Factors associated with prelacteal feeding practices in a rural Northern nigerian setting

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Study Justification:
The study aimed to investigate the factors associated with prelacteal feeding practices in a rural Northern Nigerian setting. Prelacteal feeding, which is the practice of giving newborns food or liquids other than breast milk before initiating breastfeeding, goes against the recommendations of the World Health Organization. This practice can limit the health, social, emotional, and economic benefits of optimal breastfeeding. By identifying the factors associated with prelacteal feeding, the study aimed to generate data that can inform community-level interventions to promote optimal breastfeeding.
Highlights:
– The study found that a majority (85.2%) of the interviewed women in the rural community practiced prelacteal feeding.
– The most common prelacteal feed was plain water (44.7%).
– Prelacteal feeding was associated with births assisted by unskilled birth attendants, while operative delivery reduced the likelihood of the practice.
– There was no statistically significant association between the use of prelacteal feed and women’s age, education, or access to income.
Recommendations:
– Innovative strategies should be developed to create awareness among mothers and healthcare providers about the advantages of breastfeeding and the risks of prelacteal feeding.
– Emphasis should be placed on promoting health facility deliveries, as they are associated with a reduced likelihood of prelacteal feeding.
Key Role Players:
– Community health workers: They can play a crucial role in educating mothers about the benefits of breastfeeding and the risks of prelacteal feeding.
– Healthcare providers: They should receive training on breastfeeding support and counseling to effectively communicate the importance of exclusive breastfeeding.
– Local government authorities: They can support community-level interventions by allocating resources and implementing policies that promote breastfeeding.
Cost Items for Planning Recommendations:
– Training programs for community health workers and healthcare providers on breastfeeding support and counseling.
– Development and dissemination of educational materials for mothers and healthcare providers.
– Awareness campaigns through community outreach programs and media channels.
– Monitoring and evaluation activities to assess the effectiveness of interventions.
Please note that the cost items provided are general suggestions and may vary depending on the specific context and resources available.

Introduction: Prelacteal feeding practice contravenes the recommendation of World Health Organisation that breastfeeding be initiated within an hour of childbirth. Consequently, the health, social, emotional and economic benefits of optimal breastfeeding are limited. Therefore, to break this vicious cycle of prelacteal feeding and suboptimal breastfeeding, factors associated with the practice must be identified. Objective: To assess prelacteal feeding practices and its associated factors in a rural community with the view to generate data for community-level interventions that will promote optimal breastfeeding. Methods: Data was collected during a community-based surveillance for maternal, newborn and child health project in Tsibiri, a rural community in north-western Nigeria. The survey questionnaire was uploaded into mobile devices running on an android operating system. Trained female interviewers collected the data over a period of one week in 2011. Results: A total of 270 out of 309 interviewed women had experienced childbirth and were included in the analysis. Majority (85.2%) of respondents utilised prelacteal feeds for their newborns. Plain water was the most common prelacteal feed (44.7%). Prelacteal feeding was associated with births assisted by unskilled birth attendants (AOR 5.322, 95%CI 1.634-17.333); while operative delivery reduced the likelihood of the practice (AOR 0.168, 95%CI 0.060-0.470). No statistically significant association was found between use of prelacteal feed and women’s age, education or access to income. Conclusion: The predominance of prelacteal feeding practices underscores the need for innovative strategies that create awareness among mothers and health care providers, with emphasis on health facility deliveries, advantages of breastfeeding and risks of prelacteal feeding.

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Innovation recommendations based on the study findings:

1. Community-level interventions: Develop mobile applications or text messaging services that deliver educational materials and reminders to mothers and health care providers about the benefits of breastfeeding and the risks of prelacteal feeding. This can help increase awareness and provide ongoing support at the community level.

2. Training for birth attendants: Create online training modules or interactive e-learning platforms that can be accessed by unskilled birth attendants. This can improve their knowledge and skills in supporting breastfeeding practices, even in remote areas where access to in-person training may be limited.

3. Health facility deliveries: Implement a system that uses mobile technology to track and monitor health facility deliveries. This can help identify areas with low rates of health facility deliveries and allow for targeted interventions to improve access to health facilities.

