Online Program

Closing the research-practice gap for breastfeeding support using ethnographic methods in Haiti

Monday, November 2, 2015

Elizabeth Fox, Division of Nutritional Sciences, Ithaca, NY
Gretel Pelto, Division of Nutritional Sciences, Cornell University, Ithaca, NY
Vanessa Rouzier, Les Centres GHESKIO, Port-au-Prince, Haiti
Marie Guerda Debrosse, Les Centres GHESKIO, Port-au-Prince, Haiti
Jean William Pape, Les Centres GHESKIO, Port-au-Prince, Haiti
David Pelletier, Division of Nutritional Sciences, Cornell University, Ithaca, NY
Background: Strategies for enhancing the large-scale uptake of efficacious interventions remain a major public health challenge.  Breastfeeding is one example, with only 35% of women worldwide practicing exclusive breastfeeding in the first six months despite many documented benefits. The objective of this research is to explore the potential for structured ethnographic methods to help close the breastfeeding research-practice gap by examining the ways in which mothers interpret and prioritize messages they receive, thereby strengthening counseling and behavior change strategies.

Methods: Thirty-five mothers [HIV-infected (n=30) and HIV-uninfected (n=5)] were longitudinally interviewed during pregnancy, 0-1 month and 3-5 months postpartum in urban Haiti. Pile sorting methodologies were used to determine mothers’ perceptions and prioritizations of infant feeding messages they received from various sources. 

Results: Key themes emerging from the interviews included concern for child or maternal health and nutrition, social support and fear of stigmatization. Mothers’ infant feeding decisions during pregnancy and immediately post-partum were heavily influenced by recommendations provided by medical personnel. However, as their infants grew older, messages about mixed feeding and early weaning from community and family members became important influences. 

Conclusions: Two conclusions emerge: In light of the strong role of social influences and fear of stigmatization, there is a need not only to counsel breastfeeding mothers on desired practices, but also to empower them with strategies to negotiate and mitigate conflicting infant feeding messages they receive as their infants get older. Structured ethnographic methods can indeed identify barriers to the adoption of efficacious health and nutrition interventions.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe ethnographic methods of pile sorting. Identify the ways in which Haitian breastfeeding mothers interpret and prioritize infant feeding messages they receive.

Keyword(s): International MCH, Health Promotion and Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator for the study being presented, and have been involved with all aspects of the research: development, implementation and analysis. As a part of my dissertation research and in partnership with members of my dissertation committee, I have taken coursework and received mentoring related to maternal-child nutrition, ethnographic research and social policy.
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.

Back to: 3106.1: Poster Session 12