BackgroundDespite the presence of high impact interventions to improve infant and young child feeding, only about 52% of mothers in Ethiopia exclusively breastfeed their child for the first six months after delivery. Although the decision to breastfeed a child is ultimately that of the mother, this decision could be influenced by a variety of factors including social-cognitive ones.ObjectivesThe objectives of the study were to describe the breastfeeding behaviour of primiparous mothers during their prenatal period in terms of intentions/goals, outcome expectancies, self-efficacy, and socio-structural factors and assess their exclusive breastfeeding (EBF) practices as well as identify the social-cognitive predictors of EBF practices among these mothers in Addis Ababa, Ethiopia.MethodsA prospective follow up health facility-based study with quantitative methods was used with a sample of 233 primiparous women. Both structured and semi-structured questions were used for collection of data. The Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. Findings at the 95% confidence interval and P-value of 5% were reported as statistically significant.Results39.1% (n = 59) of the respondents were found to have high breastfeeding self-efficacy, 51.4% (n = 71) have good breastfeeding outcome expectancies, and 6.5% (n = 9) respondents had supportive breastfeeding socio-structural factors. Bivariate correlation analysis showed positive and statistically significant correlation between each of breastfeeding self-efficacy, outcome expectancy, and socio-structural factors, with EBF practice. However, only breastfeeding self-efficacy and outcome expectancies were statistically significant predictors of EBF among the primiparous women when controlling for confounding variables.Conclusions and RecommendationsHealth programmes aimed at improving EBF among primiparous mothers should look beyond providing health information alone. Rather improving primiparous women’s breastfeeding self-efficacy and outcome expectancy is strongly recommended. Further community based large scale research is also recommended among similar groups of women.
Negative attitudes towards Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) communities exist in South Africa, regardless of the constitutional provision and anti-discriminatory policies. Cases of violence against LGBTI persons due to their sexual orientation have been reported in the media and scientific journals. This study focused on LGBTI students of a rural-based university. It explored and described their experiences in interacting with members and structures of the university community. A qualitative descriptive, exploratory, and contextual design was used and data were collected through individual face to face in-depth interviews. Interviews were conducted with 20 participants, who were selected through snow-balling technique. Thematic content analysis was used to analyse data.Stigma and discrimination were the mains theme that emerged from the analysis of the interviews. Four sub-themes and various categories were derived from the main theme. Despite the constitutional provisions and the core values guiding any university, LGBTI students are still being stigmatized and discriminated against because of their sexual orientation. Stigma and discrimination issues should be incorporated in all HIV prevention activities in universities in South Africa.
ObjectiveThe purpose of this study was to explore why some women who attend focused antenatal care (FANC) fail to deliver in health facilities from slums of Addis Ababa, Ethiopia.SettingPublic health facilities (three health centres and one district hospital).Study designA qualitative exploratory and descriptive research design was used.Study participantsStudy participants comprised women of reproductive age (18–49 years) living in slum areas of Addis Ababa, Ethiopia. We used 20 in-depth audio-recorded interviews. Data were analysed concurrently with data collection. Thematic analysis was done for the study. A multilevel life-course framework of facility-based delivery in low-income and middle-income countries developed by Bohren et al was used to frame the current study and link the findings of the study to the body of knowledge.ResultsFrom the analysis of in-depth interview data, four themes emerged, namely, perceived benefits of home delivery, knowledge deficit about health facility-based delivery, poor access to healthcare facilities and inadequate (demand side) resources. These themes were identified as rich and detailed accounts of the perspectives of facility-based and home delivery among attendees of FANC in Addis Ababa, Ethiopia.ConclusionThe findings of this qualitative study revealed that perceived benefits of home delivery, knowledge deficit about health facility-based delivery, poor access to healthcare facilities and inadequate (demand side) resources were related to low uptake of facility-based delivery services. Use of ANC visits to advise women about birth preparedness and complication readiness, the use of facility deliveries to reduce risks of home delivery to the mother and the newborn should be stressed.
