Kyei-Arthur Frank, Aballo Jevaise, Mahama Abraham B, Adu-Afarwuah Seth
Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana.
UNICEF Ghana, Accra-North, Ghana.
PLoS One. 2024 Aug 1;19(8):e0307961. doi: 10.1371/journal.pone.0307961. eCollection 2024.
In Ghana, breastfeeding and complementary feeding counselling have been used as a nutritional intervention to promote optimal Infant and Young Child Feeding (IYCF) and nutrition. This study examined IYCF practices in four geographically and ethnically diverse districts (Ho West, Tain, Talensi and Tolon). A qualitative study involving key informant interviews (KIIs) and focus group discussions (FGDs) was conducted between November and December 2019 among women who participated in a pilot micronutrient powder intervention for children 6-23 months of age. The KIIs and FGDs were audio-taped, transcribed verbatim, and analyzed thematically using NVivo 10. Three themes emerging from the KIIs and FGDs were: level of adherence to IYCF recommendations among mothers and caregivers; IYCF recommendations perceived as the hardest to follow; and perceived motivators, facilitators, and barriers to IYCF practices. Mothers in the four districts generally followed the eight IYCF recommendations. Mothers in the Tolon district demonstrated adherence to IYCF practices, often citing the need for early initiation of breastfeeding, timely introduction of complementary feeding, and feeding children aged 9-23 months 3 times daily in addition to breastfeeding. In contrast, mothers in other districts faced challenges that hindered adherence. Giving children 4 or more food groups and timely introduction of complementary feeding were perceived as the hardest practices to follow. The main facilitators of IYCF practices include midwives and frontline nurses teaching mothers how to breastfeed, and midwives ensuring mothers initiate breastfeeding immediately after delivery. The main barriers to IYCF practices identified were insufficient breastmilk; mothers-in-law giving water to children before six months; resumption of work; and lack of financial means. Mothers in the Ho West district reported more barriers to IYCF practices, followed by mothers in the Tain, Talensi, and Tolon districts. Health practitioners, stakeholders, and policymakers should design targeted interventions that address the contextual barriers to improve IYCF practices in the various districts.
在加纳，母乳喂养和辅食喂养咨询已被用作一种营养干预措施，以促进最佳婴幼儿喂养（IYCF）和营养。本研究调查了四个地理和种族各异的地区（霍西、泰恩、塔伦西和托隆）的婴幼儿喂养习惯。2019年11月至12月期间，对参与6至23个月儿童微量营养素粉试点干预项目的女性进行了一项定性研究，包括关键 informant 访谈（KIIs）和焦点小组讨论（FGDs）。KIIs 和 FGDs 进行了录音，逐字转录，并使用 NVivo 10 进行了主题分析。KIIs 和 FGDs 中出现的三个主题是：母亲和照顾者对婴幼儿喂养建议的遵守程度；被认为最难遵循的婴幼儿喂养建议；以及婴幼儿喂养习惯的感知动机、促进因素和障碍。四个地区的母亲总体上遵循了八项婴幼儿喂养建议。托隆地区的母亲表现出对婴幼儿喂养习惯的遵守，经常提到需要尽早开始母乳喂养、及时引入辅食，以及除母乳喂养外，每天给9至23个月大的孩子喂食三次。相比之下，其他地区的母亲面临阻碍遵守的挑战。给孩子提供4种或更多食物组以及及时引入辅食被认为是最难遵循的做法。婴幼儿喂养习惯的主要促进因素包括助产士和一线护士教导母亲如何母乳喂养，以及助产士确保母亲在分娩后立即开始母乳喂养。确定的婴幼儿喂养习惯的主要障碍包括母乳不足；婆婆在孩子六个月前给孩子喂水；恢复工作；以及缺乏经济手段。霍西地区的母亲报告的婴幼儿喂养习惯障碍更多，其次是泰恩、塔伦西和托隆地区的母亲。卫生从业人员、利益相关者和政策制定者应设计有针对性的干预措施，以解决背景障碍，改善各地区的婴幼儿喂养习惯。
