SOCIOCULTURAL FACTORS INFLUENCING EXCLUSIVE BREASTFEEDING AMONG NURSING MOTHERS IN PRIMARY HEALTH CARE CENTRE IN SURULERE L.G.A OF LAGOS STATE (Chapter 1-5)

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CHAPTER ONE

INTRODUCTION

Background to the Study

The World Health Organisation (WHO)’s effort to improve infant and young child nutrition have focused on promoting breastfeeding since 1993.  As a global public recommendation, infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health. Thereafter, to meet their evolving nutritional requirements, infants should receive nutritionally adequate and safe complementary food while breast feeding continues for up to two years of age or beyond (UNICEF, 1998). However, the World Health Organisation and United Nations International Children’s Emergency Fund recommended that babies should be fed exclusively on breast milk for the first six months of life (WHO, 2006). Breast feeding is an unequalled way of providing ideal food for the healthy growth and development of infants. It is also an integral part of the reproductive process with important implication for the health of mothers and babies (Edegbai , 2001). Exclusive breastfeeding is the practice of feeding the child in the first few months, say (six months) of life on human breast milk alone without the addition of water or other supplements (WHO, 2001).

Nutrition and nurturing during the first three years are both crucial for lifelong health and well-being of the child. In infancy, no gift is more precious than breastfeeding, yet barely one in three infants are exclusively breastfed during the first six months of life (Park, 2002).  Breast feeding is a key public health issue. The World Health Organisation and United Nations International Children Emergency Fund stress the responsibility of every society to ensure that breast feeding is facilitated to encourage the development of each child to his full potential.

Kapil, Bhasin and Monacha (1990) reported that successful breastfeeding depended not only on a willing mother, a healthy infant and an encouragement by medical personnel but also on the knowledge, attitude and beliefs about breastfeeding developed by mothers during pre and post natal care.  This view was also supported by the WHO (1991). The educational status of the mother determines the duration and practice of exclusive breast feeding. Efforts to improve breastfeeding can be targeted at the majority of women to modify their beliefs, attitude and practice and to increase their knowledge as regards the advantage and essentiality of early initiation of exclusive breastfeeding.

Artificial feeding may subject the baby to potential harm as there are risks of contaminated food, inadequate preparation, over or under preparation of nutrients. Globally, fever, respiratory infections are leading cause of death in children (Adegbenro, 2001) while diarrhoea ranks sixth, HIV/AIDS seventh and malaria ranks eight (UNICEF, 2006). However, in Nigeria, malnutrition and diarrhoea account for more than 50% of death among the under five children (Bradley & Meme 1992). By the end of the last decade, 27% of fewer than five children are underweight, 12% of children less than three years died while 46% of children fewer than 3 years have stunted growth (Zhakisheva, 1999, Federal Ministry of Health, 2001). Diarrhoea diseases which are closely related to lack of access to clean water, food as well as personal hygiene cause 2.3 million deaths annually (Alakija, 2000). The tragedy is that most of the deaths in the under 5 children which are largely due to malnutrition, and disease would have been prevented if children were exclusively breastfed in the first six months of life and continued on breast milk for at least the first two years of life.

Isokpunwu (2014) noted that Nigeria was predominantly a breastfeeding nation with 97 per cent compliance. However, the rate of exclusive breastfeeding has only shown a minimal increase from two per cent in 1990 to 17 per cent in 2013. According to him, Poor exclusive breastfeeding practices in Nigeria have been associated with inadequate support from husbands, partners and health professionals. Others include delayed initiation of breastfeeding, negative peer influences as well as short paid maternity leave for working mothers.

Statement of the Problem

Approximately 1.5 million young infants die each year as a result of lack of knowledge about exclusive breastfeeding benefits and improper infant and young child feeding practices (Nguyen, 2009). The World Health Organization (WHO), United Nations Children’s Fund (UNICEF) and other organizations promote exclusive breastfeeding as one of the key effective low-cost interventions to enhance child survival. Numerous awareness campaigns have been launched by national governments, multilateral organizations, and non-governmental and private sector organizations across the globe to educate mothers and families about the benefits of exclusive breastfeeding and with aim to encourage the practice (Nguyen, 2007).

