Thesis (PhDNursing)--University of South Australia, 2002.

Bibliography: leaves 250-267. / xx, 267, [90] leaves : ill., map ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Aims to develop a model to improve breastfeeding in a low socio-economic area through the development of health promotion strategies to create a supportive environment for breastfeeding. / Thesis (Ph.D.)--University of Adelaide, Dept. of Public Health, 2000?

PhDPH / Department of Public Health / The benefits of breastfeeding, particularly exclusive breastfeeding, are well recognized. It can reduce the risk of mortality related to malnutrition, otitis media and respiratory infection. Breastfeeding may also decrease the risk of obesity in later life for infants who have been breastfed for more than six months. Besides, breastfeeding improves cognition, and children who have been breastfed show higher intelligence quotient test scores and improved school performance. In addition, long-period breastfeeding is associated with a reduced risk of breast cancer and ovarian cancer for mothers. The World Health Organization and United Nations International Children’s Emergency Fund recommended exclusive breastfeeding for six months and breastfeeding to two years and beyond. However, this study showed that only 27% of children under six months have had been exclusively breastfed. In this situation, an intervention programme was required. The aim of this study was to develop an intervention programme to promote exclusive breastfeeding strategies in Limpopo Province. Intervention mapping was used to guide the development of a programme. A convergent, parallel mixed-method was used wherein qualitative and quantitative data were collected and analysed concurrently. A qualitative approach was used to assess the implementation of exclusive breastfeeding and to explore challenges experienced by health care workers in the implementation of exclusive breastfeeding in Limpopo Province. This was carried out by means of in-depth interviews with 30 professional nurses. Trustworthiness was ensured through credibility, confirmability, dependability and transferability. A quantitative approach was used to determine the factors that influence exclusive breastfeeding. Reliability and validity of the instrument was ensured through extensive literature review and test-retest methodology. Questionnaires were distributed to 400 respondents. Tesch’s eight steps of data analysis was used to analyse qualitative data. The Statistical Package for the Social Sciences, version 26, was used to analyse the quantitative data. The results were merged, and the interpretation discussed. Five higher-order themes emerged from quantitative data analysis. The themes emerged from qualitative data were confirmed by the findings from statistical data, thus merging both qualitative and quantitative data. Findings were presented to the stakeholders, managers and dieticians and their inputs further confirmed and supported the findings. The findings informed the development of an intervention programme. The intervention comprises of the three components, training of community health workers, healths talks focusing on lactating mothers and health talks focusing on families and community. The developed intervention was validated by the stakeholders and the results were analysed through simple descriptive statistics where the data were summarized using frequency distributions and graphic representations. The results revealed that the programme was feasible, compatible and applicable to current practice. Recommendations were made and topics for further research were also suggested. / NRF

MCur / Department of Advanced Nursing Science / Background: The Mother-Baby Friendly Initiative (MBFI) promotes and supports breastfeeding in environments such as clinics, community health centres and hospitals that have fully-functioning maternity units. The implementation of the Mother-Baby Friendly Initiative in hospitals is associated with significant increases in the initiation and duration of exclusive breastfeeding (EBF). The Mother-Baby Friendly Initiative also leads to improved healthcare for infants, children and provides improved maternal health to all mothers. The main aim of this study was to assess the knowledge, attitudes and practices (KAP) of nurses regarding the Mother-Baby Friendly Initiative in non-accredited primary healthcare (PHC) facilities of Makhuduthamaga Sub-district. Method: Descriptive, cross-sectional and correlational study designs were used with the quantitative method. All the 18 non-accredited primary healthcare facilities were purposively selected and a total sampling method was used to select all the nurses working in these non-accredited primary healthcare facilities. Permission to conduct the study was sought from the University of Venda Research Ethics Committee and the Limpopo Department of Health Research Committee. Data was collected using a structured self-administered questionnaire. Content and face validity were enhanced before the actual data collection process. One hundred and ninety questionnaires were distributed and 164 responded, giving a response rate of 86.3%. Cronbach’s alpha test determined the reliability and reflected 0.981, indicating high reliability. Data was analysed using the Statistical Package for Social Sciences (SPSS) 23.0 and the Pearson coefficient of correlation established the relationship between variables. The study followed ethical considerations such as privacy, autonomy, confidentiality, fair treatment and right to self-determination. Results: In this study, 50.6% were professional nurses (PNs), 6.7% were nursing managers (NMs), 15.2% were enrolled nurses (ENs) and 27.4% were enrolled nursing assistants (ENAs). This study found that 100% of NMs, 65.1% of PNs, 54.2% of ENs and 26.7% of ENAs had received formal training on lactation management. Seventy-two percent (72%) of NMs, 90.4% of PNs, 72% of ENs vii and 66.7% of ENAs were knowledgeable about the duration of exclusive breastfeeding. This analysis found that the majority of nurses agreed that MBFI increases breastfeeding rates. Results showed that 63.6% of NMs, 69.6% of PNs, 56% of ENs and 46.7% of ENAs teach and demonstrate hand-milk expression to breastfeeding mothers. Furthermore, this research revealed that there was a significant relationship between the knowledge, attitudes and practices of nurses with a p-value of (p-00.01). Recommendations and Conclusion: This study recommends that all nurses should receive formal training on MBFI implementation and this should be conducted to improve ENs and ENAs’ awareness about MBFI. MBFI should be integrated into the training curriculum for all nursing categories. This study further recommends that a support model for implementation of MBFI be developed and implemented.