Knowledge, attitudes and practices of nurses's regarding mother-baby friendly initiative in non-accredited primary healthcare facilities of Makhuduthamaga Sub-District in Limpopo Province

Abstract

Background: The Mother-Baby Friendly Initiative (MBFI) promotes and supports breastfeeding in environments such as clinics, community health centres and hospitals that have fully-functioning maternity units. The implementation of the Mother-Baby Friendly Initiative in hospitals is associated with significant increases in the initiation and duration of exclusive breastfeeding (EBF). The Mother-Baby Friendly Initiative also leads to improved healthcare for infants, children and provides improved maternal health to all mothers. The main aim of this study was to assess the knowledge, attitudes and practices (KAP) of nurses regarding the Mother-Baby Friendly Initiative in non-accredited primary healthcare (PHC) facilities of Makhuduthamaga Sub-district. Method: Descriptive, cross-sectional and correlational study designs were used with the quantitative method. All the 18 non-accredited primary healthcare facilities were purposively selected and a total sampling method was used to select all the nurses working in these non-accredited primary healthcare facilities. Permission to conduct the study was sought from the University of Venda Research Ethics Committee and the Limpopo Department of Health Research Committee. Data was collected using a structured self-administered questionnaire. Content and face validity were enhanced before the actual data collection process. One hundred and ninety questionnaires were distributed and 164 responded, giving a response rate of 86.3%. Cronbach’s alpha test determined the reliability and reflected 0.981, indicating high reliability. Data was analysed using the Statistical Package for Social Sciences (SPSS) 23.0 and the Pearson coefficient of correlation established the relationship between variables. The study followed ethical considerations such as privacy, autonomy, confidentiality, fair treatment and right to self-determination. Results: In this study, 50.6% were professional nurses (PNs), 6.7% were nursing managers (NMs), 15.2% were enrolled nurses (ENs) and 27.4% were enrolled nursing assistants (ENAs). This study found that 100% of NMs, 65.1% of PNs, 54.2% of ENs and 26.7% of ENAs had received formal training on lactation management. Seventy-two percent (72%) of NMs, 90.4% of PNs, 72% of ENs vii and 66.7% of ENAs were knowledgeable about the duration of exclusive breastfeeding. This analysis found that the majority of nurses agreed that MBFI increases breastfeeding rates. Results showed that 63.6% of NMs, 69.6% of PNs, 56% of ENs and 46.7% of ENAs teach and demonstrate hand-milk expression to breastfeeding mothers. Furthermore, this research revealed that there was a significant relationship between the knowledge, attitudes and practices of nurses with a p-value of (p-00.01). Recommendations and Conclusion: This study recommends that all nurses should receive formal training on MBFI implementation and this should be conducted to improve ENs and ENAs’ awareness about MBFI. MBFI should be integrated into the training curriculum for all nursing categories. This study further recommends that a support model for implementation of MBFI be developed and implemented.