Social and Bio-Medical Predictors of Exclusive Breastfeeding Among Nursing Mothers in Lagos and Taraba States, Nigeria.

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 (ß = 1.743; p < 0.001), infant sex (ß = -0.454; p < 0.05), and place of delivery (ß = -1.552; p < 0.001) were significant social predictors. Breast milk insufficiency (ß = -1.851; p < 0.001) and mother's age (ß = 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.

Developing culturally-oriented strategies for communicating women's health issues: a church-based intervention.

CONTEXT: In developing countries, messages on maternal health are often developed and conveyed without due regard to the literacy and cultural context of communities. Culturally-acceptable approaches are, however, necessary to increase awareness on womens health issues, especially in cultures where oral tradition is important. OBJECTIVE: To describe the processes adopted to engage church-based women support groups to develop innovative culturally-based strategies for communicating womens health matters. METHODS: We utilized an activity-oriented workgroup discussion methodology to engage 30 participants from 15 churches (two per church) in a two-day workshop located in an urban community in southeast Nigeria. The recruitment process included initial visits to 25 churches with an expression of interest form, followed by an invitation letter to the 15 churches that completed and returned the form. Participants were female church leaders, 26 years of age and older, from different occupations and educational levels. They attended a 16-hour (two-day) small group workshop, conducted in an adult-learning format. RESULTS: Six groups of five participants each used the Women and Health Learning Package (WHLP) to create and develop a dialogue on adolescent health, a drama on violence against women, a song on nutrition and womens health, a story on use of medicines by women, a quiz on cervical cancer and a poster on family planning. Thirteen of the 15 churches submitted a written report of the workshop to their local churches one month after the workshop as well as a copy to the workshop facilitator. Of the 13 churches, three organized a workshop to increase awareness on women s health issues in their local churches within three months of the workshop. CONCLUSION: Activity-oriented workshops can be a useful way of developing culturally- appropriate communication strategies for increasing awareness on womens health issues among church-based women groups.

Harnessing the potentials of masters/mistresses of ceremony to promote community health and wellbeing amidst COVID-19 and other public health challenges.

Public health risk communication and general health information dissemination efforts require multiple approaches to sustainably engage communities to pursue individual and collective preventive actions. Engaging only highly skilled professionals to deliver public health messages, particularly in low and middle-income countries is expensive. Thus, masters/mistresses of ceremony (MCs) have the potential to contribute to disseminating evidence-based messages to communities on existing, emerging or re-emerging public health issues in developed and developing countries, thereby complementing existing dissemination efforts being made towards malaria, HIV/AIDS and SARS-CoV-2 (COVID-19) prevention and control, among others. Establishing feedback mechanisms to assess the impact of the MC-led health promotion on the target audiences is vital.