4. Mobile technology interventions: Develop a mobile application that connects mothers with peer support groups. This can provide a platform for mothers to share experiences, ask questions, and receive guidance from other mothers who have successfully breastfed their infants.

5. Peer support groups: Utilize social media platforms or online forums to establish virtual peer support groups for mothers. This can provide a convenient and accessible way for mothers to connect with each other, share experiences, and receive support and guidance on breastfeeding.

By implementing these innovations, it is possible to leverage technology and community-based approaches to improve access to maternal health and promote optimal breastfeeding practices.
AI Innovations Description
Recommendation: Based on the findings of the study, the following recommendation can be developed into an innovation to improve access to maternal health:

1. Community-level interventions: Develop community-based programs that focus on educating mothers and health care providers about the benefits of breastfeeding and the risks associated with prelacteal feeding. These programs should emphasize the importance of initiating breastfeeding within the first hour after childbirth and discourage the use of prelacteal feeds.

2. Training for birth attendants: Provide training and education for unskilled birth attendants to improve their knowledge and skills in supporting breastfeeding practices. This can help reduce the likelihood of prelacteal feeding by ensuring that skilled birth attendants are available to assist during childbirth.

3. Health facility deliveries: Promote and encourage health facility deliveries, as the study found that births assisted by unskilled birth attendants were associated with higher rates of prelacteal feeding. Improving access to and quality of health facilities can help ensure that mothers receive appropriate support and guidance for breastfeeding.

4. Mobile technology interventions: Utilize mobile devices and applications to deliver educational materials and reminders to mothers and health care providers. This can help increase awareness about breastfeeding practices and provide ongoing support and guidance.

5. Peer support groups: Establish peer support groups for mothers, where they can share experiences, receive guidance, and learn from each other. These groups can provide a supportive environment for mothers to discuss breastfeeding challenges and receive encouragement to continue breastfeeding.

By implementing these recommendations, it is possible to create innovative strategies that address the factors associated with prelacteal feeding practices and promote optimal breastfeeding, ultimately improving access to maternal health.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health, the following methodology can be employed:

1. Study Design: Conduct a quasi-experimental study using a pre-post design to evaluate the impact of the recommendations on prelacteal feeding practices and access to maternal health. Select a rural community in Northern Nigeria as the study setting.

2. Sample Selection: Randomly select a representative sample of women who have recently given birth from the selected community. Ensure that the sample size is sufficient to detect significant changes in prelacteal feeding practices and access to maternal health.

3. Baseline Data Collection: Collect baseline data on prelacteal feeding practices, births assisted by unskilled birth attendants, health facility deliveries, and other relevant factors associated with prelacteal feeding. Use the same survey questionnaire uploaded into mobile devices running on an android operating system, as described in the original study.

4. Intervention Implementation: Implement the recommended interventions in the community. This may include developing community-based programs, providing training for birth attendants, promoting health facility deliveries, utilizing mobile technology interventions, and establishing peer support groups.

5. Post-Intervention Data Collection: After a suitable period of time, collect post-intervention data using the same survey questionnaire and data collection methods as the baseline. Ensure that the same sample of women is included in the post-intervention data collection to assess changes within the same population.

6. Data Analysis: Analyze the data using appropriate statistical methods, such as chi-square tests or logistic regression, to determine the impact of the interventions on prelacteal feeding practices and access to maternal health. Compare the pre- and post-intervention data to identify any significant changes.

7. Evaluation: Evaluate the findings to determine the effectiveness of the interventions in improving access to maternal health. Assess the extent to which the recommendations have been implemented and the level of acceptance and satisfaction among the target population.

8. Recommendations: Based on the evaluation, provide recommendations for scaling up the interventions or modifying them to further improve access to maternal health. Consider the feasibility, sustainability, and cost-effectiveness of the interventions in the local context.

By following this methodology, it will be possible to assess the impact of the main recommendations on improving access to maternal health and identify effective strategies for promoting optimal breastfeeding and reducing prelacteal feeding practices in the rural community.

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