF):defined as the

child receiving only breast milk and no other type

of milk or solids but could include vitamins, drops

of other medicines and oral rehydration

therapy(ORT).

– Offers mothers and infants several advantages.

– Decrease incidence and severity of diseases

Introduction & Background objectives Methodology Results & Discussion clusion

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American Academy of pediatrics recommend

exclusive breast feeding for the first 6 months

of life

Introduction & Background objectives Methodology Results & Discussion

• Breast feeding promotion services in Nablus is

provided in Hospitals and Primary health care

centers.

• The Primary Health Care Directorate In Nablus

noticed that “although they provide this services,

the breast feeding rate is not as optimal as what

is expected!”

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• So our partner’s need was to evaluate the

reason behind the decreasing rate and

whether it is due to an inappropriate

services or not!

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Protection, promotion, and support of breastfeeding

are critical public health needs.

Interventions to promote breast feeding include:

1.Health education interventions

2. Health sector initiatives

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Introduction & Background objectives Methodology Results & Discussion

Cont…..

3. Peer support programs

4. Media campaigns

5. Implementation of the baby friendly hospitial

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These interventions found in systemic reviews and Randomized

controlled trials to increase EBF rates at 4-6 weeks, and 6 months

Introduction & Background objectives Methodology Results & Discussion

Objectives:

- To assess the health care counselling and services

provided to mothers regarding breastfeeding

- Evaluating breastfeeding knowledge among mothers

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Methodology

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• A cross sectional study was conducted in

primary health care centers(in Nablus,

Hewwarh, Aseera) , as well as pediatric and

OBGYN departments in Nablus city, between

27. 4.-4.5. 2014

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We included:

• All mothers who attend PHCs for well-baby

services.

• All health care workers (HCWs) in pediatric and

OBGYN departments in Nablus hospitals

– Rafedia, AL-Arabi, Nablus, Al-Itihad).

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Tools:

• A questionnaire was developed by the researchers,

– consisted of two parts

• One for HCWs and

• The other to the mothers.

• We observed HCW practices and the surrounding

environment in relation to BF promotion

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Results

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Our sample:

We interviewed:

• 142 mothers

• 29 HCWs

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Of 142 mothers :100 Got information about

breastfeeding benefit (70.4%)

Immunity 77%

Uterine involution 12%

Protection from breast cancer 7%

Cheaper 5%

Baby mother bond 5%

Cognitive function of the baby 3%

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Introduction & Background objectives Methodology Results & Discussion

99 69.7%

Taught about the mechanism of

breastfeeding

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Eighty-five mothers reported seeing posters in the hospital promoting breastfeeding

Visually interesting Conveying message helpful in deciding to breastfeed

92.20% 91.80%

81.40%

Mothers noticed posters encouraging breastfeeding

Mothers noticed posters encouraging breastfeeding

Maternal knowledge about breast feeding:

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Question asked: Answer: Number

Breast milk has better nutrition than formula Yes

No

134 (94.4%)

8 (5.6%)

Breast milk protects from diseases Yes

No

140 (89.6%)

2 (1.4%)

Breastfeeding has disadvantages on mother Yes

No

14 (9.9%)

128 (90.1%)

Which is easier for the baby

Breastfeeding

Formula

110 (77.5%)

32 (22.5%)

Breastfeeding is enough for baby Yes

No

100 (70.4%)

42 (29.6%)

Breastfed baby always needs additives Yes

No

62 (43.7%)

80 (56.3%)

Do you add additives while breastfeeding? Yes

No

69 (48.6%)

73 (51.4%)

Introduction & Background objectives Methodology Results & Discussion

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• 29 HCWs were interviewed:

– 23 were from hospitals

– 6 from PHC centers

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Of the 23 hospital based HCW:

• all 23 reported that their hospital offers 24 hour

"rooming in" for mothers and infants, said that

they encourage breastfeeding on demand.

• and 21 said that they advise mothers not to use

pacifiers.

• 20 advise exclusive breastfeeding.

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About encouraging breast feeding

policies:

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• 65.5% reported written policy

• 20.7%: indirect policies

• 13.8%: no policy

Introduction & Background objectives Methodology Results & Discussion

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Outcome

• At the end of the course, a report on the project

findings was delivered to PHC directorate at Nablus

District .

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• It included:

– Summary results on the common defect areas at

health care settings in relation BF promoting services

– Recommendations on the appropriate interventions to

improve the BF promoting services.

For Us

• It improved our knowledge and understanding and made us able to:

– Describe major epidemiological study designs, advantages and limitations.

– Describe the specific PHC programs including.

• It also improved our skills to

– Analyse data in order to improve quality of care.

– Evaluate a health programs

– Design a prevention and control program for a prevalent NCD

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Now We Are Better In

• Managing time and taking responsibility for learning

required for continuous professional development

• Working effectively as a member or a leader of an

interdisciplinary team

• Communicating effectively with clients and colleagues

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Thank you

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