The interest of the researcher was aroused by interactions with nursing mothers who disclosed some factors affecting exclusive breastfeeding of their baby which include work schedule, and fears about excessive weight loss that sometimes accompanies exclusive breastfeeding.

While there is a large body of published material on the factors affecting breastfeeding, there are few studies documenting socio-cultural factors influencing exclusive breastfeeding. To improve exclusive breastfeeding, factors influencing its practice have to be identified in order to target these in programme implementation. In Nigeria, the determinants socio-cultural of exclusive breastfeeding especially in resource- poor settings have not been fully investigated, Hence the decision of the researcher to conduct this study.

Purpose of the study

The aim of the study was to investigate the sociocultural factors influencing exclusive breastfeeding among nursing mothers in Primary Health Care centre in Surulere L.G.A of Lagos State

Research Questions

This research provided answers to the following questions:

1. Will marital status have any influence on the practice of exclusive breastfeeding among nursing mothers in Lagos State?
2. Will religious beliefs have any influence on the practice of exclusive breastfeeding among nursing mothers in Lagos State?
3. Will ethnic group have any influence on the practice of exclusive breastfeeding among nursing mothers in Lagos State?
4. Will educational status have any influence practice of exclusive breastfeeding among nursing mothers in Lagos State?
5. Will marital status have any influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos State?
6. Will religious belief have any influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos State?
7. Will ethic group have any influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos State?
8. Will education status have any influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos State?

Research Hypotheses

The following research hypotheses were tested in the study:

1. Marital status will have no significant influence on the practice of exclusive breastfeeding among nursing mothers in Lagos state
2. Religious belief will have no significant influence on the practice of exclusive breastfeeding among nursing in Lagos state
3. Ethnic group will have no significant influence on the practice of exclusive breastfeeding among nursing mothers in Lagos state
4. Education status will have no significant influence on the practice of exclusive breastfeeding among nursing mothers in Lagos state.
5. Martial status will have no significant influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos state
6. Religious belief will have no significant influence on the knowledge of exclusive breastfeeding among nursing in Lagos state
7. Ethnic group will have no significant influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos state
8. Education status will have no significant influence on the knowledge of exclusive breastfeeding among nursing mothers in Lagos state.

Significance of the Study

This study is beneficial in the following ways:

1. The findings could be useful for the Ministry of Public Health and Sanitation (MOPHS) and other organizations working in child survival programmes to design interventions to improve the practice of exclusive breastfeeding in the area and other similar circumstances.
2. The findings could also be useful as a contribution to the ongoing research efforts on exclusive breastfeeding and child survival
3. The findings could be of immense benefit to the family, health, workers, the children, the government as well as the researcher.  They shall also know that breast milk is the best milk for babies and it is more economical. Children could also benefit by having less disease which hinder them from their normal growth and development in life which enhance physical, emotional and psychological with mental ability.

Delimitation of the Study

The research study was delimited to the following:

1. Primary Health Care Centre Akerelere, Surulere, Primary Health Care Center, Igbaja, Surulere, Primary Health Care Center, Aguda, Surulere and Primary Health Care Center Pako-Aguda , Surulere, LGA, Lagos
2. Staff and nursing mothers of the above- mentioned health care centers
3. The use of questionnaire.
4. The descriptive statistics of frequency and simple percentages and inferential statistic of one-way analysis of variance

Limitation of the Study

The Nurses on duty at the sites of data collection were very busy with the nursing mothers, as such the researcher waited for hours to be able to elicit responses for the participants

Operational Definition of Terms

Infant: A baby of a nursing mother

Knowledge: Facts, information, and skills acquired by nurse mothers through experience or education

Practice:  The actual application or use of an idea, belief, or method which is peculiar to nursing mother in terms of exclusive breastfeeding

Cultural belief: This are belief in ancestral practices which is peculiar to nursing mother various communities in terms of feeding exclusive breastfeeding.

Ethnic group:  A community or population made up of nursing mothers who share a common cultural background or descent.

Educational status: This is the highest academic qualification of nursing mothers in Surulere local government Area (LGA)

Exclusive breastfeeding- this is the act of feeding infant only on breast milk (including milk expressed exclusively for the first 6 months

Socio–cultural factors: Factors of cultural belief, peer influence, educational status of nursing mothers

Project Overview

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