ABSTRACT
Over
time information concerning exclusive breastfeeding has been passed to nursing
mothers. This suggests that several information sources such as healthcare
personnel’s or hospital attendants, family and friends, facebook, television,
radio, newspaper have been used as an important source of communication to
nursing mothers. The problem of this study was to investigate the influence of
information source on knowledge, attitude and practice of exclusive
breastfeeding among nursing mothers in Minna, Niger State.
The
study employed the agenda setting theory, the social learning theory and the
health belief model as foundations. It equally used the survey method, using
questionnaire as research instrument. The study population consisted of nursing
mothers attending postnatal care and health talks in 33 health care centers.
Simple random sampling technique was used. The sample size was (N=422). All
data were analysed using descriptive and inferential statistics which was used
to discuss five research questions and five hypotheses.
The
study revealed that the hospital attendants were rated the highest well known
information source, while others such as facebook had the lowest rating.
Television, newspaper, radio, family and friends were rated averagely. Most
nursing mothers also indicated that they came across messages on exclusive
breastfeeding a month and above. They also thought that there was need for
improvement.The study also revealed that television, handbills, newspaper,
hospital attendants, someone significantly influenced the knowledge of
exclusive breastfeeding, while radio did not. All information sources except
television did not influence attitude towards exclusive breastfeeding. Also
handbills and newspapers did not significantly influence practice of exclusive
breastfeeding, while others did.
The
study concluded that other information source such as facebook, television,
radio, newspaper and family and friends need to be improved upon. The study
also recommended that stake holders such as government, media organisations,
WHO, UNICEF, need to provide more frequent access to this exclusive
breastfeeding information, that way a lot of changes can occur in the practice
of exclusive breastfeeding.
CHAPTER
ONE
INTRODUCTION
1.1
Background to the Study
New born children in many African households,
especially in Nigeria receive less commitment of being exclusively breastfed by
their mothers. A news report stated mothers have many reasons why they do not
exclusively breastfeed; one of such is twin births, myths such as fear for loss
of sexual appeal, sagged breasts and fear of infecting their new born children
with Human Immunodeficiency Virus (HIV).(Business Hallmark Newspaper, 2015;
Sina, 2016).Other reasons that may stop mothers from exclusively breastfeeding
include, that nursing mothers did not
likely continue with exclusive breastfeeding for six months, influence of loved
ones like aged grandmothers affect the mother’s practice of exclusive
breastfeeding. This is because they usually insist on traditional practices
which include, discarding of colostrums, giving infants water, animal milk,
pap, infant formula, honey, herbal preparations and also washings from quoranic
inscriptions believed to be medicinal (Agunbaide & Ogunleye, 2012; Moisse,
2011; Umar & Oche, 2013). These practices can lead to an infant’s
malnourished state, and may even lead to death if they are not properly
managed.
The World Health Organisation (WHO) (2003), made it
known that inappropriate breastfeeding practices contribute strongly to high
mortality rate among children under the age of five. In the same vein, Veneman
(2008) collaborated this, during the celebration of world breastfeeding week at
Abuja, when she defined breastfeeding as a key tool in improving child survival
in this world. She further stated that exclusive breastfeeding for the first
six months of life can avert up to 13% 0f children under the age of five deaths
in developing countries, This implies that exclusive breastfeeding to a large
extent determines the health of an infant.
Nigeria demographic health survey (2008) in the view
of evaluating the state of health stated Nigeria to have the highest number of
stunted children in the continent and ranks third globally with more than ten
million stunted children. Alexandra
(2016) said the main indicator for malnutrition is stunting. Stunting is very
much prevalent in Niger state. He also stated that Niger state accounts for the
prevalence of stunting as 34%, underweight at 11% and wasting at 18% in
children less than five years. This means that a large percentage of children
under five years have symptoms of malnourishment in Niger state. This could be
as a result of not been exclusively breastfed by their mothers, since breast
milk offers all the nutrients needed, malnutrition sets in when the baby is not
exclusively breastfed.
