An intervention programme to promote exclusive breastfeeding strategies in Limpopo Province, South Africa

Abstract

The benefits of breastfeeding, particularly exclusive breastfeeding, are well recognized. It can reduce the risk of mortality related to malnutrition, otitis media and respiratory infection. Breastfeeding may also decrease the risk of obesity in later life for infants who have been breastfed for more than six months. Besides, breastfeeding improves cognition, and children who have been breastfed show higher intelligence quotient test scores and improved school performance. In addition, long-period breastfeeding is associated with a reduced risk of breast cancer and ovarian cancer for mothers. The World Health Organization and United Nations International Children’s Emergency Fund recommended exclusive breastfeeding for six months and breastfeeding to two years and beyond. However, this study showed that only 27% of children under six months have had been exclusively breastfed. In this situation, an intervention programme was required.

The aim of this study was to develop an intervention programme to promote exclusive breastfeeding strategies in Limpopo Province. Intervention mapping was used to guide the development of a programme. A convergent, parallel mixed-method was used wherein qualitative and quantitative data were collected and analysed concurrently. A qualitative approach was used to assess the implementation of exclusive breastfeeding and to explore challenges experienced by health care workers in the implementation of exclusive breastfeeding in Limpopo Province. This was carried out by means of in-depth interviews with 30 professional nurses. Trustworthiness was ensured through credibility, confirmability, dependability and transferability. A quantitative approach was used to determine the factors that influence exclusive breastfeeding. Reliability and validity of the instrument was ensured through extensive literature review and test-retest methodology. Questionnaires were distributed to 400 respondents. Tesch’s eight steps of data analysis was used to analyse qualitative data. The Statistical Package for the Social Sciences, version 26, was used to analyse the quantitative data. The results were merged, and the interpretation discussed. Five higher-order themes emerged from quantitative data analysis. The themes emerged from qualitative data were confirmed by the findings from statistical data, thus merging both qualitative and quantitative data. Findings were presented to the stakeholders, managers and dieticians and their inputs further confirmed and supported the findings. The findings informed the development of an intervention programme. The intervention comprises of the three components, training of community health workers, healths talks focusing on lactating mothers and health talks focusing on families and community. The developed intervention was validated by the stakeholders and the results were analysed through simple descriptive statistics where the data were summarized using frequency distributions and graphic representations. The results revealed that the programme was feasible, compatible and applicable to current practice. Recommendations were made and topics for further research were also suggested.