IYCF Practices, Beliefs, and Influences in SNNP ... - Alive & Thrive

contribution towards child growth and healthy development. Unlike the findings in related studies,mothers in the study areas seem to know the expected breastfeeding requirements such as: on-demandfeeding, frequency of breastfeeding, and the need to feed from both breasts. Yet exclusive breastfeeding isnot widely practiced in the study communities. Mothers commonly introduce water, fenugreek, orlinseed water as early as 2 months. Mothers also use bottle feeding and consider this a good practice forfeeding the child thin gruel, because the bottles are believed to keep the food covered and clean.This study demonstrates that mothers and other family and community members are concerned thatfeeding a sick child extra food will cause further illness, diarrhea, and vomiting, or that it wouldstimulate the child’s appetite and develop a habit for eating more food than the family can afford.In regards to complementary foods, the study indicates that the age for introduction of additional foodsranges from 2 months to 8 months, with a majority of mothers reporting that they had started givingfoods at 6 months or earlier. Certain foods such as kale, enichila, banana, egg, pumpkin, carrot, andgreen vegetables are considered unsuitable and “too strong” for young children to digest before 1 yearof age. Meat, in particular, is considered by mothers as too hard to digest. Most mothers recommendmeat for children above 1 or 2 years old. Mothers also expressed that they need to have a good incometo buy or feed their children such foods.Regardless of this, study participants believe that children in their communities are doing well due toimmunization services, improved access to health services, and improved child feeding practices.Community and family influences on mothers’ feeding practices. The role of family members ininfluencing IYCF practices was also explored. Mothers are seen as the primary caregivers for childrenin the home, sometimes assisted by an elder daughter, mother, or mother-in-law. Husbands appear toinfluence child feeding practices indirectly, primarily in their role as provider and as the one whocontrols family finances. Family members’ and community elders’ advice on feeding is often followed,even though traditional practices sometimes run counter to the MOH recommended IYCF practices.HEW and VCHP capacities. This study looked at perceptions of staff and volunteer capacity from theirown point of view and from the point of view of the families they serve. Capacity includes bothknowledge of recommended IYCF practices and the skills needed to teach, train or counsel.The study confirmed that the HEP system is well established, with trained HEWs implementing manyof the 16 key HEP packages. As a result, the HEW supervisors and HEWs believe that the overallhealth situation is improving in communities, and that morbidity and mortality have decreased. On theother hand, the potential burden of new initiatives on HEWs and VCHPs in terms of competingpriorities and demands on their time was indicated as a challenge.According to study participants, HEWs and VCHPs are well-known and active in the studycommunities. All of the HEWs have completed the 1-year HEW basic training program. They reportedthat they visit 40 or 50 households a week and also supervise 10 to 20 VCHPs.Regarding BCC materials used in promoting IYCF, two previous USAID-funded projects, EssentialServices for Health in Ethiopia (ESHE) and LINKAGES, have distributed these materials to area2