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Factors that influence attitude, beliefs and barriers of caregivers regarding complementary feeding practices of infants aged 6 – 12 months in the Breede valley district of the Western CapeMatthysen, Mariska 04 1900 (has links)
Thesis (Mnutr)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Inappropriate feeding practices are a major cause of malnutrition in young children. Within this context, it has been well documented that the incidence of malnutrition rises sharply during the period from six to 18 months of age in most countries. Complementary feeding typically covers the period from six to 24 months of age. Renewed focus has been placed on the promotion of breastfeeding. Similar attention should be paid to complementary feeding. Six percent of deaths per year are preventable through good complementary feeding practises. To improve infant nutrition it is important to know the local infant and young child feeding practises present in communities but also to identify and understand the underlying factors that influence these practises.
Aim
The study aimed to describe the various factors that influence complementary feeding practices of infants aged 6 – 12 months in 2 communities (Avian Park and Zweletemba) in the Breede Valley district of the Western Cape.
Methods
The study was conducted from May – July 2012. A descriptive study design was used. A qualitative approach was followed with the use of focus group discussions with mothers / primary caregivers, fathers and grandmothers of infants aged 6 – 12 months.
Results
The findings of this study provide insight into different aspects regarding early cessation of breastfeeding that could lead to early introduction of complementary foods. In both Avian Park and Zweletemba the age of introduction of liquids and solids ranged from birth to 12 months. Various liquids such as water, over the counter medicine, high concentrated sugar beverages and low nutrient beverages were given to infants from as young as two days post-partum by means of a feeding bottle. Cow’s milk was also introduced before six months of age for reasons such as affordability, availability and because cow’s milk does not need boiling water for reconstitution like formula milk, especially when access to electricity is inadequate. Infants from both communities also received meelbol (flour and water beverage) fed either via feeding bottles (as a beverage) or as porridge fed to the infant with a spoon. Porridge (especially rice cereal and maize meal porridge) was introduced to infants from one week post-partum and infants from both areas also received family “food from the pot” before the age of 6 months.
In this study it was found that it was most often a female (either the mother or the grandmother) in the household who was responsible for buying and preparing food and for feeding the infant. Health care workers, members of the mothers’ household as well as community members were identified as key role players in conveying information regarding breastfeeding and complementary feeding from birth to 1 year. Various factors were identified in this study that influenced suboptimal infant feeding practises in Avian Park and Zweletemba. The main factors identified were i) health, ii) physiological, iii) nutritional, iv) educational, v) behavioural, vi) financial and vii) social factors. Other aspects mentioned were viii) demographic and x) commercial factors.
Conclusion
Results indicated that the current practices and factors influencing the feeding practices in Avian Park and Zweletemba were similar there was very little to no cultural differences between the two communities in terms of current practices and influencing factors. The findings of this study have highlighted the importance of involving all household members in interventions, as well as the larger community in a public nutrition approach. Factors influencing current feeding practises should be considered carefully when planning future interventions to improve infant feeding practises. / AFRIKAANSE OPSOMMING: Onvanpaste voedingspraktyke is ‘n groot oorsaak van wanvoeding in jong kinders. Binne hierdie konteks is dit goed gedokumenteer dat die voorkoms van wanvoeding skerp styg gedurende die tydperk vanaf ses tot 18 maande ouderdom in die meeste lande. Komplimentêre voeding dek tipies die tydperk van ses tot 24 maande oud. Hernude fokus word geplaas op die bevordering van borsvoeding. Komplimentêre voeding behoort soortgelyke aandag te kry. Ses persent van sterftes per jaar is voorkombaar deur goeie komplimentêree voedingpraktyke. Om kindervoeding te verbeter is dit belangrik om bekend te wees met plaaslike baba- en jong kind praktyke in gemeenskappe, en ook om die onderliggende faktore wat hierdie praktyke beïnvloed te identifiseer en verstaan.
