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We hereby declare that the work presented, except for references to other people’s work
which have been duly acknowledged, is entirely the product of our effort carried out in
College of Nursing, Ntotroso. This is an original research work which has neither in a whole
nor in part been submitted for any other Diploma in General Nursing.
CERTIFICATION
RANK…………………………………………………………………………………
DATE………………………………………………………………………………..
NAME OF PRINCIPAL……………………………………………………………
DATE ………………………………………………………………………………
SIGNATURE……………………………………………………………………….
ABSTRACT
Background: Exclusive breastfeeding (EBF) is the best nutrition for children during the first
six months of life. However EBF remains a challenge. The aim of the study was to survey the
knowledge and practice of exclusive breastfeeding in Gyedu, a town in the Asutifi North
Methods: A community based cross sectional study was conducted with 50 respondents
using a structured questionnaire containing both closed end and open ended question. Data
collected was analysed based on the respondents’ answers with regards to set objectives and
Result: All respondents were females who were mostly aged between 26-36 years. 60% (30)
were self-employed, and 28% of the respondents were illiterate. All respondents were
affiliated to a religion as Christians were the majority with 70% count. Most respondents
breastfeeding but 19 respondents had practised it. 80% of respondents heard about EBF from
health personnel. The nature of respondents work didn’t affect the practise of exclusive
breastfeeding as 38(76%) respondents agreed to this. Insufficient breastmilk and child refusal
accounted for 68% of the reasons why respondents do not practice EBF. Most men supported
Conclusion: Based on the findings from the study, recommendations were made to
include health workers educating mothers intensively on the duration of EBF and dispelling
ii
myths and cultural beliefs that impedes the practise of EBF. Moreover government and mass
media should make deliberate effort to encourage and educate the public on the importance of
EBF.
ACKNOWLEDGEMENT
We thank the most High God without whom we could not have started this suvey at all. His
strength, grace and guidance have indeed brought me this far and we are most grateful.
Great achievements are never possible without the diverse contributions of great men and
support throughout the 3year stay in the college was under his leadership.
supervisor……………... Thank you …………. for the encouragement to stay focused and
We would like to say thank you to all our respondents for their enthusiasm to join in this
Thank you for your time and your voices. This research represents your thoughts and
feelings.
Finally, we would like to acknowledge the authors of the various books, journal and write-
ups we used.
Dedicated to our respondents, loved ones, friends, family and colleagues who made this work
a reality.
viii
TABLE OF CONTENT
CONTENT PAGE
DECLARATION …………………………………………………………………………
ACKNOWLEDGEMENT ……………………………………………………………..
DEDICATION…………………………………………………………………………...
1.7 Scope/Delimitation………………………………………………………………
ix
CHAPTER TWO
LITERATURE REVIEW……………..…………………….………….………..………..
2.0 Introduction…………………………………………………………………………
CHAPTER THREE
CHAPTER FOUR
x
4.3 Practice of exclusive breastfeeding ……………….…………………..
4.4 Problems associated with exclusive breastfeeding.…………………….
CHAPTER FIVE
5.0 Introduction…………………………………………………..………..…………...
5.1Discussion of findings ………………………………………..…………………..
5.2 Recommendations……………………………………………………...………….
5.3 Conclusion…………………………………….…………………………………...
REFERENCES …………………………………………………………………...….…….
QUESTIONAIRES……………………………………………….………………………...
xi
LIST OF TABLES
TABLE PAGE
2. Occupation of respondents
3. Level of education
4. Religion of respondents
LIST OF FIGURES
6 A bar chart showing how often babies are to be breastfed when practicing EBF
7. A bar chart showing the whether respondents nature of work allowed them to practice EBF
8. A pie chart showing whether religious and cultural belief affected practice of EBF
xii
9. A pie chart showing the challenges faced by respondents when practicing EBF
10 A pie chart showing whether respondent’s family and husband support practice of EBF
xiii
ix
CHAPTER ONE
Breastfeeding is the feeding of an infant or young child with breast milk directly from human
breast (Adelekan, 2003). It begins from the day the child is born and last for about two years
Exclusive breastfeeding (EBF) -is defined as ‘’an infant’s consumption of human milk with
no supplementation of any type (no water, no juice, no human milk, and no food) except for
EBF for six months is important for both infant and maternal health. Infants who are not
exclusively breastfeeding are more likely to develop gastrointestinal infections, not only in
developing but also in industrialized countries. The risk of mortality due to diarrhoea and
other infections can increase many-fold in infants who are either partially breastfed or not
breastfed at all. During the first two months of life, infants who are not breastfed are nearly
six times more likely to die from infectious diseases such as gastroenteritis, pneumonia etc
than infants who are breastfed; between 2 and 3 months, non-breastfed infants are 4 times
Infant and young child feeding practices directly affect the nutritional status of children under
