Barriers and Facilitators to Participation in Support Groups and Counseling Services in Promotion of Infant and Young Child Feeding Practices in West Timor, Indonesia Open Access

Abstract

Background: Optimal infant and young child feeding (IYCF) practices have the potential
to reduce health outcomes related to undernutrition in developing countries. A number of
strategies are being implemented to improve IYCF, improve nutrition, and related
maternal and child health outcomes. There is limited research as to what are effective
methods for improving IYCF practices.

Objective: The study explores the barriers and facilitators to participation in MtMSG in
West Timor, Indonesia. Additionally, the study also explores the role of other support
groups, and investigates alternative resources of IYCF information.

Methods: A doer/non-doer survey (D/ND) (n=29) investigated the differences between
those who attend, or facilitate, MtMSG, and those who do not. Focus group discussions
(FGDs) (n=12) investigated the village perceptions of MtMSG and alternative support
groups. In-depth interviews (IDIs) (n=4) investigated the trust relationships and decision-
making processes. Lastly, key informant interviews (KIIs) (n=5) investigated the national
context of IYCF.

Results: Major themes from the data indicated that MtMSG were not functioning
optimally due to the didactic style of the group and the duplication of IYCF information
that women receive. Data also demonstrate that husbands are prominent influences on
decision-making, and that women experience issues of privacy and lack of trust that may
prevent participation in MtMSG.

Discussion/Conclusion: The didactic style and the duplication of IYCF information that
women receive inhibit participation in MtMSG. Women, instead, are turning to
individual counseling, or receive information as a part of a monthly growth monitoring
day. Support groups should be restructured to create a supportive environment, while
limiting didactic nature. Individual counseling should be scaled up to reflect women's
feelings regarding privacy and trust. Lastly, buy-in from husbands is valuable, regardless
of the strategy. Evidence from this study can be used to inform future CARE
programming.

Table of Contents

Table of Contents

Chapter 1: Introduction
1
Definition of Terms
6
Chapter 2: Review of the Literature
7
Chapter 3: Methods
29
Chapter 4: Results
41
Chapter 5: Discussion and Conclusions
55
References
81

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	complementary feeding mother-to-mother support groups infant and young child feeding support groups Indonesia breastfeeding
Committee Chair / Thesis Advisor	Girard, Amy Webb, Emory University
Committee Members	Beeson, Abigail, CARE International
Partnering Agencies	Emory University schools, faculty or affiliated programs International Non-governmental organization (e.g., CARE, Inc.)

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