Doelwit
Hierdie studie het gepoog om die verskillende faktore ten opsigte van die komplimentêre voeding praktyke van babas tussen 6 – 12 maande te beskryf in 2 gemeenskappe (Avian Park en Zweletemba) in die Breede Vallei distrik van die Wes-Kaap.
Metodes
Die studie is uitgevoer vanaf Mei – Julie 2012. ‘n Beskrywende studie ontwerp is gebruik. ‘n Kwalitatiewe benadering is gevolg met die gebruik van fokusgroepbesprekings met moeders / primêre versorgers, vaders en oumas van babas tussen 6 – 12 maande.
Resultate
Die bevindinge van hierdie studie voorsien insae in die verskillende aspekte van die vroeë beëindiging van borsvoeding wat kan lei tot vroeë bekendstelling van komplimentêre voeding. In beide Avian Park en Zweletemba het die ouderdomme van insluiting van vloeistowwe en vaste stowwe gewissel van geboorte tot 12 maande.Verskeie vloeistowwe soos water, oor-die-toonbank-medisyne, hoë konsentrasie suiker drankies en lae voedingswaarde drankies was aan babas gegee so vroeg as twee dae post-partum deur middel van ‘n voedingsbottel. Koeimelk was ook gegee voor 6 maande, om redes soos bekostigbaarheid, beskikbaarheid en omdat koeimelk nie kookwater benodig vir hersamestelling soos formule melk nie, veral in situasies waar toegang tot elektrisiteit onvoldoende is. Babas van beide gemeenskappe was ook meelbol (meel en water drankie) gevoer óf via voedingsbottels (as ‘n vloeistof) of as ‘n pap wat gevoer word met ‘n lepel. Pap (veral ryspap en mieliemeelpap) was gegee vanaf een week post-partum en babas van beide gebiede het ook familie kookkos ontvang “vanuit die pot” voor 6 maande.
In hierdie studie is bevind dat dit heel dikwels ‘n vrou (óf die moeder of ouma) in die huishouding is wat verantwoordelik is vir die koop en voorbereiding van voedsel asook die voer van die baba. Gesondheidswerkers, lede van die moeder se huishouding sowel as lede van die gemeenskap is geïdentifiseer as belangrike rolspelers in die oordrag van inligting oor borsvoeding en komplimentêre voeding vanaf geboorte tot een jaar. Die belangrikste faktore geïdentifiseer was verwant aan: i) gesondheid, ii) fisiologie, iii) voedingswaarde , iv) opvoedkunde, v) gedrag, vi) finansies en vii) sosiale faktore. Ander aspekte genoem is: vii) demografiese en x) kommersiële faktore.
Gevolgtrekking
Resultate het aangedui dat die huidige voedingpraktyke soortgelyk was in Avian Park en Zweletemba en dat daar baie min kulturele verskille tussen die twee gemeenskappe was in soverre huidige praktyke en faktore wat dit beïnvloed. Die bevindinge van hierdie studie het die belangrikheid daarvan uitgelig om al die lede van die huishouding, sowel as die breër gemeenskap in te sluit in intervensies met ‘n openbare voeding benadering. Faktore wat die huidige babavoeding praktyke beïnvloed moet versigtig oorweeg word tydens die beplanning van toekomstige intervensies om babavoeding praktyke te verbeter.
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An intervention programme to promote exclusive breastfeeding strategies in Limpopo Province, South AfricaMudau, Azwinndini Gladys 03 1900 (has links)
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
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The current infant feeding practices and related factors of Zulu mothers with 0-6 month old infants attending PMTCT and non-PMTCT clinics in central Durban, KwaZulu-Natal : an exploratory study.Kassier, Susanna Maria. January 2005 (has links)
Abstract: Introduction:
Exclusive breastfeeding for the first six months of an infant's life is
recommended worldwide. In 1998 the South African Demographic and
Health Survey (SADHS) showed that only 10% of mothers exclusively
breastfeed at three months. As the HIV virus is transmissible via breast milk,
UNAIDS (2002) recommends that women in developing countries should be
given a choice of feeding method after being counselled on the risks and
benefits of breast feeding versus formula feeding. As a result, the Prevention
of Mother-to-Child Transmission (PMTCT) programme was launched in
KwaZulu-Natal with the aim of providing interventions to prevent Mother-to-Child
Transmission of the HIV virus. However, research has shown that infant
feeding practices are influenced by numerous factors. Ultimately mothers will
feed their infants in a manner they feel comfortable with, even if it is not
always the most appropriate choice.