two years of age and, ultimately, impact child survival. Worldwide, more than nine million
www.who.int/nutrition/topics/exclusive_breastfeeding/en/
Sub-Saharan Africa has been the worst affected with the highest proportion of disease burden
1
timely initiation of breastfeeding within the first hour of birth, exclusively breastfeeding up to
the age of 6 months and continued breastfeeding through to 24 months together with
To promote EBF, Ghana adopted the Baby-Friendly Hospital Initiative (BFHI) in 1991 and
breastfeeding policy and training of health workers to promote and support the practice of
Promotion Regulation 2000 otherwise known as Legislative Instrument [LI] 1667) to curb the
Similar to several countries in the sub-Saharan region, these have not yielded the desired
impact as the practice of exclusive breastfeeding is still low ( Aryeetey,2013) .In 2008, the
Ghana Demographic and Health Survey (GDHS) estimated Ghana’s EBF rate to be 63 %
(GDHS 2008). Forty-six percent of Ghanaian children aged less than 6 months were
exclusively breastfed in 2011(Ghana Statistical Service ,2011) obviously these estimates fall
and attitudes towards exclusive breastfeeding as well as family pressures, maternal level of
education, socio-cultural practices, maternal age, marital status and family income/social
class. Place of delivery, and time of initiation of first breastfeeding have been previously
cited for the current situation. It is thus imperative to explore these mothers’ practice,
knowledge and problems faced towards EBF . Evidence from this study may further increase
understanding of the practice and associated factors of EBF among mothers. Understanding
the knowledge and challenges of mothers towards the practice of EBF may be a necessary
step to help improve infant feeding practices among lactating mothers as a means of reducing
infant morbidity and mortality. Furthermore, findings from this study may be used as a basis
2
for the design of future EBF promotion programs to improve the practice and knowledge of
Exclusive breastfeeding is the best way of feeding babies under six (6) months of age since
breastfeeding is the optimal food for infant. Despite, the numerous advantages that is
It is estimated that about five thousand (5000) infants die each year in Ghana from diarrhoea
and acute respiratory infection (the major killer of children throughout the developing world)
(Aryeetey, 2013) when breastfeeding is not done appropriately. Both early and more recent
studies confirmed that breastfed infants are not likely to develop complications
In 2006-2012 an estimated 43% of infants in the WHO European region were exclusively
breastfed for 6months as compared with only 25% in the WHO Sub-Saharan countries
(WHO,2013). The average rate of exclusive breastfeeding thus remains far below the global
recommendation. Although the situation in Ghana has improved a lot over the last couple of
years it still is below what WHO recommends. Ghana’s exclusive breastfeeding percentage
February,2018).
Some mothers’ attribute their attitude towards EBF to the fear of losing the firmness and
shape of their breast which they believe may lead to divorce in their marriages because they
Again, some mothers with cracked nipples and engorged breasts tend not to breastfeed at all
due to the pain and discomfort they experience at the site. This leads to cessation of
breastfeeding and resorting to bottle feeding. To others, small size of breast and breastmilk
3
production is insufficient to the child and therefore must be supplemented with other formula
food. Some also think nature contributes to the development and growth of the child and not
The above factors as indicated may not be the only factors that affects exclusive
breastfeeding their infants. This study identified gaps in knowledge, attitudes and perception
towards the practice of EBF among mothers in in Gyedu, a town in the Asutifi North District
The aim of the study is to find out the about the practice of exclusive breastfeeding among
mothers in Gyedu, a town in the Asutifi North District of Brong Ahafo . The study will also
find out about the knowledge and problems faced by mothers during exclusive breastfeeding.
The main objective of the study is to find out the practice of exclusive breastfeeding among
mothers.
mothers?
4
Do mothers practice exclusive breastfeeding?
What are the problems breastfeeding mothers face during exclusive breastfeeding?
(a) Useful information about the practice, knowledge level and problems on exclusive
(b) Inform public debate that could lead to the development of appropriate policies on
1.7 Scope/Delimitation
The study focused on women who had given birth before and had breastfed or were
breastfeeding a baby. Respondents were drawn from Gyedu, a town in the Asutifi North
For the purpose of this research, the following words are defined as;
supplementation of any type (no water, no juice, no human milk, and no food) except for
Practice; the observance or pursuit of breastfeeding a baby for the required number of
months.
5
1.09 Organization of chapters
Chapter one (introduction) includes background of the study, problem statement, purpose
of the study, objectives of the study, research questions, significance of the study, limitations,
Chapter two (literature review) provides salient review of literature related to the study.
