Assessment of Health Care Providers' Knowledge and Counseling Practices about Breastfeeding in the Ukrainian Maternities Implementing WHO Effective Perinatal Practices (EPC)

The study consisted of a post-test analysis of the facilities, implementing EPC practices in order to assess differences in knowledge or practices by both size of facility, type of provider, and level of training received. All health care facilities were divided into one of three groups: small (less than 50 providers), medium (50-100 providers), and large (over 100 providers). Two-stage sampling proportionate to size was used which resulted in 27 selected facilities in the small group, 8 in the medium group, and 4 in the large group, for a total of 39 facilities selected. Results: Only 38,1% of the health care providers know how to counsel women about mastitis: in large facilities 43,8% (p<.038) whereas in smaller facilities the percentage is lower (medium - 37,4% and small – 33,6%). There were not marked differences in the proportion of correct responses by position group. However, the neonatologist/pediatrician/ob/gyn group was significantly more likely than the nurse/midwife group to know that: - Supplemental feeding is detrimental to a good milk supply than the nurse/midwife group (96.0% vs 85.5%, p<.000); - Mothers should not restrict her fluids when her milk comes in (86.6% vs 77.7%, p<.005); and - The correct treatment for a one-month old child with diarrhea but without any dehydration is exclusive breastfeeding (97.2% vs 92.8%, p<.019). On the other hand, the nurse/midwife group was significantly more likely to know that there was no need for mothers of infants under 6 months to ‘top up' after each feed (77.7% vs 66.3%, p<.002).