The Effect of Health Education on the Knowledge, Attitude, and Practice of Exclusive Breast Feeding Among Mothers in Rural Communities

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The Effect of Health Education on the Knowledge, Attitude, and Practice of Exclusive Breast Feeding Among Mothers in Rural Communities

Abstract

The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life and continued breastfeeding up to two years of age or beyond. Promotion of exclusive breastfeeding is the single most cost -effective intervention to reduce infant mortality in developing countries. It is estimated that sub-optimal breastfeeding, especially non-exclusive breastfeeding in the first six months of life, results in 1.4 million deaths and 10% of diseases in under-fives. Evidence showed that of the sixty percent of under-five mortality caused by malnutrition (directly or indirectly), more than two-thirds of those are associated with inappropriate breastfeeding practices during infancy. Not more than 35% of infants worldwide are exclusively breastfed during their first four months of life. In view of the above, we carried out health education intervention study in eight rural health facilities in Enugu east of Enugu state. It was designed to effect a change on their practices of exclusive breast feeding. A multi-stage sampling method was used to select 384 and 371 respondents for study and control respectively. These were pregnant women at their last month of gestatlon and had at least breast -fed a baby. An interviewer administered questionnaire was used. Pre-intervention, over 80% of respondent had heard about exclusive breast feeding among both study and control groups. However in-depth knowledge of exclusive breast’ feeding was lacking resulting in inappropriate practices such as pre-lacteal feeding, complementary feeding with water and formular milk. Health education intervention successfully improved the knowledge and practice of exclusive breast feeding. more that 50% of women in both study and control groups practiced pre-lacteal feeding prior to intervention. Post-intervention, showed that more than 50% of women still practiced pre-lacteal feeding in the control group (with no intervention) while less than 24% of women practice prelacteal feeding in the study group. This was statistically significant (p value = < 0.05). Pre-intervention, in both the study and control groups showed a very poor knowledge and practice (23% and 28% respectively) of the correct positioning and attachment of a child to a breast during bre astfeeding. However, post intervention, the knowledge and practice of the correct positioning and attachment of a child to the breast during breastfeeding in the study group increased from 23% to 75.5%. This was actually statistically significant (p value = < 0.05). The rate of EBF preintervention of the study group was 25.8%, 16.7% and 12.5% at 6weeks, i 0 weeks and 14 weeks respectively. The rate post-intervention (after Health educat ion) of the study group w~s 51.9%, 51.4% and 47.7% at 6 weeks. 10 weeks and 14 weeks respectively. This was statistically significant (p= <0.005). We therefore recommended grass-route oriented health education to change these inappropriate practices.

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