An exploratory study on factors associated with adoption of exclusive breastfeeding in Chelstone-Zambia

Abstract

Exclusive breastfeeding (EBF) is recognised to make an important contribution in improving infant health and survival and is further associated with decreased risks of HIV transmission compared to mixed-feeding (breast milk in addition to other liquids or solids). Despite this knowledge EBF remains rarely practiced in most countries, especially in low-income settings where infants could benefit most from this feeding mode.In Zambia for example, adoption of EBF is still low standing at 46.7% for the whole country and 57% for Lusaka province. It has been difficult to specifically account for factors that are leading to low adoption of EBF. This study therefore aimed at exploring factors that may be associated with low adoption of EBF in order to help direct both policy and practice of EBF. An exploratory mixed methods study was conducted at Chelston clinic in Lusaka capturing 309 mothers from high, medium and low density residential areas. A study questionnaire was used to collect quantitative data while focus group discussions (FGDs) were used to collect qualitative data. Four FGDs were done each comprising of 10 women drawn from all the three residential areas. Quantitative data was analysed statistically using STATA 11 while qualitative data was analyzed by thematic method. Findings from this study indicate that EBF is still low among the mothers and stands at 52.1% in areas surrounding Chelston clinic in Lusaka. Chi square tests of association showed that there was no association between EBF and demographic and economic factors (Age, marital status, education and income), but EBF practice was strongly related to spouse (p<0.001), support from EBF mothers (p<0.001), culture (p=0.014) and presence of EBF in the neighbourhood (p=0.05) Environmental factors had more influence on EBF. The findings suggest that policy implementation strategies should put more efforts on the environment around the EBF mothers. These are the spouses, family, members and the community in general. Among the factors leading to non-adherence to EBF were children crying due to hunger, traditional beliefs, less milk production and HIV+ mothers respectively. Most of the mothers also complained of low iv milk production as one of the reasons for non-adherence to EBF. Providing health education to the spouses, family members and the community in general on the importance of EBF is what should be encouraged.