Chapter three (research methodology) explains the background of the study area, study
population, sampling technique, study type, data collection tools, data processing and
encompasses the comparison of findings with the literature review, summary and
6
CHAPTER TWO
LITERATURE REVIEW
1.0 Introduction
This chapter focuses on the work of other writers and research already conducted about
Exclusive breastfeeding (EBF) is defined as “an infant’s consumption of human milk with no
supplementation of any type (no water, no juice, no non-human milk, and no foods) except
for vitamins, minerals, and medications until six months (WHO, 2010)
Kramer (2003) reported that breastmilk is the first natural food for infants
Breastfeeding is an unequalled way of providing ideal food for the healthy growth and
development of infants; it is also an integral part of the reproductive process with important
implications for the health of mothers. Review of evidence has shown that, on a population
basis, exclusive breastfeeding for 6 months is the optimal way of feeding infants. Thereafter
The importance and pertinence of exclusive breastfeeding cannot be understated. Its positive
impact extend to the mother and baby. In fact a study by Matthew & Bhatia(1989), reported
that artificially fed infants are denied the benefit of autoimmunization whereby breast
produces antibodies against organisms to which the infant has been exposed. Bottle feeding
are associated with poorer oxygenation during feedings in both pre – mature and normal
infants
7
To enable mothers to establish and sustain exclusive breastfeeding for 6 months, WHO AND
UNICEF recommend:
Exclusive breastfeeding – that is the infant only receives breast milk without any
Breastfeeding on demand – that is as often as the child wants, day and night
Temboury’s (1994) studies into exclusive breastfeeding showed that, it acts as a protective
Because full breastfeeding includes frequent feeding throughout 24hours period tends to
delay resumption of ovulation (Lewis et al, 1991), spacing between births tends to increase.
Again studies has shown that exclusive breastfeeding reduces the risk of ovarian cancer and
breast cancer, increases family and national resources, is a secure way of feeding. (Kramer m
et al 2001). This fact is affirmed by Walshe et al (2000) who states that breastfeeding serves
as huge protective mechanism against breast cancer especially in young women. He also
affirmed that the risk of developing breast cancer decreases with increasing duration of
breastfeeding. That is the longer the months of breastfeeding the lower the risk of developing
breast cancer. Breastfeeding has other beneficial effect on the health of women. Studies have
shown that breastfeeding helps in losing pregnancy weight faster (Kramer, 2012). A study
revealed that women who breastfed lost 4.4kg within a year, while those who did not
breastfeed only lost 2.4 kg (Dewey, Heinig and Nommsen, 1993). Breastfeeding promotes
uterine contraction, thereby reducing blood loss after delivery and promotes uterine
Again Temboury’s (1994) studies into exclusive breastfeeding showed that, it acts as a
protective mechanism for the baby. Luwellyn (1993) concludes that, breastmilk contains
antibodies that protect babies from all forms of infections e.g. gastroenteritis, during the first
Kramer (2001) reported that breastmilk is the first natural food for infants. It provides all the
energy and nutrients the infant needs for the first six months of life and continues to provide
up to half or more of the child’s nutritional needs during the second half of the first year and
up to one-third during the second year of life. Breastmilk also promotes sensory and
cognitive development and protects babies against chronic and infectious diseases such as
diarrhoea, pneumonia etc. Exclusive breastfeeding reduces infant mortality due to common
childhood illness such as diarrhoea and pneumonia and provides a quick recovery during
Exclusive breastfeeding also improves children’s intellectual, mental and physical health in
childhood and throughout life and again enhances bonding between mother and child.( Baker,
Gamborg,2008)
9
2.2 Practice of exclusive breastfeeding
In a study, involving 140 countries, showed that, despite the well-acknowledged importance
of EBF worldwide and efforts made by UNICEF and health policy makers to support and
enhance its practice, the situation is not improving worldwide especially in the developing
countries. It was also realized a greater number of mothers practiced EBF in countries with
guaranteed paid work breaks with the low income level earners recording the highest rate of
EBF practices (Cai, Wardlaw, & Brown, 2012). 90% of the mothers were in agreement that
bottle feeding is more expensive than BF (Mccann, Baydar, & Williams, 2007). But a
mother’s decision to breastfeed does not only depend on the mother’s knowledge, or
perception on EBF but also on the influence of other decision makers of the family. These
may include mother in laws, grandmothers and other relations who have questioned the
practicability of EBF and introduced water, traditional medicines, and porridges to infants
before 6 months of age (Aborigo, 2012). They may possibly support EBF if they were well
informed by health workers. Therefore if health workers (nurses) are knowledgeable and share
information on EBF practices verbally without the needed counselling skills, it might not aid
in influencing the practice (Arts et al., 2011). Also, the practice of EBF can sometimes be
influenced by the mother’s beliefs, intentions and fears. In Ghana we have a number of
varying cultures which have different effects on a person’s decision making or opinion. For
instance in Tamale, these beliefs and practices which involve “pakopilla” ritual is the feeding
of infants with herbal concoctions or teas for a number of days. It is perceived culturally to
protect the infant against diseases and any harm which could be caused by the “pakopilla”
(white widow). These practices has a negative influence on EBF practices (Iddrisu, 2013)
10
2.3 Factors influencing the practices of exclusive breastfeeding
A number of factors have been found to influence BF duration and EBF practices worldwide
(Aidam et al, 2005). According to Santo, de Oliveira, & Giugliani, (2007) and Senarath,
Dibley, & Agho, (2007), the age of the mother, educational level, place of birth, age of infant,
employment status as well as initiation of the use of pacifiers within the first month of
delivery which can lead to poor latching on the breast by the infant. Also, not assessing ideal
prenatal care are factors that contributed to the low practice of EBF among mothers in East
Timor and Porto Alegre (Brazil). Another factor for imitating EBF is the source of
information. According to study by Ekambaram, Bhat & Ahamed (2012), most mothers gain
information about EBF from parents and relatives and friends which may not be enough to
sustain the 6 months duration of EBF practice. Out of100 respondents used in their study in
Tanzania, only 17 had information from health care workers, 14 heard about EBF from the
media and 9 heard about EBF from other sources such as the church. Furthermore a mother’s
decision to breastfeed is usually done before delivery. And mostly the perceived benefit of
breastfeeding the infant, the naturalness and emotional bonding with infants are some of the
factors that contribute to this decision making (Arora, McJunkin, Wehrer, & Kuhn, 2000).
