Chale Lucy E, Fenton Tanis R, Kayange Neema
Bugando Medical Centre, Department of community health services, Faculty of Nursing, Catholic University of Health and allied sciences (CUHAS), Mwanza, Northwest Tanzania.
Nutrition Services, Alberta Health Services, Department of Community Health Sciences, Alberta Children's Hospital Research Institute, O'Brien Institute for Public Health, Faculty of Medicine, University of Calgary, Calgary, AB Canada.
BMC Nurs. 2016 Dec 30;15:72. doi: 10.1186/s12912-016-0192-0. eCollection 2016.
Universal exclusive breastfeeding (EBF) for the first 6 months is estimated to reduce infant mortality by 13-15% (9 million) in resource poor countries. Although 97% of women initiate breastfeeding in Tanzania, exclusive breastfeeding for 6 months remains below 50%. Accurate knowledge and practical skills pertaining to exclusive breastfeeding among health workers is likely to improve breastfeeding rates. Our study reports the health workers' knowledge and practice on EBF in Mwanza City, northwest of Tanzania.
One principal researcher and two research assistants conducted data collection from 11 June-6 July 2012. In total, 220 health care workers including: 64 clinicians (medical specialists, residents, registrars, assistant medical officers and clinical officers) and 156 nurses were interviewed using a structured knowledge questionnaire. Amongst 220 health workers, 106 were observed supporting Breastfeeding using a checklist. Logistic regression was used to determine factors associated with exclusive breastfeeding knowledge and desirable skills.
Almost half of the 220 health workers interviewed correctly described EBF as defined by the World Health Organization. Only 52 of 220 respondents had good knowledge. In the adjusted analysis, working at hospital facility level compared to dispensary (OR 2.1; 95% CI 1.1-4.0, -value = 0.032) and attending on job training (OR 2.7; 95% CI 1.2-6.1, -value = 0.015) were associated with better knowledge. In total, 38% of respondents had a desirable level of practical skills. Clinicians were more likely to have good practice (OR 3.6; 95% CI 1.2-10.8; -value = 0.020) than nurses. Most of the health workers had no training on EBF, and were not familiar with breastfeeding policy.
Less than 25% of healthcare workers surveyed had good knowledge of EBF. These findings identify the need for comprehensive training and mentoring of health workers on exclusive breastfeeding, making breastfeeding policies available and understood, along with supportive supervision and monitoring.
据估计，在资源匮乏国家，头6个月完全纯母乳喂养可使婴儿死亡率降低13% - 15%（900万）。尽管在坦桑尼亚97%的妇女开始进行母乳喂养，但6个月纯母乳喂养率仍低于50%。卫生工作者掌握准确的纯母乳喂养知识和实践技能可能会提高母乳喂养率。我们的研究报告了坦桑尼亚西北部姆万扎市卫生工作者关于纯母乳喂养的知识和实践情况。
2012年6月11日至7月6日，由一名首席研究员和两名研究助理进行数据收集。总共对220名卫生保健工作者进行了访谈，其中包括64名临床医生（医学专家、住院医师、注册员、助理医务人员和临床干事）和156名护士，使用结构化知识问卷进行调查。在220名卫生工作者中，有106人使用检查表观察其对母乳喂养的支持情况。采用逻辑回归分析确定与纯母乳喂养知识和理想技能相关的因素。
在接受访谈的220名卫生工作者中，近一半正确描述了世界卫生组织所定义的纯母乳喂养。220名受访者中只有52人有良好的知识水平。在调整分析中，与在诊疗所工作相比，在医院设施层面工作（比值比2.1；95%置信区间1.1 - 4.0，P值 = 0.032）以及参加在职培训（比值比2.7；95%置信区间1.2 - 6.1，P值 = 0.015）与更好的知识水平相关。总共有38%的受访者具备理想水平的实践技能。临床医生比护士更有可能有良好的实践表现（比值比3.6；95%置信区间1.2 - 10.8；P值 = 0.020）。大多数卫生工作者没有接受过纯母乳喂养方面的培训，并且不熟悉母乳喂养政策。
接受调查的卫生工作者中，不到25%对纯母乳喂养有良好的知识水平。这些研究结果表明需要对卫生工作者进行关于纯母乳喂养的全面培训和指导，提供并使其理解母乳喂养政策，同时进行支持性监督和监测。
