In-Depth Assessment of Exclusive Breastfeeding Attitudes, Beliefs, Practices, and Key Influencers of Behavior in Villa Guadalupe, Managua Open Access

Avila, Wendy (Spring 2018)

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Background: Adequate nutrition within the first 1,000 days between a woman’s pregnancy and a child’s second birthday is critical for child development. To maintain low morbidity and mortality rates related to malnutrition, the World Health Organization recommends exclusive breastfeeding for the first six months of a child’s life. Nicaragua, the second poorest country in Central America, experiences disparate rates of breastfeeding practices with high general breastfeeding rates and low exclusive breastfeeding rates. This disparity is distinct in communities with high malnutrition rates like Villa Guadalupe in the department of Managua. Manna Project International is a nongovernmental organization whose mission is to serve vulnerable populations similar to the one in Villa Guadalupe through their various programs, which include: The Villa Guadalupe Clinic and the Maternal-Child Nutrition program. One of their primary goals is to gain an understanding of the influential factors behind breastfeeding practices in order to implement programming that encourages exclusive breastfeeding.

Objective: To explore local attitudes, beliefs, practices, and key influencers related to exclusive breastfeeding in the Villa Guadalupe community in Managua, Nicaragua.

Methods: A qualitative assessment involving 20 in-depth interviews with mothers was used in this study. Mothers had to be 0-1 postpartum and residents of the Villa Guadalupe community.

Results: The Theory of Planned Behavior was employed for this study. Only two of the 20 women were practicing exclusive breastfeeding at the time of the interview. Results showed that the main barriers towards exclusive breastfeeding among this community adhered to the construct, perceived behavioral control and include work, mother’s poor diet, perceived insufficient milk production, and pain and sickness.

Table of Contents

Table of Contents

Chapter I. Introduction

Background and Context

Problem and Significance

Primary Objective and Specific Aims

Theoretical Framework

Figure 1. Diagram of Theory of Planned Behavior

Chapter II. Review of the Literature

Exclusive Breastfeeding

National Statistics

Theory of Planned Behavior

Chapter III. Methods

Participants, Measures, and Procedures

Data Analysis

Chapter IV. Results

Descriptive Statistics


Exclusive Breastfeeding

Intention to Breastfeed

Formula, Substances, and Other Foods

Family and Partner Support

Partner Support

Family Support

Mother’s Diet

Insufficient Food


Information from Health Workers and Specialists

Chapter V. Discussion


Figure 2. Theoretical Constructs Applied to Results

Figure 3. The Role of Perceived Behavioral Control on Exclusive Breastfeeding

The Role of Poverty


Future Research




Appendix A: Spanish In-Depth Interview Guide

Appendix B: Codebook

Appendix C: Villa Guadalupe Participant Sociodemographic Information

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