Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study
Abstract Background Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-08-01
|
| Series: | International Breastfeeding Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13006-022-00495-4 |
| _version_ | 1828358140453715968 |
|---|---|
| author | Atif Riaz Shelina Bhamani Sheraz Ahmed Fayaz Umrani Sadaf Jakhro Abdul Khaliq Qureshi Syed Asad Ali |
| author_facet | Atif Riaz Shelina Bhamani Sheraz Ahmed Fayaz Umrani Sadaf Jakhro Abdul Khaliq Qureshi Syed Asad Ali |
| author_sort | Atif Riaz |
| collection | DOAJ |
| description | Abstract Background Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan. Methods The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and mothers-in-law, and lady health workers (LHWs) serving in the study catchment. FGDs were audio-recorded, transcribed, and translated into English from the local language and analysed using thematic content analysis. Results Barriers to EBF included low awareness and cultural practices of prelacteal feeds, insufficient breast milk production, undernutrition of mothers, mothers’ occupation as fieldworkers, less birth spacing, low awareness about the correct technique of breastfeeding, maternal and child ailments, abnormal breasts, and influence of in-laws to start top-up feeds. Several facilitators were identified: family support, appropriate maternal diet, maternal awareness, and support in the neighborhood. Conclusion Barriers to EBF are multifaceted in rural areas, and interventions aiming to improve adherence to EBFshould be multipronged. Awareness-raising alone might not be sufficient, and other interventions should be designed to address the barriers of maternal malnutrition, insufficient milk production, and socio-cultural practices. In addition, safe alternatives to breast milk may be necessary if breastfeeding is truly not feasible. Lack of breast milk substitutes is particularly challenging for poor rural women who cannot afford infant formula milk. |
| first_indexed | 2024-04-14T03:24:17Z |
| format | Article |
| id | doaj.art-413981628e274a91840820fd8a34c446 |
| institution | Directory Open Access Journal |
| issn | 1746-4358 |
| language | English |
| last_indexed | 2024-04-14T03:24:17Z |
| publishDate | 2022-08-01 |
| publisher | BMC |
| record_format | Article |
| series | International Breastfeeding Journal |
| spelling | doaj.art-413981628e274a91840820fd8a34c4462022-12-22T02:15:12ZengBMCInternational Breastfeeding Journal1746-43582022-08-011711810.1186/s13006-022-00495-4Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory studyAtif Riaz0Shelina Bhamani1Sheraz Ahmed2Fayaz Umrani3Sadaf Jakhro4Abdul Khaliq Qureshi5Syed Asad Ali6Department of Pediatrics and Child Health, Aga Khan UniversityDepartment of Obstetrics and Gynaecology, Aga Khan UniversityDepartment of Pediatrics and Child Health, Aga Khan UniversityDepartment of Pediatrics and Child Health, Aga Khan UniversityDepartment of Pediatrics and Child Health, Aga Khan UniversityDepartment of Pediatrics and Child Health, Aga Khan UniversityDepartment of Pediatrics and Child Health, Aga Khan UniversityAbstract Background Exclusive breastfeeding (EBF) of children until six months of age is considered one of the most critical interventions in tackling childhood undernutrition. EBF rates are suboptimal in Pakistan, particularly in rural areas where child undernutrition is most prevalent. This study aimed to explore barriers to EBF in a rural context of Pakistan. Methods The study was conducted in the rural district Matiari of Sindh, Pakistan, during Jan-March 2020. We used a qualitative exploratory study design and conducted 36 focus group discussions (FGDs). Participants were purposively selected mothers who had not practiced EBF during their previous childbirth, their spouses and mothers-in-law, and lady health workers (LHWs) serving in the study catchment. FGDs were audio-recorded, transcribed, and translated into English from the local language and analysed using thematic content analysis. Results Barriers to EBF included low awareness and cultural practices of prelacteal feeds, insufficient breast milk production, undernutrition of mothers, mothers’ occupation as fieldworkers, less birth spacing, low awareness about the correct technique of breastfeeding, maternal and child ailments, abnormal breasts, and influence of in-laws to start top-up feeds. Several facilitators were identified: family support, appropriate maternal diet, maternal awareness, and support in the neighborhood. Conclusion Barriers to EBF are multifaceted in rural areas, and interventions aiming to improve adherence to EBFshould be multipronged. Awareness-raising alone might not be sufficient, and other interventions should be designed to address the barriers of maternal malnutrition, insufficient milk production, and socio-cultural practices. In addition, safe alternatives to breast milk may be necessary if breastfeeding is truly not feasible. Lack of breast milk substitutes is particularly challenging for poor rural women who cannot afford infant formula milk.https://doi.org/10.1186/s13006-022-00495-4BarriersFacilitatorsExclusive breastfeedingRural Pakistan |
| spellingShingle | Atif Riaz Shelina Bhamani Sheraz Ahmed Fayaz Umrani Sadaf Jakhro Abdul Khaliq Qureshi Syed Asad Ali Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study International Breastfeeding Journal Barriers Facilitators Exclusive breastfeeding Rural Pakistan |
| title | Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study |
| title_full | Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study |
| title_fullStr | Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study |
| title_full_unstemmed | Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study |
| title_short | Barriers and facilitators to exclusive breastfeeding in rural Pakistan: a qualitative exploratory study |
| title_sort | barriers and facilitators to exclusive breastfeeding in rural pakistan a qualitative exploratory study |
| topic | Barriers Facilitators Exclusive breastfeeding Rural Pakistan |
| url | https://doi.org/10.1186/s13006-022-00495-4 |
| work_keys_str_mv | AT atifriaz barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy AT shelinabhamani barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy AT sherazahmed barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy AT fayazumrani barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy AT sadafjakhro barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy AT abdulkhaliqqureshi barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy AT syedasadali barriersandfacilitatorstoexclusivebreastfeedinginruralpakistanaqualitativeexploratorystudy |