But for a mother to do otherwise, factors such as mother's perception of father's attitude
toward the practice of EBF, uncertainty by the mother regarding the quantity of breast milk
produced or ability to breastfeed and having to return to work determines the likelihood for a
mother to exclusively breastfeed ( Cox, Giglia, Zhao, & Binns, 2014). Additionally, a
woman is most likely to breastfeed exclusively if her husband is the only bread winner of the
house and the only prevailing reason for her to do otherwise is due to fear that her breast milk
is not adequate for the nourishment of her infant (Chatman et al., 2004). Even among low-
challenges, mother’s preference and low milk supply were factors that influenced EBP
11
practices, although the reasons differed by age of the infant weaning (Rozga, Kerver, &
Olson, 2014). In the promotion and support of breastfeeding the health care system has a role
to play (Lu, Lange, Slusser, Hamilton & Halfon, 2001). For breastfeeding to be successful,
support from friends, family and healthcare professionals is needed (Ryan, Wenjun, &
Acosta, 2002). Also various demographic factors such as family size, age at marriage, type of
family, occupation, type of delivery, number of children, monthly income and religion have
Tamil Nadu (Radhakrishnan & Balamuruga, 2012). While in Accra, Ghana, a study
conducted to assess factors associated with EBF highlighted that EBF practices are
influenced by the level of education of the mother, place of delivery and positive attitude of
the mother towards EBF practices before delivery as well as owning a house. All these are
factors that would determine whether the mother is likely to breast feed exclusively (Aidam
et al., 2005). Also, EBF can be very effective among people with a strong breastfeeding
According to (Emily C. Taylor 2008), optimal breastfed rates are impacted by myriad factors
including, but not limited to health care systems and providers. Other key variables to
consider include social, economic, political factors, media and marketing of infant formula.
A major worry of many mothers during the first week postpartum is that their milk supply
might not be enough for their baby. This is almost the universal reason given by mothers for
Although many women fear they will not be able to produce enough milk to feed their babies,
the conclusion that many women have an insufficient milk supply is unsubstantiated.
12
Breastmilk may often be a perceived problem rather than an actual one, generated in part by
social ignorance of normal breastfeeding and in part of iatrogenic elements that make
breastfeeding difficult to accomplish or sustain (Beekan & Waterson, 1992; Hewman, 1986)
National data gathered in USA over a period of several years by an infant formula company,
Ross Laboratories, suggests that, on an aggregate basis, employment has little effect on
whether or not women initiate breastfeeding. However work does appear to have a substantial
effect on how long women are able to breastfeed, particularly those with less education (Ryan
The impact of fathers, grandmothers, relatives, friends, employers, community leaders and
others can’t be counted out. For instance Scott et al (1977) reported that paternal preference
for breastfeeding was a crucial factor that influenced mothers to breastfeed. Bar- yam and
Derby (1997) are of the view that a husband’s positive attitude is the most important factor
about the decision to exclusively breastfeed. Ligenoah (1996) claimed that grandmothers
caused impediment to the promotion of EBF. These grandmothers who bathed the babies
claimed to have nursed a lot of infants including their own babies to be healthy adults without
Lackadaisical attitude of health workers too have being questioned in the quest for proper
exclusive breastfeeding. Bangam (1996) said that lactating mothers were not encouraged to
practise exclusive breastfeeding by some “curative nurses” and doctors. He complained that
such professionals advised them to give water to babies after birth. In the same vain
King(1989) revealed that, many women failed to breastfeed because health services did not
support them..
Some people have raised concerns that the evident of the advantages of exclusive
13
for infants in developed countries, that breastmilk may not meet the full energy requirements
of the average infant at 6 months of age, and that estimates of the proportion of exclusively
breastfed infants at risk of specific nutritional deficiencies are not available (Am J. Clin Nutr.
2007).
