Background: The health benefits and economic gains of exclusive
breastfeeding for the mothers and the new-born are well-documented in the
literature as discussed in the background and the rationale for this study. The
effectiveness of the social cognitive based interventions in promoting
breastfeeding among women in general is also documented. However, there is
lack of evidence regarding social-cognitive strategies that could be used to
promote exclusive breastfeeding practices among primiparous mothers in
Ethiopia means that current exclusive breastfeeding promotion interventions or
strategies may not produce the expected outcomes. This assumption seems to
be supported by low rate of early initiation of breastfeeding in country (52.1%
instead of at least 75% as recommended by WHO) and shorter period of
breastfeeding (one month) among mothers in Addis Ababa (CSA and ICF 2012)
despite various strategies and interventions that have been implemented.
Aims: The study was conducted with the aim of determining the social-cognitive
predictors of exclusive breastfeeding among primiparous mothers during the
first six months post-delivery with the view of developing social-cognitive
strategies to promote exclusive breastfeeding practices among primiparous
mothers in Addis Ababa, Ethiopia.
Research design and method: The study was carried out within the
quantitative positivist paradigm. The study was divided into two phases. The
researcher used quantitative longitudinal, descriptive, exploratory and correlational designs to determine the social cognitive predictors of exclusive
breastfeeding among primiparous mothers in Addis Ababa, Ethiopia within the
first six months post-delivery. The results of the first phase assisted the
researcher to design social-cognitive strategies to promote exclusive
breastfeeding among primiparous mothers using a Delphi survey. A Delphi
survey design was used to assist the researcher to develop the social-cognitive
strategies to promote exclusive breastfeeding among primiparous mothers. It
consisted of three rounds of mailed self-completion questionnaires. The Delphi
was supported with critical review and synthesis of literature throughout the
strategies’ development process. Descriptive summary statistics were used to
analyse the prenatal breastfeeding behaviour of 141 primiparous mothers
followed from the last antenatal care visits up to six months after delivery.
Bivariate correlational and multiple logistic regression analyses were used to
identify the social cognitive determinants and predictors of exclusive
breastfeeding within the first hour post-delivery and six months thereafter.
Findings: Positive breastfeeding outcome expectancy and high breastfeeding
self-efficacy were identified as the independent social cognitive predictors of
exclusive breastfeeding among primiparous mothers in Ethiopia. These
predictors were used to develop social cognitive strategies to promote exclusive
breastfeeding, which comprise six main components: (1) scientific evidence for
the strategies, (2) the rationale for the strategies, (3) the aim of the strategies,
(4) the scope of the strategies, (5) the guiding principles, and (6) the key results
areas. These strategies were developed and validated with the inputs from 37
experts on breastfeeding and social cognitive theory. Two key results areas
(build individual capacity for exclusive breastfeeding and create an enabling
environment) and five strategic objectives were formulated and validated.
Conclusions: The successful implementation of the social cognitive strategies
to promote exclusive breastfeeding among primiparous mothers in Addis
Ababa, Ethiopia as described above will require among others (1) in-service
training on social cognitive skills for healthcare providers with focus on how to
build self-efficacy and outcome expectancy, (2) the development of self-efficacy
and outcome expectance assessments tools relevant to the Ethiopian context,
and (3) additional support and resources from the healthcare managers.
Recommendations: To the researcher recommend that programs aimed at
promoting exclusive breastfeeding practices among primiparous mothers should
be based on the combined attributes of positive social cognitive outcome
expectance and high breastfeeding self-efficacy. Further research is needed to
develop assessment tools for breastfeeding self-efficacy and outcome
expectancy before the implementation of the proposed strategies. / Health Studies / D. Litt. et Phil. (Health Studies)
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:unisa/oai:uir.unisa.ac.za:10500/23116 |
| Date | 09 1900 |
| Creators | Anteneh Girma Minas |
| Contributors | Ganga-Limando, M. |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 1 online resource (xvi, 109 Leaves) : illustrations (some color) ;30 cm |
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