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"If I have money, I cannot allow my baby to breastfeed only …" barriers and facilitators to scale-up of peer counselling for exclusive breastfeeding in Uganda.
Rujumba, Joseph; Ndeezi, Grace; Nankabirwa, Victoria; Kwagala, Mary; Mukochi, Michelle; Diallo, Abdoulaye Hama; Meda, Nicolas; Engebretsen, Ingunn M S; Tylleskär, Thorkild; Tumwine, James.
Afiliação
  • Rujumba J; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda. jrujumba@yahoo.com.
  • Ndeezi G; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
  • Nankabirwa V; School of Public Health Makerere University, Kampala, Uganda.
  • Kwagala M; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
  • Mukochi M; Department of Paediatrics and Child Health, College of Health Sciences, Makerere University, P.O. Box 7072, Kampala, Uganda.
  • Diallo AH; Department of Public Health, Faculty of Health Sciences, University of Ouagadougou, Ouagadougou, Burkina Faso.
  • Meda N; Centre Muraz, Bobo-Dioulasso, Burkina Faso.
  • Engebretsen IMS; Centre Muraz, Bobo-Dioulasso, Burkina Faso.
  • Tylleskär T; Centre for International Health, University of Bergen, Bergen, Norway.
  • Tumwine J; Centre for International Health, University of Bergen, Bergen, Norway.
Int Breastfeed J ; 15(1): 43, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-32414404
ABSTRACT

BACKGROUND:

Early initiation and exclusive breastfeeding for 6 months reduces infant morbidity and mortality and can positively impact on cognitive function. In Uganda, exclusive breastfeeding for 6 months is recommended but many women introduce alternative feeds early. Interventions to scale-up peer support provision for exclusive breastfeeding are limited. We explored the barriers, facilitators and solutions to scaling-up of peer counselling support for exclusive breastfeeding in Uganda.

METHODS:

A qualitative study was conducted in Mbale District and Kampala City between April and July 2014. Data were collected through 15 key informant interviews with health workers and managers of organizations involved in child and maternal health as well as seven focus group discussions with peer counsellors who took part in the PROMISE EBF Trial (2006-2008), VHT members, mothers and fathers of children aged 1 year and below. Data were analysed using the content thematic approach.

RESULTS:

The need for peer support for exclusive breastfeeding, especially for young and first-time mothers, was highlighted by most study participants. While mothers, mothers-in-law, friends and husbands were mentioned as major stakeholders regarding infant feeding, they were perceived to lack adequate information on breastfeeding. Health workers were mentioned as a key source of support, but their constraints of heavy workloads and lack of education materials on breastfeeding were highlighted. High community expectations of peer counsellors, the perceived inadequacy of breast milk, general acceptability of complimentary feeding, household food insecurity, heavy workload for women and unsupportive 'work-places' were key barriers to scaling-up of peer counselling support for breastfeeding. The peer counsellors who were part of the PROMISE EBF trial in Mbale, the village health team programme, health facilities, community groups, the media and professional associations emerged as potential facilitators that can aid the scaling-up of peer counselling support for breastfeeding.

CONCLUSIONS:

Peer support for breastfeeding is highly valued in this setting. The health system and health workers are regarded as the main facilitators to scaling-up of peer support for exclusive breastfeeding. Partnerships with village health teams (VHTs), community groups, role models, professional associations and the media are other potential facilitators to this scaling-up.
Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: Agenda de Saúde Sustentável para as Américas / ODS3 - Saúde e Bem-Estar Tema em saúde: Objetivo 3: Recursos humanos em saúde / Meta 3.1: Reduzir a mortalidade materna Base de dados: MEDLINE Tipo de estudo: Pesquisa qualitativa Idioma: Inglês Revista: Int Breastfeed J Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Uganda

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Texto completo: Disponível Coleções: Bases de dados internacionais Contexto em Saúde: Agenda de Saúde Sustentável para as Américas / ODS3 - Saúde e Bem-Estar Tema em saúde: Objetivo 3: Recursos humanos em saúde / Meta 3.1: Reduzir a mortalidade materna Base de dados: MEDLINE Tipo de estudo: Pesquisa qualitativa Idioma: Inglês Revista: Int Breastfeed J Ano de publicação: 2020 Tipo de documento: Artigo País de afiliação: Uganda
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