EFFECT OF NURSING- BASED INTERVENTION ON EXCLUSIVE BREASTFEEDING PRACTICE AMONG PREGNANT WOMEN ATTENDING TWO PRIMARY HEALTH CARE CENTERS IN IKENNE LOCAL GOVERNMENT OGUN STATE

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TABLE OF CONTENTS 

 Content Page
Title page i
Certification ii
Dedication iii
Acknowledgements iv
Abstract v
Table of Contents                                                                         vi
List of Tables List of Appendices                                                                                                                    ix x
List of Figures xi
   

CHAPTER ONE: INTRODUCTION

1.1 Background to the study  1
1.2 Statement of the study  2
1.3 Objective of the study  3
1.4  Research Questions                                                                                                      3
1.5  Hypotheses                                                                     4
1.6 Scope of the Study                                                                                                      4
1.7 Significance of the Study                                                                                           4
1.8 Operational Definition of Terms                                                                                4

CHAPTER TWO: REVIEW OF LITERATURE

    
2.0 Introduction 6
2.1 Overview of Breastfeeding                                                                                     6
2.2 Exclusive Breastfeeding practice in developing world                                          9
2.3 Global prevalence of exclusive breastfeeding                                                       10
Content 2.4     Prevalence of exclusive breastfeeding practice in Africa                                       Page 11
2.5 Prevalence of exclusive breastfeeding practice in Nigeria                                   12
2.6 Effect of nursing intervention on exclusive breastfeeding practice                     13
2.7 Theoretical Framework                15
2.7 Conceptual Model                                                    17

CHAPTER THREE: METHODOLOGY

                                                                                                                                                                                                                                            
3.0 Introduction     18
3.1 Research Design                                                                                                            18
3.2 Population                                                                                                     18
3.3 Sample size and sampling Technique        19
3.4 Instrumentation        20
3.5 Validity of instrument         21
3.6 Reliability of the Instrument        21
3.7 Method of Data Collection                                                                                      22
3.8 Method of Data Analysis                                                                                             23
3.9 Ethical consideration                                                                                                  23

CHAPTER FOUR: DATA ANALYSIS, RESULTS

                             AND DISCUSSION OF FINDINGS

4.0 Introduction         24
4.1 Data analysis and result presentation                                                       25
4.2 Discussion of findings                                                                                                        32
                                                                                                 

Content                                                                                                  Page

CHAPTER FIVE: SUMMARY, CONCLUSION AND       

                                 RECOMMENDATIONS

5.1 Summary                                                                         36
5.2 Conclusion37
5.3 Recommendations 37
5.4 Limitation of the Study 38
5.5 Suggestion for Further Studies                                                38
  REFERENCE 39
  APPENDICES  6

LIST OF TABLES

Table Page
1Showing Frequencies and percentage on demographic data    25
2 3 Showing Descriptive statistics of Frequency on Obstetric data Showing Participants’ knowledge category                                                26 26
4 5Showing Descriptive statistics of pre-test knowledge regarding  Showing Participants’ practice category      28 28
6Showing Descriptive statistics of post-test practice        29
7Showing Descriptive and inferential statistics of post-test knowledge                  30
8 Descriptive and inferential statistics of post-test practice 30

APPENDICES

  Appendix Page
  Informed Consent Form 46
  Questionnaire 47
  Teaching Module                                                           51
  Pictures from field work    55

LIST OF FIGURE

Figure   Page
   1 Theory of planned behavior conceptual framework               17

CHAPTER ONE

INTRODUCTION

  • Background  to the Study

The importance of the provision of a nursing-based intervention such as breastfeeding-readiness education for mothers during the antenatal visits is crucial to achieving exclusivity among them. Janson (2010) stated that, nurse- based intervention is very important in establishing successful breastfeeding practice. Valine and Apaldia (2014) suggested that the nursing intervention consisting of breastfeeding education is helpful at improving early initiation and thereafter continuation of breastfeeding for the first two months. Despite the nutritional, economic, immunological, and psychological advantages of breast milk, breastfeeding practice appear to remain below recommended level and one thing that plays a role in breastfeeding success may be nursing intervention. According to World Health Organization (WHO) all lactating mothers should exclusively breastfeed their children for the initial six months and go on with breastfeeding up to two years (WHO, 2010). However studies have shown exclusive breastfeeding is practiced below WHO recommendation (Nasserpour, Nouhjak, & Sharifat, 2010). A target of 90% universal coverage for Exclusive breastfeeding (EBF) is recommended by WHO to prevent 13-15% of 9 million deaths of children under-five in low and middle-income countries annually (Jones, 2013). Reports from Agunbiade and Agun, 2012 in Ile-Ife town also showed that only 19% of the breastfeeding mothers practiced exclusively. On the other hand, mother’s breastfeeding practice can be enhanced with continuous interventions such as prenatal breastfeeding education. UNICEF, (2011) describes that breast milk is the standard, healthiest, simplest, and not expensive feeding way that complete all the children’s needs. Knowledge, expertise and advice of nurses are very vital in creating awareness, education and support for mothers and their babies to achieve exclusivity. Nursing intervention strategies is a significant approach to some of the challenges of breastfeeding practice, making mothers informed of the cost effective benefit of exclusive breastfeeding

