Exclusive breastfeeding in Manafwa District, Eastern Uganda - opportunities and challenges :

Abstract

Background: The history and importance of breastfeeding is emphasized from anthropology of nutrition studies albeit with challenges. Furthermore exclusive breastfeeding (EBF) is a known economically effective intervention that can help reduce maternal and childhood morbidity and mortality. Moreover the global prevalence of EBF have remained low with Uganda averaging 42.6%.Subsequently in 2012, the World Health Assembly endorsed a Comprehensive maternal, infant and young child nutrition implementation plan with six specific global nutrition targets, one of which was to increase the rate of EBF in the first 6 months to at least 50% by 2025.This study aimed at tracking whether eastern Uganda had met the set target and what factors would be influencing EBF. Methods: We carried out a mixed methods cross sectional study in Manafwa district, eastern Uganda. We employed both qualitative and quantitative data collection tools. We based on the concepts of habitus and dispositions to explore the EBF through in-depth interviews (IDI). Qualitative data was summarized into tables and analysed using STATA version 14 while qualitative data was analysed using NVIVO version 12. Results: In total 387 mothers’ data was analysed. The average age was 25.2 years. The prevalence of EBF was 63.31% and it was majorly influenced by education level (P= 0.02,AOR=2.4,95%CI:1.39-4.13),religion(P=0.03,A OR=0.4,95%CI:0.2-0.72) and employment status(P=0.002,AOR=0.52,95% CI:1.79-15.18). During the IDI, several enablers of EBF such as need for spouse support and barriers such as lack of enough time, not feeding well and sexual play involving caressing the breasts emerged and misconceptions such as it being an abomination to breastfeed once gravid, insufficient breastmilk, breastmilk causing sores, and improper feeding. Conclusions: EBF is above the target in Manafwa district and efforts to strengthen it should involve more community and male involvement and health communication to demystify the misconceptions. Keywords: Exclusive breastfeeding • Male involvement • Manafwa • Uganda