241035 Traditional Birth Attendants can be trained to maximize breast feeding and decrease prelacteal feeding in Ethiopia's Amhara region

Sunday, October 30, 2011

Nikki L. Rogers, PhD , Department of Community Health, Substance Abuse Resources & Disability Issues (SARDI) Program, Wright State University, Boonshoft School of Medicine, Dayton, OH
Andrew J. Carlson, PhD , Department of Political Science, Capital University, Columbus, OH
Amsalu Feleke, MPH , College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
The World Health Organization recommends that newborns begin breastfeeding within the first hour after birth. The Ethiopia Demographic and Health Survey (EDHS, 2005) indicates that in the northern region of Amhara, this milestone is met in only an estimated 63% of all cases. Interview of mothers and health workers in this region found that colostrum is widely thought to cause abdominal pain or other harm to the infant and may be partially discarded at the start of breastfeeding. Additional public health concerns are the separation of mother and baby during delivery of the placenta and in the hours immediately following birth and widespread (63%) traditional practice of prelacteal feeding of unpasteurized butter, cow's milk or yeast and water. Our experience with Amhara communities suggests that women have a great desire for education about infant/child care and nutrition. An estimated 94% of all births in Ethiopia take place at home, and approximately one third of births (30%) in Amhara are attended by a Traditional Birth Attendant (TBA) (EDHS, 2005). With health access in Ethiopia limited by the strain of population growth coupled with “brain drain” of qualified health personnel, a practical solution to improving breastfeeding initiation and postnatal infant nutrition might be training TBAs to implement WHO recommendations through birth methods that include early skin-to-skin contact and protection of the mother-baby dyad in the hours immediately after birth. The emerging use of mobile telephones and reports of regular consultation among TBAs would facilitate educational and follow-up efforts.

Learning Areas:
Planning of health education strategies, interventions, and programs
Provision of health care to the public

Learning Objectives:
1. Learners will be able to explain deficits in breastfeeding behavior in the Amhara region relative to WHO recommendations. 2. Learners will be able to list reasons why the authors propose training of traditional birth attendants in early skin-to-skin contact and WHO breastfeeding recommendations.

Keywords: Rural Health Care Delivery System, Breastfeeding

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have conducted primary field research and have peer-reviewed research in press in this area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.