FACTORS ASSOCIATED WITH BREAST FEEDING PRACTICE AMONG PASTORALIST MOTHERS IN EASTERN ETHIOPIA

Lensse Gobu, Lead Researcher: VSF-SUISSE EthiopiaMulubirhan Assefa, Researcher: Mekelle UniversityYoseph Legesse (DVM, MSc), Researcher: Jigjiga UniversityNamukolo Covic (PhD), Research Coordinator: IFPRI

7th African Nutrition Epidemiology Conference9 – 14 October 2016Marrakesh, Morocco

Presentation outline

• Introduction• Methodology• Result and Discussion • Conclusion • Acknowledgment

Background • Proper breast feeding during infan cy is essential to

ensures growth, health, and development of children to their full potential

• Optimal IYC feeding practices rank among the most effective interventions (WHO 2009)

• Poor breast feeding practices Increases the risk of illness; their growth will be retarded; major death contributor [(Quinn V, 2004), (WHO, 2009; Black RE et.al,, 2008)]

The problem

Ethiopia, despite encouraging economic progress • U5 child Mortality levels remain high -180/1000

(IGCME 2015)• Still holds one of the highest child-stunting rates in

the world (above 40%)• Have High recurrent problem despite of numerous

interventions trying to tackle malnutrition• Under-nutrition is particularly pronounced in the

pastoralist areas

Evidence gap Scanty of evidence about breast feeding among

pastoral communities Previous studies conducted in Ethiopia provide

limited and/or definitely not show details about the impact of IEC / BCC

Role of pastoral community platforms has overlooked on the current nutrition intervention program

Donors seeking increasingly rigorous scientific justification for their investments in SBCC

The baseline study was designed to assess the current knowledge, attitude and practice of mothers on key breast feeding practices

Baseline Survey MethodsStudy areas and setting

Methods…

Study design and approach

• A community based quasi-experimental design was used and baseline study was conducted from August - November 2015

• Mixed method

Target and Study Population• The study’s targets were all mothers with

children up to 23 months old

Methods…

Sample-Size Estimation and Sampling Techniques

• Estimated using Epi-Info Windows Version 7, with an assumption of 90% power, 1:1 ratio of the two study groups (intervention and ), and the percentage of the outcome in the unexposed (control) group to be 2.2%

• Total of 942 HHs was enrolled

Methods…Data Collection Tools and Procedures

• Standard KAP survey questionnaire - UN-FAO’s 2014 Guideline for Assessing Nutrition-Related KAP

• Pretested on d/t population before the baseline survey

Methods…

Data-Quality AssuranceThe quality of the data had assured in the following ways:• Training and pretest was conducted• On daily basis, questionnaires and records was checked

thoroughly for completeness• Re-interview 5% of the study subjects by supervisor • Data cleaning was performed by data editors using

SPSS

Methods…

Data Analysis procedure• The collected data was entered using Epi-data (version

3.1) and transferred to SPSS version 20• A descriptive statistical analysis was then be used to

explore the variables • Exploratory analysis of KAP, examining the relationship

between the nutrition-education-related variables• A logistic regression was carried out in order to identify

limiting factors to behavioral change regression

Methods…

Ethical Considerations• Ethical clearance has obtained from the Jigjiga

University ethical-review committee• Verbal consent was obtained from all study

participantsLimitation

Language barriers because the local language doesn't have script

Result and Discussion Socio-demographic characteristics of the respondents

The preliminary finding revealed that:• Almost all (97%) of participant did not read and

write in both groups• Mean age of participant 27 in study group and 30

in comparison group• Main source income was depend on livestock

Distribution of Knowledge measurement towards breast feeding

Characteristics Study group Comparison group

Frequency

Percentage

Frequency

Percentage

Know early initiation of Breast Feeding Yes 239 50.7% 354 75.2% No 232 49.3% 117 24.8%

Know what EBF Is Yes 127 27.0% 108 22.9% No 344 73.0% 363 77.1%

Know benefit of EBF Yes 77 16.3% 94 20.0% No 394 83.7% 377 80.0%

Distribution of Attitude measurement towards breast feeding

Characteristics Study group Comparison group Frequency Percentage Frequency Percentage

Perception of EBF benefit Perceived 422 89.6% 443 94.1%

Not perceived 49 10.4% 28 5.9%

Self-confidence Confident 465 98.7% 446 94.7%

Not confident 6 1.3% 25 5.3%

• Of those mothers having child less than 6 months Only 28.3% had practiced EBF

• Alongside this result; (Qualitative finding)• Insufficient breast milk• Inaccessibility of water and • Time constraint was found the major barriers of

optimal feeding

Core practice indicators

• Knowledge on Early initiation of Breast feeding• Perception on benefits of Exclusive Breast feeding and • Having self-confidence had associated with mothers

EBF practice

• In addition to this; The likelihood of mothers to breast feed their

child in the last 24 hours is associated with Wealth status Presence of young child between 6-23 months

In conclusion;• knowledge and practice on breast feeding was found

low; • Wealth, birth gaps, source of information, knowledge,

perception was found significantly associated to breast feeding issues

• Nutrition message channeling interventions using existed community platforms might be effective

Acknowledgment

AuthorAID at INASP Mekelle University VSF-SUISSE Jigjiga University

• International Food Policy Research Institute- Research project funds

• Regional government and study participants

I would like to acknowledge

THANK YOU