Implementation of Breastfeeding Practices in Bagamoyo District Tanzania

Abstract

Background: Breastfeeding is one of the best primary interventions in ensuring a ppropriate infant health and child survival. Breastfeeding practices involves breastfeeding initiation, exclusive breastfeeding, and continued breastfeeding . In 2013, Tanzania introduced Infant and Young Children feeding guideline aiming at improving brea stfeeding practices. However, despite introduction of the IYCF guideline breastfeeding practices is still low. The factors influencing breastfeeding practice in Tanzania are not well documented. It is not clear if parity and marital status have association with breastfeeding practices in Tanzania. Therefore, a study to determine associations existing between these factors and breastfeeding practice in Tanzania setting is essential in the implementation of the IYCF guidelines. Objective: To assess the implem entation of breastfeeding practices as stated by the IYCF guideline in Bagamoyo District and to determine the factors that are associate d with breastfeeding practices. Methods: A cross sectional study was conducted at Bagamoyo from 19 of April to 7 of May 2021. Interview er administered questionnaire was used to collect data from 384 mothers whose children were aged under 2 years . Data were analyzed using SPSS. Descriptive statistics was used to calculate frequencies and proportions. Additionally, chi square test was carried out using cross tabs to analyze if there was significant difference between respondents’ groups and breastfeeding practice in order to understand and to be able to explain the proportions obtained. It must be noted, chi square was used to provide additional information and was not meant to establish associations . To determine the factors associated with breastfeeding practices, s tepwise logistical regression was used to develop a model. Omnibus chi square test was included to determine if the prediction of breastfeeding practice using the factors was significantly better compared to prediction without factors Results were compared with results from other studies and data relating to IYCF National guidelines. Results: The results for the proportion of mothers practicing breastfeeding in Pwani were 55%, 75, 62% for BFI, EBF and CBF respectively. Logistic regressions models were developed each for BFI, EBF, and CBF. Seven associated factors were identified: awareness (aware vs not aware), cultural values (non-believer vs believer), due date delivery (yes vs no), marital status (married vs single), mode of delivery (normal vs caesarian), number of children, and parity (primiparous vs multiparous). BFI model: awareness (OR = 5.47; 95% CI: 3.05,9. 78), delivered on due date (OD = 4.64; 95% CI: 1.22,17.69), and parity (OR = .28; 95% CI: .1,.77). EBF model: awareness (OR = 2.05; 95% CI: 1.177,3.58), marital status (OR = 2.14; 95% CI: 1.22, 3.74), cultural values (OR = 5.08; 95% CI: 1.27,20.45), and mo de of delivery (OR = 2.01; 95% CI: 1.15,3.5). CBF model: awareness (OR = 2.25; 95% CI: 1.39,3.65), marital status (OR = 2.55; 95% CI: 1.51,4.31), and number of children (OR = 1.80; 95% CI: 1.12,2.90 Conclusion: The proportions indicate an improvement in breastfeeding practice in Pwani region, implying that the implementation of the IYCF National guidelines is optimal. The study identified important factors that influences breastfeeding practices in Pwani region that need to be considering in efforts of i mproving nutritional status on children in Tanzania through breastfeeding practices as proposed by the Infant, Youth and Child Feeding National Guideline. These factors are marital status, awareness of the benefits of breastfeeding practice and understandi ng of cultural values relating to breastfeeding.