An additional problem in Africa, over the last two decades has been the potential
transmission of HIV through breastmilk. A recent study from Zimbabwe indicates that
There is circumstantial evidence that the fear of spreading HIV to their infants through breast
milk has scared mothers (Thairu L.N et al, 2005) and (Doherty T et al, 2006), some of the
women may not know their HIV sero–status, with resultant negative influence on their
breastfeeding practices. On the other hand, recent studies done in Africa have reported that
women who are HIV – positive continue to breastfeed to avoid stigmatization by their
Peer counsellors in Cape Town, South Africa, (Moherbacher N, Stock J, 2002) found out
that some cultural and traditional beliefs and practices regarding breastfeeding which may
influence the practice of exclusive breastfeeding negatively. Beliefs and practices related to
expressing breast milk, use of colostrum together with understanding and managing breast
studies have also highlighted traditional and cultural beliefs and practices related to
breastfeeding that may negatively influence the practice of exclusive breastfeeding (Shirima
et al, 2012). Shirma et al (2012) states that some traditions considers breastmilk as ‘bad milk’
which brings bad luck to the baby. Other traditional beliefs are;
14
a. Pressures from village elders and families to supplement or not to breastfeed at all
since it’s a traditional practice and a taboo against their gods to wholly breastfeed a
baby.
c. That all family members should receive the benefit of food grown in the family farm.
d. The taboo of prohibiting sexual contact during breastfeeding. As the men may want to
have sexual intercourse with the breastfeeding mother they cease them from
2.5 Summary
The literature review that has been done shows that: exclusive breastfeeding has diverse and
compelling advantages to infants, mothers, families and societies. This involves health,
vital role of breastfeeding has been recognized by professionals and institutions around the
practices and knowledge of exclusive breastfeeding permeate through all societies but the
concepts and patronage differ. Socio-cultural factors are barriers to the practice of exclusive
breastfeeding. It is also abundantly clear that much effort has been made to improve
exclusive breastfeeding despite the numerous factors that discourage the practice of exclusive
breastfeeding in Ghana.
15
CHAPTER THREE
METHODOLOGY
3.0 Introduction
This section gives a detail account on how the study was conducted, how data was collected
The study was conducted in Gyedu, a town in the Asutifi North District of the Brong Ahafo.
The purpose of the study was explained to the respondents and their consent was sought.
This design was the overall plan for obtaining answers to the questions studied. The type of
research design used for the study was Non – Interventional, descriptive case study
Gyedu is a town located within the Asutifi North of the Brong Ahafo region. According to
Ghana’s population census, the population of the Asutifi North is 52,259. It is bounded to the
north by Wamahinso, to the South by Tutuka, to the east by Ntotroso and to the West by Yaw
owusukrom. The economy of the town is mostly agrarian with most of them being peasant
farmers who largely depend on rudimentary methods of farming. Cocoa, Coffee, Oil palm, and
Cashew are the major cash crops in the town with plantain, cassava cocoyam and maize being the
food crops. The town has minor financial institutions that residents are able to access financial
services. There are educational facilities in the area also. Most of the residents are of Akan origin
16
A map showing the location of Gyedu
17
3.3 Sampling Technique / Sample Size
This study was carried out among mothers at Gyedu with a sample size of fifty (50).
Data was collected from 50 mothers in Gyedu, in the Asutifi North District.
A structured questionnaire with open and closed – ended questions was used and written
questionnaires also for interview schedule. The questionnaires were administered in hand to
For meaningful and simplified data, pie charts, frequency tables and percentages were used in
3.7 Limitation
Various difficulties and limitations were encountered in the course of carrying out this
research work, among which were; Lack of co-operation on the part of some respondents
This led to generalization of the results to a larger group since it may not reflect the true
picture. Some respondents were illiterates and such questionnaires had to be read to them and
the questionnaires filled for them. This may have twisted the actual fact as some respondents
18
3.8 Ethical Considerations
All respondents were informed of the purpose of the study and giving adequate information
about the topic. Respondents were assured of anonymity and confidentiality. Respondents
had the right to withdraw from the research at any time. Each respondent who participated in
the research did it out of their own will. For ethical purpose, an introductory letter was taken
from the College of Nursing, Ntotroso administration and proper community entry done
19
CHAPTER FOUR
4.0 Introduction
The chapter entails the analysis and interpretations of the data obtained from the field. In
concurrence with the objectives of the study, the analysis covers the characteristics of the
respondents, their general knowledge and factors that influence drug abuse among the youth.
Methods used in the analysis are Bar chart, pie chart and tables.
4.1 SECTION A
Demographic data
15-25 18 36
26-36 23 46
37-45 9 18
Total 50 100
Table 1 shows that 18 respondents (36%) were aged between 15-25 years, 23 respondents
(46%) were aged 26-36, and 9 respondents (18%) were aged between 37-45 years.
