Hoyos-Loya Elizabeth, Pérez Navarro Cecilia, Burrola-Méndez Soraya, Hernández-Cordero Sonia, Omaña-Guzmán Isabel, Sachse Aguilera Matthias, Ancira-Moreno Mónica
Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico.
Health Department, Universidad Iberoamericana, Mexico City, Mexico.
Front Nutr. 2024 Jan 9;10:1278280. doi: 10.3389/fnut.2023.1278280. eCollection 2023.
This article aimed to identify the main barriers related to promoting and counseling breastfeeding (BF) at the Primary Health Care (PHC) in Mexico.
A qualitative study with a phenomenological approach was carried out in 88 health centers of the Ministry of Health in the states of Chihuahua, Oaxaca, Chiapas, Veracruz, Mexico, and Yucatan. From September to November 2021, we interviewed 88 key health professionals (HPs) (physicians, nurses, nutritionists, and others) from the PHC of the Ministry of Health in Mexico and 80 parents of children under 5 years old. In addition, nine focus groups were conducted with parents and caregivers. The data obtained were triangulated with information from focus groups and semi-structured interviews.
Of the total interviews, 43.2% ( = 38) were nurses, 29.5% ( = 26) were physicians, 19.3% ( = 17) were nutritionists, and the rest were other health professionals. In the group of users, 97.6% ( = 121) were women. We identified contextual barriers, such as the lack of well-trained health professionals and the scarcest nutrition professionals, as material resources in the health units, without mentioning the low user attendance at their control consultations. Furthermore, we identified barriers related to the orientation and promotion of breastfeeding in health units, including a lack of specific strategies, ineffective communication, and the recommendations of commercial milk formulas.
The results presented reflect the reality of Mexico in relation to BF, making it urgent to take immediate action to improve the quality of nutritional care related to the promotion and orientation of BF at the PHC.
本文旨在确定墨西哥初级卫生保健机构中促进和咨询母乳喂养相关的主要障碍。
采用现象学方法进行定性研究，研究对象来自奇瓦瓦州、瓦哈卡州、恰帕斯州、韦拉克鲁斯州、墨西哥州和尤卡坦州卫生部的88个卫生中心。2021年9月至11月，我们采访了墨西哥卫生部初级卫生保健机构的88名关键卫生专业人员（医生、护士、营养师等）以及80名5岁以下儿童的家长。此外，还与家长和照顾者进行了9次焦点小组讨论。所获数据与焦点小组和半结构化访谈的信息进行了三角验证。
在所有访谈对象中，43.2%（n = 38）是护士，29.5%（n = 26）是医生，19.3%（n = 17）是营养师，其余为其他卫生专业人员。在用户群体中，97.6%（n = 121）是女性。我们确定了一些背景障碍，如缺乏训练有素的卫生专业人员以及营养专业人员最为稀缺，卫生单位的物质资源不足，且未提及用户在其定期咨询中的低出勤率。此外，我们还确定了卫生单位在母乳喂养指导和推广方面的障碍，包括缺乏具体策略、沟通无效以及商业配方奶粉的推荐。
所呈现的结果反映了墨西哥在母乳喂养方面的实际情况，迫切需要立即采取行动，以提高初级卫生保健机构中与母乳喂养促进和指导相关的营养护理质量。