Aim:
The aim of this study was to determine and compare current infant feeding
practices and some of the factors that influenced these practices among Zulu
mothers with 0 - 6 month old infants attending PMTCT and non-PMTCT
clinics in Central Durban, KwaZulu-Natal.
Methodology:
A cross-sectional, descriptive survey was conducted amongst 150 mothers
sampled from three non-PMTCT clinics and 150 mothers sampled from three
PMTCT clinics. Systematic random sampling of mothers attending the two
types of clinics was used to ensure an equal number of mothers· with infants
aged 0 - < 6 weeks, 6 - < 14 weeks and 14 weeks to 6 months. The number
of mothers interviewed per clinic was determined proportionate to clinic size.
Interviews were conducted in Zulu by trained fieldworkers according to a
structured interview schedule consisting of 87 open- and closed-ended
questions.
Summary of most important findings and conclusion:
Overall, one quarter of the mothers attending non-PMTCT and one third of
mothers at PMTCT clinics were practising exclusive breastfeeding at the time
of the survey. The general trend was that mothers attending PMTCT clinics
were more inclined than those attending non-PMTCT clinics to breastfeed
their infants exclusively (34% versus 24% respectively) or to formula feed
(16,7% versus 12,7% respectively). Furthermore, there was a significant
decline in exclusive breastfeeding and predominant breastfeeding with
increasing infant age in both clinic groups. The opposite held true for mixed
feeding and formula feeding in that infants were more inclined to mixed
feeding or formula feeding with increasing infant age. In both clinic groups,
exclusive breastfeeding was the method of choice in the 0 - < 6 week age
category, while a preference for mixed feeding was shown in the 6 - < 14
week category. This trend persisted in the 14 week - < 6 month age
category, especially in the non-PMTCT clinics, while there was a small but
pronounced increase in formula feeding amongst PMTCT mothers. Although
these findings can be explained as a result of implementing the PMTCT
programme, the positive trends observed in non-PMTCT clinics serve as an
indicator that the Integrated Nutrition Programme (INP) and Baby Friendly
Hospital initiative have also had an impact on the feeding choices mothers
make.
Despite the limited duration of the PMTCT programme at the time of the
study, indicators of the impact of the intervention include that a lower
percentage of PMTCT mothers introduced foods and/or liquids in addition to
breast milk to their infants before six months of age compared to non-PMTCT
mothers. Furthermore, more mothers attending PMTCT clinics were
shown how to breastfeed and were more likely to have received information
about formula feeding. Despite these indicators of a positive impact of the
PMTCT programme, the mean age for introducing liquids and/or solids in
addition to breast milk was about six weeks and the incidence of this practice
was very high for both groups. The similar incidence of formula feeding
observed between the two clinic groups suggests the presence of constraints
to safe infant feeding choices among mothers attending PMTCT clinics.
As observed, infant feeding practices were still not ideal in either of the two
clinic groups. However, the high level of antenatal clinic attendance
documented for both groups serves as evidence that, if opportunities for
providing mothers with appropriate infant feeding advice are utilized
optimally, the antenatal clinic could serve as an ideal medium through which
infant feeding education can take place, especially as the clinic-based nursing
staff were cited as the most important source of infant feeding information by
both groups of mothers in the antenatal and postnatal phases. The
documented infant feeding practices should be interpreted against the
backdrop of factors such as socio-demographic characteristics of the
mothers, availability of resources such as social support from peers and
significant others and reigning infant feeding beliefs that could influence
infant feeding decisions.
