Barriers and facilitators to exclusive breastfeeding practices in a disadvantaged community in southern Zimbabwe: A maternal perspective

Abstract

Background: Despite the well-documented significance of EBF in developing countries, many poor communities still present with the highest percentage of disease burden resulting from suboptimal breastfeeding. Objectives: To identify the maternal perception on barriers and facilitators to EBF in Gwanda District, Zimbabwe. Methods: Five focused group discussions were conducted using 40 purposively-selected mothers while eight in-depth key informant interviews were also conducted. The qualitative data collected were analyzed using thematic network analysis. The themes were used in interpreting the perceived barriers and facilitators of EBF. Results: The study identified individual, socio-cultural, health service-related and environmental factors as the basic themes influencing maternal infant feeding choice. These were grouped into two organizing themes, namely, barriers and facilitators of EBF which were summarized into one global theme: EBF intention. Facilitating factors were maternal autonomy, self-efficacy, knowledge of EBF definition, maternal diet, support and sourcing information from healthcare workers. Poor infant feeding practices, affordability of alternative infant feeding options, ritualistic/symbolic infant preparations, family conflicts, increased workload and hot climate were barriers to EBF. Conclusion: To increase in uptake of EBF in the study area required comprehensive multiple stakeholder interventions incorporating the mothers, influential family members, religion and traditional advisors, and healthcare workers.

Keywords

• maternal
• exclusive breastfeeding
• focus group discussions
• perceptions
• barriers
• facilitators