20
2. Occupation of respondents
Self employed 30 60
Government worker 8 16
Unemployed 12 24
Total 50 100
The table above indicates that 30 respondents (60%) were self employed, government
3. Level of education
Primary 11 22
JHS 9 18
SHS 9 18
Tertiary 7 14
Illiterate 14 28
Total 50 100
The table above shows that 14 respondents (28%) were illiterate, 11 (22%) were primary
leavers, JHS and SHS leavers were 9(18%) each, and those who had completed tertiary were
7 (14%).
21
4. Religion of respondents
Christianity 35 70
Islam 14 28
Traditionalist 1 2
Total 20 100
From the table above, 35 respondents (70%) were Christians, 14(28%) were Muslims and 1
respondents (2%) were traditionalist. No respondents fell under other religious affiliation
0-500 31 62
600-900 9 18
1000-1500 10 20
Total 50 100
The table above shows that most respondents (31, 62%) earned between GhC 0-500, 18% (9)
22
6. Number of children of respondents
20
number of respondents
15
4
3
2
1 2 3 4 5 ABOVE 5
number of children
Source : Field data The line graph above shows a downward slope of the relationship
between the number of children of respondents and the number of respondents. 20
respondents had 1 child, 15 respondents had 2 children, 6 respondents had 3 children, 4
respondents had 4 children, 3 respondents had 5 children and 2 respondents had above 5
children.
23
7. Marital Status of respondents
Table 6 A percentage table showing the marital status of respondents
Marital status of respondents Number of respondents Percentage (%)
Married 25 50
Single 6 12
Divorced 2 4
Widowed 2 4
Separated 15 30
Total 50 100
SECTION B
Yes 50 100
No 0 0
Total 50 100
Table 7 shows that all respondents (50) had heard of exclusive breastfeeding.
24
9. Source of Information about exclusive breastfeeding
Figure 2 A pie chart showing the source of information about exclusive information.
Friends, 1, 2%
Figure 2 Shows that 40 respondents had heard of EBF from health personel, 7 heard it from
When respondents were asked about the benefits of EBF to the mother, the following answers
25
b. Helps to reduce weight after birth 12 respondents
The following are the benefits of EBF to the baby according to respondents
DURATION OF EBF 28
NUKMBER OF RESPONDENTS
12
6
4
26
The bar chart shows that 28 respondents claimed EBF should be practiced for 6 months, 6
respondents said it should be done for 5 months, 12 respondents said it should be practiced
35
31
30
25
NUMBER OF RESPONDENTS
20 19
15
10
0
Yes No
RESPONSE OF RESPONDENTS
The Figure above shows that only 19 respondents had practiced EBF and 31 had not
practiced EBF.
27
14. Commencement of EBF
Figure 5 A bar chart showing the period that EBF should be commenced.
47
number of respondents
3 0
The figure shows that 47 respondents taught EBF should commenced immediately after birth,
28
15. How often to Breastfeed the baby when practicing EBF
Figure 6 A bar chart showing how often babies are to be breastfed when practicing EBF.
45
40
40
35
30
Number of Respondents
25
20
15
10
7
5
3
0
Demand feeding When baby is awake 4-5 times daily
Number of times to feed
The figure shows that 40 respondents taught the baby should be breastfed on demand, 3 said
when baby is awake and 7 said baby should be breastfed 4-5 times daily.
29
16. Work and practice of EBF.
Figure 7 A bar chart showing the whether respondents nature of work allowed them to
practice EBF
40
38
35
30
NUMBER OF RESPONDENTS
25
20
15
12
10
0
Yes No
RESPONSE
Source: Field data According to the bar chart 38 respondents said their nature of work
allowed them to practice EBF and 12 said their nature of work do not allow them to practice
EBF.
30
SECTION D : PROBLEMS OF EXCLSUIVE BREASTFEEDING.
Figure 8 A pie chart showing whether religious and cultural belief affected practice of
EBF
YES
4%
YES
NO
NO
96%
Source: Field data The pie chart shows that 4%(2 respondents) said cultural and religious
belief affected EBF and 96%(48 respondents) said it did not affect EBF.
31
18. Respondents Challenges when practicing EBF
Figure 9 A pie chart showing the challenges faced by respondents when practicing EBF.
lack of family
support
8%
work related
problems
24%
Insufficient
breastmilk
Child refusal 60%
8%
Source: Field data the Pie chart above shows that 60% (30 respondents) faced lack of
sufficient breastmilk, 8%(4 respondents) complain of lack of family support and child refusal
32
19. Family and Husband Support and Practice of EBF
Figure 10 A pie chart showing whether respondent’s family and husband support practice of
EBF.
Yes Yes
Unconcern 40%
No
46%
Unconcern
No
14%
Source: Field data the pie chart shows that 23 respondents (46%) said their husband were
unconcern, 20 (40%) said they were supported by their husband and 14%(7) respondents said
33
20. Promotion of EBF practice among women
When respondents were asked about what can be done to ensure that all newly babies are
c. Health workers must improve upon their education to ensure all women know the
benefits of EBF.
