Background: Universal exclusive breastfeeding coverage for six months could reduce infant mortality by 13 – 15% (9 million) in resource poor countries. Although 97% of women initiate breastfeeding in Tanzania, exclusive breastfeeding for 6 months remains 50% which is lower than the WHO recommended prevalence of 90% to make an impact at community level. Several studies have shown that information obtained from health workers could influence mother’s exclusive breastfeeding practice. Accurate knowledge and skills pertaining to exclusive breastfeeding among health workers is likely necessary to improve breastfeeding rates. This thesis presents the findings of the study of health worker’s knowledge, attitude and practice on exclusive breastfeeding (EBF), in Ilemela and Nyamagana district –Mwanza City-Northwest of Tanzania.
Methods: A cross sectional study involving 220 health workers from 11 purposively sample health facilities was conducted using a structured questionnaire and practice checklist. The health workers were conveniently selected and interviewed. The data were entered, cleaned and analyzed using SPSS version 17.0. The results were summarized in frequency tabulation; univariate and multivariate regression analyses were done to determine factors associated with knowledge and practice of exclusive of exclusive breastfeeding.
Results: Among 220 health workers interviewed, 103 (46.8%) gave a correct description of EBF, 195 (88.6%) correctly answered the recommended timing skin-to-skin contact, and 196 (89.1%) correctly answered the recommended timing BF initiation. Overall, 52% and 38% of the respondents had good knowledge and practical skill respectively. Univariate logistic regression analysis indicated that clinicians (Clinical Officers/Assistant Medical Officers/Doctors) were more likely to have good practice of exclusive breastfeeding than Nurses (OR 4.2; 95% CI 1.6 - 10.9; p-value 0.003). However, clinicians were less likely to have good knowledge (OR 0.4; 95% CI 0.1 – 0.9, p-value 0.033) than Nurse. On multivariate analysis, hospital based health workers demonstrated good practice compered to workers in dispensaries and health Centres combined (OR 2.1; 95% CI 1.1 – 4.0; p-value 0.032). Also respondents who had no job training significantly demonstrated good practice compared to those with no training (OR 2.7; 95% CI 1.2 – 6; p-value 0.015).
Conclusion: Generally, the breastfeeding knowledge was high compared to the practical skill, which was poor. There was a variation among health workers at the hospitals and health Centre and dispensaries in terms of knowledge and practical skills. Most of the health workers had no training on CBF, as well as not aware of a breastfeeding policy in their centres, contributory factor to limited knowhow. The study recommends comprehensive training and mentoring of health workers on exclusive breastfeeding; breastfeeding policy availability, supportive supervision and monitoring; and anthropological study of socio-cultural practices that support exclusive breastfeeding in the communities.