An article by Summary of child survival partnership
(2008), stated Nigeria as one of the six countries that account for half of all
children’s death worldwide with one million children under-five dying every
year. Also, an article by Federal
ministry of health saving newborn lives in Nigeria, 2011, stated that
malnutrition contributes to over one third (35%) of those deaths. This implies
that infants who are malnourished due to improper breastfeeding are likely to die. This could be the reason why Niger state has
under-five mortality rate at 123 per 1000 live births (Alexandra, 2016).
Malnutrition is a cause of child mortality; this is in agreement with the
account given by Isaiah (2015) that malnutrition is responsible for over 50% of
less than five mortality rate in children and women in northern Nigeria. United
Nations Children’s Fund stated that 13% of 10 million deaths of children in the
42 countries that account for 90% of child’s deaths throughout the world can be
prevented by exclusively breastfeeding children for the first six months of
their lives (UNICEF, 2005). In order to reduce child mortality, deliberate
efforts must be put together by government to ensure mothers exclusively
breastfeed their infants.
Attempts have been made by the government and WHO to
ensure that infant malnutrition is limited. In relation to this is the world
breastfeeding week. The week is an annual celebration which is held every year
within August 1-7 in more than 120 countries. It was first celebrated in 1992
by the World Alliance for Breastfeeding Action (WABA). It was formed on the 14th
February 1991(World Breastfeeding Week, 2010).
According to an article by Nursing World (2016) Nigeria is one of the
countries that celebrate the world breastfeeding week; the week is spent
campaigning, encouraging exclusive breastfeeding and also warning against risk
of formula feeding. Many mothers are informed about exclusive breastfeeding
through such campaigns. According to Brikins (2016), the materials distributed
during this breastfeeding campaign are flyers, stickers and handbills on
breastfeeding. This shows that information has been passed across to mothers
concerning exclusive breastfeeding.
According to Nigeria’s Federal Ministry of Health
(2011), exclusive breastfeeding refers to feeding babies with breast milk only,
without giving them water, mixtures from local herbs or other forms of liquid
and food. Drops such as vitamins, minerals supplements or medicines can however
be given when they are prescribed. Furthermore exclusive breastfeeding means
that the infant or newborn receives only breast milk. WHO (2016) stated that
exclusive breastfeeding should therefore not be combined with any other food
while it is being practiced. Exclusive breastfeeding emphasizes feeding solely
with breast milk. Veneman (2008) emphasized that exclusive breastfeeding means
that no other liquid or solid is fed to the infant, with the exception of
medicines. The importance of exclusive breastfeeding is propagated on occasions
such as world breastfeeding week. UNICEF (2015) affirmed that exclusive
breastfeeding is a good influence on child nutrition. The United Nations
Children Fund in Nigeria, invited journalists to Kano as part of its activities
to mark “breastfeeding week”. It solicited for media assistance on ways of
sensitizing authorities and other stakeholders on the crisis of child
malnutrition in Nigeria. UNICEF Chief of Communication, Porter (2015) in her
remark called for intensified media advocacy on child nutrition in Nigeria.
Porter noted that past efforts by the media have been effective. This was said
based on many media campaigns ranging from topics such as breastfeeding and
childcare, women breastfeeding, the essence of exclusive of exclusive breastfeeding
to new born health in Nigeria. The media and other information sources have, in
electronic, print and vocal forms being used to convey the importance of
exclusive breastfeeding to mothers.