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CHAPTER FIVE
5.0 Introduction
This chapter discusses the study based on the findings from respondents on the various
Demographic Data
The study found that majority of respondents were aged 26 -36 years who were 23(46%) out
of the 50 respondents, followed by 15-25 year group which recorded 18 (36%) respondents
unemployed and 16%(8) were government workers. Concerning the educational status of
respondents, 14(28%) were illiterate, 11 respondents had completed primary school, 9(18%)
respondents had either completed JHS or SHS and tertiary level was only 7(14%).
70%( of respondents were Christians, 28% (14 respondents) were Muslims and traditionalist
recorded 2%(1 respondents). This shows the study population is very religious.
62% (31 respondents) earned from 0-500 Ghana cedis, 20 %( 10 respondents earned 1000-
1500 Ghana cedis while the remaining 18 %( 9) respondents earned 600-900. It can be said
that all respondents were not financially handicap. All respondents had given birth since 20
respondents had at least a child, 15 respondents had 2 children, 6 respondents had 3 children,
3 respondents and only 2 respondents had more than 5 children. 50% of respondents were
35
married, 15 respondents were separated from their partners, 6 respondents were single, and 2
Data from the survey showed that all respondents had heard of exclusive breastfeeding. This
findings is in line with a study by UNICEF (2012) which found in 140 countries surveyed
The main source of information on exclusive breastfeeding was health personnel which
recorded 40, followed by media which was 7 respondents, 2 heard it from close relatives and
1 had heard it from friends. This contradicts the data from Ekambaram, Bhat & Ahamed
(2012), which suggested that only 17 out 100 respondents heard about EBF from health
pregnancies, helps to reduce weight after birth, prevents cancer especially ovarian cancer, and
also reduces blood loss after birth. This findings from respondents affirmed previous studies
that list the various importance of EBF to the mother. For instance, Lewis et al,( 1991) and
Walshe (2000) found that EBF delay ovulation thereby leading to spacing between births, and
Moreover, according to respondents the benefits to the baby were it helps the baby to grow
well, it helps baby to grow intelligent, it helps to bond the mother and baby and finally
prevent diseases such as diarrhoea. Temboury’s (1994) studies into exclusive breastfeeding
showed that it acts as a protective mechanism for the baby. Luwellyn (1993) concludes that,
breastmilk contains antibodies that protect babies from all forms of infections e.g.
gastroenteritis, during the first six months of life. Lastly, Gamborg (2008) indicated that EBF
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improves children’s intellectual, mental and physical health. This showed that respondents
On the exact duration of EBF, 28 respondents said it should be practiced for 6 months, 12
respondents agreed it should be practice for 4 months, 6 respondents said it should be practice
for 5 months and lastly 4 respondents said it is done for 3 months. This findings is in variance
with WHO (2010) recommendations that says that EBF should be sustain for 6 months
Although the study proves that most respondents had knowledge on EBF, 31(62%)
respondents had not practised EBF and only 19(38%) respondents had practiced EBF. This
assertion is falls short even by the findings from Ghana Demographic and Health Survey
(GDHS) 2008, that found that Ghana’s EBF rate is 63% and further falls short of world
47 respondents believed that EBF should commence immediately after birth, 3 said it should
start a day or days after birth. Moreover, 40 respondents affirmed that babies are to be
breastfed on demand when practicing EBF, 3 respondents said babies should only be
breastfed when babies are awake and 7 respondents are to be breastfed 4-5 times daily. The
findings mostly agrees with WHO recommendations on practice of EBF which are; Initiation
of breastfeeding within the first hour of life, the infant only receives breast milk without any
additional food or drink, not even water and breastfeeding on demand – that is as often as the
National data gathered in USA over a period of several years by an infant formula company,
Ross Laboratories, suggests that, on an aggregate basis, employment has little effect on
37
whether or not women initiate breastfeeding. (Ryan et al, 1990) This findings agrees with the
data from our survey that showed that 38respondents (76%) said their work allowed them to
practice EBF and 12(24%) said the nature of their work would not allow them to practice
EBF.
Cultural and religious belief has being taught to influence practice of EBF. But the study
proved otherwise. 48(96%) respondents said it didn’t not affect the practice of EBF and 2
(4%) respondents said it affected the practice of EBF contradicting Moherbacher N, Stock J
(2002) that found out that some cultural and traditional beliefs and practices regarding
According to respondents the main challenge facing them when practising EBF is insufficient
lack of family support (8%, 4 respondents) and finally baby refusing to suck (8%, 4
respondents). This contradicts with the findings of a study by Hill & Humerick, (1989) that
indicates that a major worry of many mothers during the first week postpartum is that their
milk supply might not be enough for their baby. This is almost the universal reason given by
From the study it was deduced that 46% of respondents’ family and husband were
unconcerned about whether they practiced EBF or not, 40% of respondents said they had
active support from their families and husband when practicing EBF and 14% said they were
not supported by their families and husband when practising EBF. This findings may partially
be supported by findings from Cox, Giglia, Zhao, & Binns, (2014) that indicates that factors
such as mother's perception of father's attitude toward the practice of EBF. If the father
supports the woman, then its likely the woman will practice EBF.
