Infant and Young Child Feeding in Four Departments in Haiti: A Mixed-method Study of Practices, Determinants, Attitudes, and Beliefs Öffentlichkeit

Laterra, Anne (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/mg74qm804?locale=de
Published

Abstract

Objectives : Although breastfeeding is near universal in Haiti, sub-optimal complementary feeding practices have been observed and documented. The objective of this study was to determine the prevalence and patterns of exclusive breastfeeding (EBF), continued breastfeeding (CBF) and diverse complementary feeding among children less than 24 mo in four regions in Haiti. This study also aims to identify attitudes and beliefs that inform these behaviors and identify factors associated with these recommended practices.

Methods: This study utilized a mixed-methods approach consisting of a cross-sectional survey of 310 women and 12 focus group discussions among women with children ≤ 2 y of age. Multivariable logistic regression analyses were conducted to identify factors associated with EBF for the first 6 mo of life, CBF for ≥ 2 y of age, and receipt of a diverse variety of complementary foods. Qualitative data were recorded, transcribed verbatim and analyzed for common themes.

Results: The prevalence of EBF, CBF, and achievement of minimum dietary diversity (MDD) was 57%, 11.9% and 21.2%, respectively. EBF was statistically significantly associated with infant's age when controlling for annual household income, location of most recent birth, or receipt of continued-breastfeeding counseling [OR=0.67 (95% CI: 1.10-16.60)]. CBF was not statistically significantly associated with rural place of residence, receipt of continued breastfeeding counseling, parity, or infant's age. Meeting MDD was not significantly associated with parity, receipt of postnatal care, rural place of residence, location of most recent birth, receipt of IYCF counseling, or level of schooling attended. Beliefs surrounding the relationship between the mother's health and her diet on the quality of breastmilk may prohibit EBF and CBF. Qualitative data revealed that dietary diversity may be low because mothers often struggle to introduce complementary foods and those that are traditionally introduced are not varied and primarily consist of grains and starches.

Conclusions: The practice of the three recommended IYCF practices examined in this study is sub-optimal, particularly CBF and achievement of MDD. Future communication and programming efforts should address the misunderstandings and concerns identified through qualitative methods.

Table of Contents

Table of Contents

CHAPTER 1: INTRODUCTION...............................................................................................1

Infant and Young Child Feeding...........................................................................................2 Aims and Objectives..........................................................................................................3 Study Setting: Infant and Young Child Feeding in Haiti.............................................................4 CHAPTER 2: LITERATURE REVIEW.........................................................................................6 Infant and Young Child Feeding Worldwide.............................................................................6 Infectious Disease.............................................................................................................7 Nutrition...........................................................................................................................9 Development....................................................................................................................10 Global Gains.....................................................................................................................11 Infant and Young Child Feeding in Lower-Income Countries.......................................................12 Infant and Young Child Feeding in Haiti.................................................................................15 Importance of Infant and Young Child Feeding in Haiti..............................................................18

CHAPTER 3: MANUSCRIPT...................................................................................................20

Chapter 4: PUBLIC HEALTH IMPLICATIONS.............................................................................48 Future Directions..............................................................................................................49 Conclusion.......................................................................................................................52 REFERENCES....................................................................................................................53 APPENDIX........................................................................................................................58 A. Survey Tool.................................................................................................................58 B. Focus Group Discussion Guide..........................................................................................72

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