A survey of nurse ward leaders understanding of, and their attitude to, community/ problem based learning (CPBL) approach adopted for the education of nursing students in the degree programme of the University of Natal in Durban (UND) was conducted. This was with a view to intervening, if necessary, to ensure positive understanding and attitude among the nurse leaders towards the non-traditional CPBL of UND nursing students. It was hypothesised that focused discussions, between facilitators and nurse ward leaders, aimed at providing information and explanation about the advantages of changing from traditional to non-traditional educational programmes in nursing would enhance positive attitude towards the students and their education programme. Using a questionnaire developed for this study, quantitative and qualitative data were twice collected at intervals of 5-6 months from 54 nurse ward leaders who interacted with the CPBL students in 27 wards of 2 provincial hospitals. The data, collected in the early part of the students’ deployment and at 5-6 months after included information about the participants understanding of CPBL; their rating of CPBL students in terms of expected knowledge and practice; and their attitude towards CPBL nursing students in clinical settings. Contact sessions were held with the participants in between the measures for a discussion about the CPBL programme and the expectations of the learners. Analysis of the pre and post measures showed more favourable attitude, improved understanding, and tolerance towards the students by the nurse ward leaders in the post-measures than in the pre-measures. The writers concluded that if students in this type of programme must experience satisfaction with less intimidation, implementers of CPBL programmes in nursing should relentlessly involve the qualified nurses and other professionals working with the students in informative discussions about the purpose and the process of learning in such programmes
Background: Exclusive breastfeeding for the first 6 months can prevent diseases, boost immunity and improve quality of lives of infants. Ghana implemented programmes aimed at reaching the global target of increasing exclusive breastfeeding for the first 6 months to at least 50% by the year 2025. The country witnessed a decline in the overall rate of exclusive breastfeeding and an increase in the number of teenage mothers. Globally, teenage mothers are less likely to breastfeed than mothers of other age groups. Understanding enablers of exclusive breastfeeding by teenage mothers is important for any intervention aimed at improving exclusive breastfeeding rates and the quality of lives of infants.Method: The study used a qualitative, exploratory, descriptive and contextual design, with focus groups. A total of six group discussions were conducted with 30 pregnant teenagers recruited from six public hospitals.Results: Seven enablers emerged from the analysis of data. These included positive beliefs about the benefits of breast milk, family history of positive exclusive breastfeeding outcomes, support of the intimate partner, approval of closed-family members, expert opinions of antenatal care staff, teenage-oriented breastfeeding education and community-based breastfeeding education.Conclusion: Health professionals and policy makers could learn from these enablers and use them to promote exclusive breastfeeding practices amongst teenage mothers in Ghana.
Background Global strategies to target high maternal mortality ratios are focused on providing skilled attendance at delivery along with access to emergency obstetric care. Research that examines strategies to increase facility-based skilled birth attendance among slum residents in Addis Ababa, Ethiopia, is limited. Objective The study aimed to explore women's perspectives on the measures that need to be taken to increase the use of the facility—delivery service among slums women, Addis Ababa, Ethiopia Methods Qualitative exploratory and descriptive research designs were used. Participants in the study were women in the reproductive age group (18–49 years of age) living in the slum areas of Addis Ababa, Ethiopia. A purposive sampling strategy was used to select study participants. Potential participants' names were gathered from health facilities and followed to their homes for the study. Four audio-recorded focus group discussions [FGDs] were conducted with 32 participants from the three public health centers and one district hospital. The number of participants in FGDs was between 6 and 10 women. Data were analyzed simultaneously with data collection. Thematic analysis was used in data analysis, which entails three interconnected stages: data reduction, data display, and data conclusion. In addition, thematic analysis entailed evaluating the structure and content of textual data, identifying data themes, coding the themes, and then interpreting the structure and content of the themes. A codebook was first devised, discussed, and adopted by the writers before they could use this technique. Using the codebook, the theme codes were then manually produced. To explain the study results, verbatim excerpts from participants were given. The researcher used Techs' eight steps of qualitative data analysis method for analyzing the data. A multi-level life-course framework of facility-based delivery in low- and middle-income countries (LMICs) developed by Bohren et al. was used to frame the current study and link the findings of the study to the body of knowledge. Results The FGDs included a total of 32 participants. The mean age of the overall sample was 32.6 years (± SD = 5.2). Participants' educational characteristics indicate that the majority (24 out of 32) was found to have no formal education, and two-thirds of participants were found to have one to five children. Three-fourths of them attended the ANC twice and they all gave birth to their last child at home. Two themes emerged from the analysis of focus group data, namely provision of quality, respectful and dignified midwifery care, and lack of awareness about facility delivery. These themes were described as a rich and comprehensive account of the views and suggestions made by focused antenatal care [FANC] participants on measures required to improve the use of the facility-delivery services. The findings of the study raise concerns about the effectiveness of FANC in encouraging facility-deliveries since FANC participants had not used health facilities for their last childbirth. According to the findings of the focus groups, women who took part in this study identified measures required to increase the use of health facility-delivery services among FANC participants in Addis Ababa's slum residents. It is to be expected that diligent counseling during antenatal care about birth plans would facilitate prompt arrival at facilities consistent with the desires of women.
Background: Maternal mortality and human immunodeficiency virus (HIV) continue to be major challenges to the Kingdom of Swaziland. In the past, the government introduced focused antenatal care and integrated it with national strategies to reduce maternal mortality and the mother-to-child transmission of HIV. It was anticipated that individualised and integrated principles guiding the focused antenatal care model would enhance the quality of care received by pregnant women, consequently leading to high utilisation of the antenatal care services, a low rate of mother-to-child transmission of HIV and better pregnancy outcomes. Method: The study used a qualitative, descriptive and exploratory design, with individual semi-structured, face-to-face interviews. A total of 18 interviews were conducted with 18 HIV-positive pregnant women who attended at least two antenatal care visits at a regional referral hospital. Results: Seven potential barriers emerged from the thematic comparative content analysis of the participants' descriptions. These were long waiting hours, poor equipment, nonadherence by the nurses with the working hours, fragmented care, lack of privacy, the length of time spent with health professionals, and inadequate health education. Conclusion: It is essential for healthcare providers to understand and address the factors which are viewed by HIV-positive pregnant women as being potential barriers to the use of focused antenatal care.
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