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5.2 Recommendations
Based on the findings of the study, the following recommendations are being put forward to
the government, media , health workers, policy makers as well as future researchers.
The government must work hand in hand with health care workers, the media and
other policy makers to educate the population including the husbands and relatives of
The media must help in eradication of such cultural and religious belief that impedes
Government must put measures in place that ensures that all nursing mothers have
adequate maternal leave. This will go a long way to ensure the nature of women
Policy makers must advocate for provision of serene place where mothers can
NGO’s, government and policy makers must make regulations that ensures that
Health care workers must ensure inter- personnel counselling for mothers and skilled
Health care workers must follow up on all breastfeeding mothers and to encourage
them to ensure continuous, unadulterated breastmilk till six months of life of the baby.
must provide accurate, consistent and evidenced based information on the benefits
39
Nurses must collaborate with individuals, groups, policy makers and organisations in
The study showed that all respondents are affiliated to one religion or the other. It is therefore
recommended that religious and opinion leaders in the community and the country as a whole
are educated and empowered on the benefits of EBF. This will ensure they support and
encourage the people they reside over to practice EBF and also help eschew cultural and
Exclusive breastfeeding (EBF) is defined as “an infant’s consumption of human milk with no
supplementation of any type (no water, no juice, no non-human milk, and no foods) except
for vitamins, minerals, and medications until six months (WHO, 2010). Even though it is
generally perceived that people know about EBF, most mothers do not practice EBF and
those who practice it do not practice it for the required number of months. Due to the
enormous benefits of practicing and the enormous disadvantages both and baby may acquire
if EBF is not practised, this study was conducted in Krupease a suburb of Drobo, the capital
city of Jaman South District in the Brong Ahafo Region of Ghana. 50 respondents were
surveyed using cross-sectional survey method and data was collected using a structured
questionnaire to obtain answers from respondents. Data collected was then analysed and
presented with pie, bar and line charts and also simple percentage tables. The results was
generalised to apply to the whole society. The target population were women who had
40
REFERENCE
Baker, J.L., Gamborg, M., Heitmann, B.L., Lissner, L., Sorensen, T.I. & Rasmussen, K.M.
Davis, S.K., Stichler, J.F. &Poeltler, D.M. 2012. Increasing Exclusive Breastfeeding Rates in
Hill and Humerick 1989. Introduction to health behavior theory. NewyorkJones & Bartlett
Jager, M.D, Hartley, K., Terrazas, J. & Merrill, J. 2012.Barriers to breastfeeding-a global
Lewis, T.O., Olawuyi, J.F. &Onadeko, M.O. 1994. Factors associated with exclusive
41
Ministry of health, (1995), Nutrition Facts for Ghanaian Families, Accra, Ghana
Okeh, U.M. 2010. Breastfeeding and the mother–child relationship: A case study of Ebonyi
Journal
Temboury, K.L. 1994. Factors associated with exclusive breastfeeding among infants under
Watson, J.I, Platt, B.A (1997), Breastfeeding at its Best Health Journal, Page 3-4.
January 2018].
42
QUESTIONAIRES
Dear Respondent,
exclusive breastfeeding among women in Gyedu. The study is for academic purposes hence
information given would be treated as confidential and only be made available for such
purpose only. To ensure anonymity, no name is required. You can withdraw from the study
anytime you deem necessary. We shall be grateful if you cooperate with us by giving your
Kindly tick the right option and write the correct answer where necessary.
1. Age
a. 15-25 ( )
b. 26-36 ( )
c. 37-45 ( )
2. Occupation
a. Self-employed ( ) specify________________
c. Unemployed ( )
3. Level of Education
d. Tertiary ( ) e. Illiterate ( )
e. other(specify)__________
43
5. Income level
a. Ghc 0-500 ( )
b. Ghc 600-900 ( )
c. Ghc 1000-1500 ( )
1 { } 2 { }
3 { } 4 { }
5 { } Above 5 { }
Married { } Single { }
SECTION B
Yes { } No { }
…………………………………………………………………………………………………
………………………………………………………………………………………………..
…………………………………………………………………………………………………
Yes { } No { }
After the yellow aspect of the breast milk has being expressed out. ( )
16. Does your work allow you to practice exclusive breastfeeding when you are at work?
Yes ( ) No ( )
Yes { } No { }
Others (specify)……………………….
19. Does your family and husband support you on exclusive breastfeeding?
Yes ( ) No ( ) Unconcern ( ).
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20. What do you think can be done to promote exclusive breastfeeding?
......................................................................................................................................
46