Predictors of exclusive breastfeeding in PMTCT and non-PMTCT clinics were
determined by means of multivariate logistic regression analysis. Significant
values were obtained for both clinic groups in terms of the infant not having
received liquids in addition to breast milk. No additional predictors were
found amongst mothers attending non-PMTCT clinics, however predictors
amongst mothers attending PMTCT clinics included whether the mother had
not visited the clinic since the infant's birth, whether she practiced demand
feeding and whether she was experiencing stress at the time of the study.
The limited number of predictors of exclusive breastfeeding documented in
this study, especially among non-PMTCT mothers may be explained by the
fact that infant feeding behaviour is multifactorial by nature and the
interaction between factors that influence feeding choice is strong. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2005.
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Prevention of mother-to-child transmission programme : how "informed" is the literate mother's decision regarding infant feeding options in the Gert Sibande district, Mpumalanga province, South AfricaDavis, Annemarie, Labadarios, D., Marais, D., Cotton, M. F. 12 1900 (has links)
225 leaves printed on single pages, preliminary pages i- xxiii and numbered pages 1-203. Includes bibliography, list of abbreviations, list of definitions, list of tables and figures and list of appendices. / Digitized at 330 dpi color PDF format (OCR), using KODAK i 1220 PLUS scanner. / Thesis (MNutr (Interdisciplinary Health Sciences))--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: "A comprehensive package of care for the Prevention of Mother- To-Child Transmission
(PMTCT) of HIV" states that all mothers participating in the PMTCT Programme should
receive education that will enable them to make informed decisions about infant feeding
options. Rapid, same-day HIV testing and results that are available immediately, enable
health care workers to be responsible for providing pre- and post-test counselling (which
includes infant feeding options) on the same day. This could place a tremendous
workload and time pressure on the health care workers.
The aim of this study was to determine how "informed" is the literate mother's decision
regarding infant feeding options, who participated in the PMTCT Programme, in the Gert
Sibande District, Mpumalanga, South Africa.
Method:
Data was collected from health care workers and mothers on the PMTCT Programme at
23 PMTCT sites in the Gert Sibande District, with the help of 6 field workers and the
PMTCT site manager at each PMTCT site, by means of once-off, self-administered
questionnaires, which had been previously tested and validated.
Results:
Health care workers' attitude towards the PMTCT Programme was positive, although
some (14%) indicated that what was expected of them was not achievable in their
working environment. The most prominent change relating to the personal preferences of
health care workers regarding infant feeding options for HIV-infected mothers, after
attending the 5-day PMTCT course, was from formula-feeding to breast-feeding. Most
(65%) indicated it was possible to stay neutral in a counselling session regardless of
personal preference for infant feeding and 60% of those who could not stay neutral, still
thought it was in the mother's best interest to be counselled by them. Most (98%) agreed
mothers had the right to make informed decisions and 80% agreed mothers were able to make such a decision. Most (67%) health care workers indicated that not enough staff
was stationed at PMTCT sites, only 53% used the feeding option cards when counselling
mothers and indicated that more educational material was needed. Sixty one percent of
the health care workers demonstrated the preparation of the formula to the mothers and
allowed the mothers to demonstrate back to them. Between 49-82% and 37-56% of the
health care workers knew the correct answers to knowledge questions relating to breastfeeding
and formula-feeding, respectively. Not one health care worker, nor mother, knew
all the steps in preparing a formula feed. Most (80%) mothers made decisions based on
information provided to them by health care workers and only a small (13%) percentage
were influenced by the community to practise a different feeding option than what they
had chosen. Conclusions: The attitude, personal preferences, knowledge of and resources available to health care
workers, influenced the decision made by mothers regarding infant feeding options and
seeing that most mothers made their decision, based on information provided by health
care workers, it is concluded that mothers can only make an informed decision about
infant feeding options if they are advised appropriately by well trained, equipped and
informed health care workers. / AFRIKAANSE OPSOMMING: "A comprehensive package of care for the Prevention of Mother-To-Child Transmission
of HIV", vermeld dat moeders, wat deelneem aan die Voorkoming van Moeder-Tot-Kind
Oordrag (VMTKO) progam, voorligting behoort te ontvang ten opsigte van
voedingsopsies vir hul babas, sodat hulle in staat sal wees om 'n ingeligte keuse te maak.
