evaluation of breastfeeding promotion among health care ... of... · primary health care centers(in...
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Faculty of Human Medicine and Health Sciences
An-Najah National University
Supervised by: Dr.Zaher Nazzal
Dr.Ameera Alhindi Prepared by:
Community medicine group
Evaluation of Breastfeeding Promotion
among Health Care System in Nablus
Governorate
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Introduction & Background
Exclusive breast feeding(EBF):defined as the
child receiving only breast milk and no other type
of milk or solids but could include vitamins, drops
of other medicines and oral rehydration
therapy(ORT).
– Offers mothers and infants several advantages.
– Decrease incidence and severity of diseases
Introduction & Background objectives Methodology Results & Discussion clusion
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American Academy of pediatrics recommend
exclusive breast feeding for the first 6 months
of life
Introduction & Background objectives Methodology Results & Discussion
• Breast feeding promotion services in Nablus is
provided in Hospitals and Primary health care
centers.
• The Primary Health Care Directorate In Nablus
noticed that “although they provide this services,
the breast feeding rate is not as optimal as what
is expected!”
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• So our partner’s need was to evaluate the
reason behind the decreasing rate and
whether it is due to an inappropriate
services or not!
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Protection, promotion, and support of breastfeeding
are critical public health needs.
Interventions to promote breast feeding include:
1.Health education interventions
2. Health sector initiatives
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Introduction & Background objectives Methodology Results & Discussion
Cont…..
3. Peer support programs
4. Media campaigns
5. Implementation of the baby friendly hospitial
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These interventions found in systemic reviews and Randomized
controlled trials to increase EBF rates at 4-6 weeks, and 6 months
Introduction & Background objectives Methodology Results & Discussion
Objectives:
- To assess the health care counselling and services
provided to mothers regarding breastfeeding
- Evaluating breastfeeding knowledge among mothers
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Methodology
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• A cross sectional study was conducted in
primary health care centers(in Nablus,
Hewwarh, Aseera) , as well as pediatric and
OBGYN departments in Nablus city, between
27. 4.-4.5. 2014
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We included:
• All mothers who attend PHCs for well-baby
services.
• All health care workers (HCWs) in pediatric and
OBGYN departments in Nablus hospitals
– Rafedia, AL-Arabi, Nablus, Al-Itihad).
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Tools:
• A questionnaire was developed by the researchers,
– consisted of two parts
• One for HCWs and
• The other to the mothers.
• We observed HCW practices and the surrounding
environment in relation to BF promotion
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Results
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Our sample:
We interviewed:
• 142 mothers
• 29 HCWs
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Of 142 mothers :100 Got information about
breastfeeding benefit (70.4%)
Immunity 77%
Uterine involution 12%
Protection from breast cancer 7%
Cheaper 5%
Baby mother bond 5%
Cognitive function of the baby 3%
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Introduction & Background objectives Methodology Results & Discussion
99 69.7%
Taught about the mechanism of
breastfeeding
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Eighty-five mothers reported seeing posters in the hospital promoting breastfeeding
Visually interesting Conveying message helpful in deciding to breastfeed
92.20% 91.80%
81.40%
Mothers noticed posters encouraging breastfeeding
Mothers noticed posters encouraging breastfeeding
Maternal knowledge about breast feeding:
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Question asked: Answer: Number
Breast milk has better nutrition than formula Yes
No
134 (94.4%)
8 (5.6%)
Breast milk protects from diseases Yes
No
140 (89.6%)
2 (1.4%)
Breastfeeding has disadvantages on mother Yes
No
14 (9.9%)
128 (90.1%)
Which is easier for the baby
Breastfeeding
Formula
110 (77.5%)
32 (22.5%)
Breastfeeding is enough for baby Yes
No
100 (70.4%)
42 (29.6%)
Breastfed baby always needs additives Yes
No
62 (43.7%)
80 (56.3%)
Do you add additives while breastfeeding? Yes
No
69 (48.6%)
73 (51.4%)
Introduction & Background objectives Methodology Results & Discussion
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• 29 HCWs were interviewed:
– 23 were from hospitals
– 6 from PHC centers
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Of the 23 hospital based HCW:
• all 23 reported that their hospital offers 24 hour
"rooming in" for mothers and infants, said that
they encourage breastfeeding on demand.
• and 21 said that they advise mothers not to use
pacifiers.
• 20 advise exclusive breastfeeding.
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About encouraging breast feeding
policies:
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• 65.5% reported written policy
• 20.7%: indirect policies
• 13.8%: no policy
Introduction & Background objectives Methodology Results & Discussion
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Outcome
• At the end of the course, a report on the project
findings was delivered to PHC directorate at Nablus
District .
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• It included:
– Summary results on the common defect areas at
health care settings in relation BF promoting services
– Recommendations on the appropriate interventions to
improve the BF promoting services.
For Us
• It improved our knowledge and understanding and made us able to:
– Describe major epidemiological study designs, advantages and limitations.
– Describe the specific PHC programs including.
• It also improved our skills to
– Analyse data in order to improve quality of care.
– Evaluate a health programs
– Design a prevention and control program for a prevalent NCD
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Now We Are Better In
• Managing time and taking responsibility for learning
required for continuous professional development
• Working effectively as a member or a leader of an
interdisciplinary team
• Communicating effectively with clients and colleagues
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Thank you
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