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Perceptions of exclusive breastfeeding in Sissala East District |
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Ida Høgstedt, University of Copenhagen, Institute of Public Health Science. 2008.
Background: Each year a large number of children below five years die because they were not exclusively breastfed. In Sissala East District, Ghana, the level of exclusive breastfeeding is very low, but little is known about the perceptions on exclusive breastfeeding. Objective: To explore the perceptions of exclusive breastfeeding among mothers, health workers and other relevant people in Sissala East District, in order to suggest ways to increase exclusive breastfeeding rates. Material and methods: Qualitative semistructured interviews were carried out with 22 mothers, health workers, TBAs, mangasias, CBAs and fathers in the town of Tumu and three villages in Nabulo sub-district. The empirical material was analyzed using Grounded Theory. Results: Exclusive breastfeeding is embedded in a process of change. The process of change consists of several steps from education to exclusive breastfeeding for six months. At all steps different factors affect the mother and some contextual factors affect the whole process. All mothers seemed to have completed the first step, education, as everyone knew the concepts of exclusive breastfeeding. The two major ob- stacles to the practise of exclusive breastfeeding is the perceived need to give water and mothers-in-law, who stick to traditional practises. Discussion: The process of change has similarities to other behaviour change models, but none of those studied cover the empirical findings from this study. Thus the process of change provides a new way to consider feeding practises and interventions to change those. Conclusion: Exclusive breastfeeding is widely known and partly accepted in Sissala East District. Generally it is viewed positively, but not everyone is convinced about the goodness and different obstacles make it hard to practise. To increase the level of exclusive breastfeeding it is important to target mothers at the various levels in the process of change, as well as targeting the contextual factors and people influencing the mother.
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