Gesondheidswerkers is verantwoordelik om voorligting voor en na die HIV toets te gee,
wat die voedingsopsies vir babas insluit, op dieselfde dag. Dit kan 'n ontsaglike
werkslading op die gesondheidswerkers plaas.
Die doel van die studie was om te bepaal hoe "ingelig" is die geletterde moeder se keuse
ten opsigte van voedingsopsies, wat deelneem aan die VMTKO program, in die Gert
Sibande distrik, Mpumalanga, Suid-Afrika.
Metode: Die data is ingesamel by 23 VMTKO-klinieke en -hospitale in die Gert Sibande distrik
onder gesondheidswerkers en moeders op die VMTKO-program, met behulp van 6
veldwerkers en VMTKO-bestuurders, deur middel van eenmalige, selfvoltooide
vraelyste, wat van tevore getoets en gevalideer was.
Resultate: Die gesondheidswerkers se houding teenoor die VMTKO-program was positief, alhoewel
14% aangedui het dat wat van hulle verwag word nie prakties of moontlik is in hul
werksomgewing nie. Die prominentste verandering rakende die persoonlike voorkeure
van die gesonheidswerkers teenoor voedingsopsies vir HIV -geinfekteerde moeders, na
die 5-dag VMTKO kursus, was van formulevoeding na borsvoeding. Meeste (65%) het
aangedui dit is moontlik om neutraal te bly gedurende 'n voorligtingssessie, ten spyte van
persoonlike voorkeure vir voedingsopsies en 60% van die wat nie neutraal kon bly nie,
het steeds gedink dit is in die beste belang van die moeder om deur hulle voorgelig te
word. Meeste (98%) het saamgestem dat dit die moeder se reg is om 'n ingeligte keuse te maak en 80% het saamgestem dat die moeder wel in staat is om so 'n besluit te neem.
Meeste (67%) gesondheidswerkers het aangedui dat personeel tekorte bestaan by die
VMTKO klinieke en hospitale. Slegs 53% gebruik die voedingsopsie kaarte gedurende 'n
voorligtingsessie met die moeder en het aangedui dat meer voorligtingsmateriaal benodig
word. Een en sestig persent van die gesondheidswerkers het die voorbereiding van die
formulevoeding aan die moeders gedemonstreer en het moeders toegelaat om ook die
demonstrasie te doen. Nege en veertig tot twee en tagtig persent en 37-56% van die
gesondheidswerkers kon die korrekte antwoorde verskaf vir vrae oor borsvoeding en
formulevoeding, afsonderlik. Nie een gesondheidswerker of moeder kon al die stappe vir
die voorbereiding van die formulevoeding noem nie. Meeste (80%) moeders maak keuses
gebaseer op inligting wat aan hulle verskaf word deur die gesondheidswerkers en slegs 'n
klein persentasie (13%) word beinvloed deur familielede om die teenoorgestelde
voedingsopsie te praktiseer as wat hulle gekies het.
Gevolgtrekking: Die houding, persoonlike voorkeure, kennis van en hulpbronne beskikbaar aan die
gesongheidswerkers, beinvloed die besluit wat moeders neem ten op sigte van
voedingsopsies en aangesien die moeders hulle besluit baseer op inligting wat deur die
gesondheidswerkers aan hulle gegee word, word die gevolgtrekking gemaak dat moeders
slegs 'n ingeligte keuse aangaande voedingsopsies kan maak indien hulle voorligting
ontvang deur goed opgeleide en ingeligte gesondheidswerkers.
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