The global exclusive breastfeeding rate for children aged less than six months between the years 2000 and 2007 was 38% (UNICEF, 2008). Within the same period, only 23% of infants less than six months were breastfed exclusively in West and Central Africa while  Middle East and North Africa recorded a little higher rate of 26% was (UNICEF, 2008), in  Eastern and Southern Africa; East Asia and the Pacific; and South Asia respectively prevalence of  39%, 43% and 44% were observed (UNICEF, 2008).In addition, a study in England showed that infants’ exclusive breastfeeding rate was low, and only 25% of babies remain breastfed until 6 to 8 weeks after birth and 16% of mothers continued breastfeeding for three to five months after birth (Cernadas, Noceda, Barrera, Martinez, & Garsd, 2008). In Nigeria, the practice of exclusive breastfeeding is uncommon with only 13% of infant younger than six months are being exclusively breastfed (Nigerian Demographic and Health Survey, 2008), while in Nigeria, between year 2000 and 2012 merely 15.1% of babies less than six months of age were exclusively breastfed (UNICEF, 2012). Nigeria Demographic and Health Survey 2013 later on reported a a little higher prevalence of 17% EBF rate. A study in Plateau state showed that only 6% of mothers practiced exclusive breast feeding (Amosu, 2010). Niguse, Frehiwot ,  Dinu  and Eyerus (2016) stated that mothers knowlwdge and practice regarding exclusive breastfeeding as been low despite their exposure to training programmes on exclusive programs. According to Agunbiade and Oguunleye 2012, knowledge and practice concerning exclusive breastfeeding among mothers has been low despite exposure to training programmes on exclusive breastfeeding. Tyndall, Kamai, and Changchangi (2016) stated that despite the exposure of mothers to exclusive breastfeeding training, knowledge and practice regarding exclusive breastfeeding among mothers as been low. Despite initiation of exclusive breastfeeding programmes, problem associated with poor exclusive practice seems to persist suggesting a fundamental problem. These prompted the researcher to study the effect of nursing based intervention on exclusive breastfeeding practice among pregnant women attending two primary health care centers in Ikenne local government.

1.2 Statement of the Problem                                                

The rate of infant morbidity and mortality as a result of poor exclusive breastfeeding among mothers as been high (Onah , Osuorah , Ebenebe , Ezechukwu , Ekwochi  & Ndukwu,  2014). The incidence of of childhood communicable disease and infection in infants has significantly increased as a result of poor exclusive breastfeeding knowledge and practice among mothers (Talayero, Lizan-Garcia, Puime, Muncharaz, Soto, Sanchez-Palomares, Serrano & Rivera, 2006). The incidence of diarrhea and lower respiratory tract infections has been persistently high due to poor knowledge and practice regarding exclusive breastfeeding among mothers (Rivera, 2006). According to UNICEF (2013), exclusive breastfeeding knowledge and practice in Nigeria is significantly low. Knowledge and practice of mothers regarding exclusive breastfeeding as been low (Chola, 2011; Rea, 2009).  Problems associated with poor exclusive breastfeeding practice such as infections, diarrhea, upper respiratory tract infections, childhood obesity, low immunity, sudden infant death syndrome and malnutrition has significantly increased due to poor knowledge and practice regarding exclusive breastfeeding among mothers. The researcher through clinical experience as observed high incidence of malnutrition, childhood obesity and infection and diarrhea. These may be attributed to poor knowledge and practice regarding exclusive breastfeeding and it may also be attributed to a gap in the type of training programme offered to mothers on exclusive breastfeeding. Hence the need for a study on the effect of nursing based intervention on exclusive breastfeeding practice among pregnant women attending two primary health care centers in Ikenne local government

Objective of the Study

EFFECT OF NURSING- BASED INTERVENTION ON EXCLUSIVE BREASTFEEDING PRACTICE AMONG PREGNANT WOMEN ATTENDING TWO PRIMARY HEALTH CARE CENTERS IN IKENNE LOCAL GOVERNMENT OGUN STATE