Nursing mothers are continuously remembered of the
importance of exclusive breastfeeding through information sources around them,
one of which is the media. Since there have been few systematic, large scale
media campaigns, full potential of mass media to promote breastfeeding is as
yet unrealized and therefore unknown. What has been learnt is that
breastfeeding promotion programs are designed to address three types of factors
affecting breastfeeding practices: 1) negative public attitudes toward
breastfeeding; 2) lack of knowledge of specific breastfeeding skills such as
correct positioning of the baby on the breast and increasing milk production;
and 3) social norms that define breastfeeding as unusual behaviour (Cynthia,
1989). This shows that for information sources campaigns to be effective they
have to largely cover every breastfeeding issue and not be limited in their
coverage. Cynthia (1989) stated that one of the lessons learnt about
breastfeeding campaigns is that general messages proclaiming the benefits of
breastfeeding are not effective since they do not address the major impediments
to optimal breastfeeding practice. Successful breastfeeding programs use mass
media as part of a long range promotion strategy rather than as sporadic, short
lived campaigns. A change in group norms
favouring breastfeeding which some experts believe is the key factor
determining breastfeeding practices cannot be achieved by a brief media
campaign. Similarly, specific breastfeeding skills and advice need to be
provided on a continuous basis; there are always new mothers giving birth .As
the world evolves lots of issues arise concerning the practice of exclusive
breastfeeding and media campaigns on exclusive breastfeeding should be able to
address these issues. Joan (2016) in agreement with Cynthia noted that factors
influencing exclusive breastfeeding are evolving. Years past, the public
encouraged breastfeeding mothers to breastfeed their infants where ever the
need arises but presently it seems uncultured to breastfeed in public places
like markets, offices.
1.2
Statement of the Problem
Over time information concerning exclusive
breastfeeding and its importance have been passed across to mothers through
several information sources such as mass media, internet, interpersonal sources
and information education materials. Exclusive breastfeeding has been noted to
solve the problem of malnutrition which
is at factor influencing infant mortality as agreed by (Mde 2011; Lloyd, 2011,
Save the children 2012). Some much
effort has been put in by stakeholders to see that nursing mothers adopt
exclusive breastfeeding for their infants. This study found out the influence
of information sources on knowledge, attitude and practice of exclusive
breastfeeding amongst nursing mothers in Minna, Niger state.
1.3 Objective of the Study
The main objective of this study was to investigate
influence of information sources on knowledge, attitude and practice of
exclusive breastfeeding amongst nursing mothers, in Minna, Niger State. The
specific objectives are to:
1.
indentify the sources
from which nursing mothers get information about exclusive breastfeeding;
2.
ascertain respondents
knowledge on exclusive breastfeeding in
Minna, Niger State;
3.
determine the attitude
of respondents towards exclusive breastfeeding in Minna, Niger State;
4.
ascertain the practice
of exclusive breastfeeding by respondents in Minna, Niger State;
5.
examine the influence
of intervening demographic variables such as age, religion, academic
qualification, employment status, marital status on the practice of exclusive breastfeeding by respondents
in Minna, Niger State;
6.
determine if
information sources of exclusive breastfeeding significantly influence
knowledge of exclusive breastfeeding;
7.
find out if information
sources of exclusive breastfeeding significantly influence attitude to exclusive
breastfeeding and
8.
find out if information
sources of exclusive breastfeeding significantly influence practice of
exclusive breastfeeding.
1.4
Research Questions
1.
What are the sources
from which nursing mothers get information on exclusive breastfeeding in Minna,
Niger State?
2.
What is knowledge of
respondents on exclusive breastfeeding in Minna, Niger State?
3.
What is the attitude of
respondents towards exclusive breastfeeding in Minna, Niger State?
4.
What is the practice of respondents towards
exclusive breastfeeding in Minna, Niger State?
5.
How do intervening
demographic variables such as age, religion, academic qualification, employment status, marital status influence
the practice of exclusive breastfeeding by respondents in Minna, Niger State?
6.
Do information sources
of exclusive breastfeeding significantly influence knowledge of exclusive
breastfeeding?
7.
Do information sources
of exclusive breastfeeding significantly influence attitude to exclusive
breastfeeding?
8.
Do information sources
of exclusive breastfeeding significantly influence practice of exclusive
breastfeeding?
1.5
Hypotheses
H01:
Respondents’ attitude to exclusive breastfeeding will not be significantly
influenced by their knowledge of exclusive breastfeeding got from the information
sources.
