Barriers to postnatal care and exclusive breastfeeding among urbanwomen in southeastern Nigeria

Abstract

Background:Available evidence shows that only a small proportion of Nigerian women access postnatal care and practice exclusive breastfeeding. Given that both interventions are critical to the survival of both the mother and the new born, it is important to identify factors that militate against an effective postnatal care and exclusive breastfeeding in the country, in order to scale up services. The aim was to determine the major barriers to postnatal care and exclusive breastfeeding among urban women in southeastern Nigeria.Materials and Methods:A cross-sectional survey of 400 urban market women using semistructured questionnaires and focus group discussions.Results:Out of 400 women interviewed, 365 (91.7%) attended postnatal clinic. Lack of knowledge about postnatal care services (42.2%; n = 14), distant location of the hospitals (36.4%; n = 12) and feeling that postnatal visits was not necessary (21.1%; n = 7) were the main reasons for non-attendance to postnatal clinic. With respect to exclusive breastfeeding, 143 (35.9%) of the women practiced EBF. The main reasons for nonpractice of EBF were that EBF was very stressful (26.2%; n = 67), mother's refusal (23.5%; n = 60), and the feeling that EBF was not necessary (18.1%; n = 46). Thirty five (13.7%) of the women were constrained by time while the husband's refusal accounted for 1.5% (n = 3) of the reasons for nonpractice of exclusive breastfeeding.Conclusion:Poor knowledge and inaccessibility to health facilities were the main obstacles to postnatal care while the practice of exclusive breastfeeding was limited by the stress and mothers refusal.

Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications

“…Ten studies were cross-sectional (11)(12)(13)(14)(15)(16)(17)(18)(19)(20) , three were mixed-methods (21)(22)(23) and two were prospective cohort studies (24,25) . Five crosssectional studies reported a significant positive association between ANC attendance and EBF (14)(15)(16)18,20) . Women with attendance at any ANC visit were twice as likely to practise EBF compared with women who did not attend ANC (36·4 v. 18·2 %, respectively; P = 0·00, χ 2 test) (16) .…”

“…Pakistan Cross-sectional X X Ssenyonga et al (38) 353 Uganda Cross-sectional X Suresh et al (53) 400 India Cohort Susiloretni et al (20) 541 Indonesia Cross-sectional X X Tamiru et al (22) 382 Ethiopia Cross-sectional X X Tiwari et al (15) 279 India Cross-sectional X Ugboaja et al (16) …”

“…India Cohort Susiloretni et al (20) 541 Indonesia Cross-sectional X X X X Tamiru et al (22) 382 Ethiopia Cross-sectional X Tiwari et al (15) 279 India Cross-sectional X X X X Ugboaja et al (16) 400 Nigeria Cross-sectional Ukegbu et al (40) Nigeria Cohort X X X X Webb-Girard et al (56) 150 Kenya Cross-sectional Yotebieng et al (27) 66 DRC Cross-sectional TOTAL 16 15 8 7 9 DRC, Democratic Republic of Congo. …”

Barriers to Breastfeeding in South-Asia: A Systematic Literature Review

“…They also believed that mother's milk does not meet nutritional requirements of a baby, has no effect on baby's weight and prohibits sexual intercourse while breast- feeding [11]. In southeastern Nigeria, the critical indicators for non-practice of EBF included maternal unwillingness, mother's being stressful and the feeling that EBF is unimportant [12]. In Southwest Nigeria, the barriers to breastfeeding were: maternal health problem, not enough to satisfy baby's hunger, the need to return to work, mother-in-law's demand, breast pain, and a fear of child's breast milk addiction [13].…”

“…Also, general discussions about breastfeeding challenges, promoting EBF through education and extending maternity leave are suggested for better outcomes [12][13][14][15][16]. Strategies to clarify the misconceptions about breastfeeding's insufficiency for an infant's growth need to be strengthened.…”