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

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5. Summary and Implications for ProgrammingThe SNNP formative research on infant and young child feeding identified the beliefs and currentfeeding practices for breastfeeding and complementary feeding of children, along with key facilitatingfactors to improve young child feeding. The study also assessed the roles of different groups, includingfamily and community members, health extension workers, and voluntary community health promotersin supporting IYCF in their communities.5.1 IYCF practices and related beliefs and attitudesThis study indicates that breastfeeding is widely practiced in the research communities and is expectedof all mothers and valued in the community for its contribution towards child growth and healthydevelopment. Unlike the findings in related studies, mothers in the study areas seem to know theexpected breastfeeding requirements such as: on-demand feeding, frequency of breastfeeding, and theneed to feed from both breasts. Yet exclusive breastfeeding is not widely practiced in the studycommunities. Mothers commonly introduce water, fenugreek, or linseed water as early as 2 months.Mothers also use bottle feeding and consider this a good practice for feeding 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.Implications. Almost universal acceptance that breastfeeding should begin early and continue throughat least 2 years of age and widespread belief in the benefits of breastfeeding simplify promotion ofrecommended IYCF practices through 6 months of age. Program activities and materials onbreastfeeding should build on its positive “brand” and address mothers’ concerns about illness.Bottle feeding may need to be addresed. Mothers tend to use bottles for the sanitary storage of gruel,but may be introducing contaminants through unclean bottles and the water used to prepare the thinfoods.32
Efforts to promote extra feeds when a child is sick or recuperating may meet resistance. As noted,mothers and other family members may need to be convinced that the extra food does not contribute tothe illness.Similarly, program activities will need to help mothers put aside traditional wisdom about the manyfoods that are considered “too strong” for a young child to digest. This is particularly important, giventhe reluctance to feed meats and other animal source food at the very ages that young children requireprotein to prevent stunting. Program planners will want to identify interventions and messages thatwill resonate with mothers and enable them to adopt improved practices even in the face of entrenchedtraditions or misconceptions.IYCF programs would do well to build on HEP’s credibility and community members’ perceptions thattheir children are becoming stronger and healthier as the HEWs and VCHPs promote recommendedpractices.5.2 Community and family influences on mothers’ feeding practicesThe role of family members in influencing IYCF practices was also explored. Mothers are seen as theprimary caregivers for children in the home, sometimes assisted by an elder daughter, mother, ormother-in-law. Husbands appear to influence child feeding practices indirectly, primarily in their role asprovider and as the one who controls family finances. Family members’ and community elders’ advice onfeeding is often followed, even though traditional practices sometimes run counter to the MOHrecommended IYCF practices.Implications. The study’s findings confirm that any intervention aimed at changing traditionalpractices related to child feeding must engage the family and community members who influenceindividual mothers’ choices. These influentials can play a supportive role if they are brought on boardwith new ideas, and just as importantly to keep in mind, can interfere with promotion of recommendedpractices when they offer incorrect information or outmoded beliefs.As this study shows, the ways a community’s young children are nourished are the product ofgenerations of tradition, and many traditional feeding practices are linked to deeply-held cultural andeven spiritual beliefs.5.3 HEW and VCHP capacitiesThis study looked at perceptions of staff and volunteer capacity from their own point of view and fromthe point of view of the families they serve. Capacity includes both knowledge of recommended IYCFpractices 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 the33
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Page 8 and 9: GlossaryAabilaAtekanaBessoBullaChik
Page 10 and 11: contribution towards child growth a
Page 12 and 13: 1. BackgroundIn Ethiopia, A&T’s g
Page 14 and 15: 3.2 Sampling techniquesSite Selecti
Page 16 and 17: • Evening discussions were held t
Page 18 and 19: important for protection. A few mot
Page 20 and 21: Other mothers in these areas with o
Page 22 and 23: Consistency of foods. Children are
Page 24 and 25: In the mother interviews, some moth
Page 26 and 27: “To feed the child meat, fish, an
Page 28 and 29: When mothers were asked how they en
Page 30 and 31: and gain weight,” “the child wa
Page 32 and 33: • Some mothers are already giving
Page 34 and 35: Mothers explained that husbands are
Page 36 and 37: HEWs. Most mothers who talked about
Page 38 and 39: Working more with VCHPs could also
Page 42: other hand, the potential burden of

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

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