H02:
Respondents practice of exclusive breastfeeding will not be significantly
influenced by their knowledge of exclusive breastfeeding got from these
information sources.
H03:
Information sources of exclusive breastfeeding do not significantly influence
knowledge of exclusive breastfeeding.
H04:
Information sources of exclusive breastfeeding do not significantly influence
attitude to exclusive breastfeeding.
H05:
Information sources of exclusive breastfeeding do not significantly influence
practice of exclusive breastfeeding.
1.6 Scope of the Study
This
study was delimited to influence of information source on knowledge, attitude
and practice of exclusive breastfeeding among nursing mothers in Minna, Niger
State. The study was not concerned with only the reasons why mothers do not
practice exclusive breastfeeding rather it covered the influence all kinds of
information source on knowledge, attitude and practice of exclusive
breastfeeding amongst nursing mothers in Minna, Niger State.
The
study was conducted in the capital of Niger State, from January 31, 2017 to
March 31 2017. It was delimited to the capital, Minna, because it was where we
could find diverse nursing mothers with different attributes such as
educational status, employment status and marital status which helped the
population of the study to be unbiased. There were only two local governments
in the capital, which are Bosso and Chanchaga, thirty three healthcare centres
in the two local governments have were selected, this was to limit the time
scope of the study.
1.7
Significance of the Study
The contributions and outcome of this study
would be of great benefits to stakeholders such as media organizations,
government, healthcare systems, World Health Organizations and United Nations
child’s fund. It was an evaluation of how much effort that has been put in to
ensure mother adopt exclusive breastfeeding by these stakeholders. To mass
media scholars, it would likely act as a guide for further studies towards
influence of mass media on knowledge, attitude and practice of exclusive
breastfeeding. It also enlightened media professionals on the approach most
suitable for influencing mother’s knowledge, attitude and practice towards
exclusive breastfeeding.
1.8 Operational Definition of Terms
These
are some operational definition of terms in relation to this study.
1.
Influence:
In this study, the term influence is used to mean power to change something in
some way. The power of information sources to change exclusive breastfeeding
knowledge, attitude and practice among mothers in Minna, Niger State.
2.
Information
Source: In this study, the term information
source is used to mean all forms of communication sources of exclusive
breastfeeding. This refers to mass media, interpersonal sources, new media,
pamphlets, fliers and all kinds of tools used in communicating information about
exclusive breastfeeding.
3.
Knowledge:
In this study the term knowledge is used to explain awareness, understanding of
information concerning something. Knowledge refers to information gotten from
information source about exclusive breastfeeding by nursing mothers in Minna.
Knowledge here means definition of exclusive breastfeeding, the importance of
exclusive breastfeeding, how to practice exclusive breastfeeding, when to
practice exclusive breastfeeding (exclusive breastfeeding is to be practiced
for the first six months of the infants life), and also challenges of exclusive
breastfeeding.
4.
Attitude:
In this study the term refers to the behaviour towards something. That is the
positive and negative feelings that mothers have towards exclusive
breastfeeding among nursing mothers in Minna.
5.
Practice:
In this study the term, practice is used to mean continuous exercise of
exclusive breastfeeding by mothers in Minna; this includes the committed or
negligent practice of exclusive breastfeeding. Practice will be measured by the
information sources messages that encouraged continuity of exclusive
breastfeeding by nursing mothers.
6.
Exclusive
breastfeeding: In this study it means infant
receiving only breast milk. No other liquids or solids are given, not even
water, with the exception of oral rehydration solution or drops of syrups of
vitamins, minerals or medicines. In exclusive breastfeeding, the mother feeds
the child with only breast milk with the exception of drugs recommended by the
doctor”.
7.
Nursing
mother: In this study, the term refers to women
of all ages who have the ability to breastfeed and are also within the time of
this study breastfeeding their infants. Nursing mothers in this study also
encompasses nursing mothers who are employed or unemployed, young or old.
Mothers who have lost their babies after childbirth are not included in the
term “nursing mothers” for this study.
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