DECLARATION

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

NAME OF STUDENT INDEX NUMBER SIGNATURE

GOKA CHRISTIANA YAYRA B52015076 …………………

GYAMAA SANDRA B52015077 .…………………

HABIB MOHAMMED B52015078 …………………

IBRAHIM HAMIDATU B52015079 ………………….

NAME OF SUPERVISOR ………………………………………………………….

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

District, Brong Ahafo.

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

the literature review.

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

earned between 0-500 ghc and 50% of them were married.

On the knowledge on exclusive breastfeeding, all respondents had knowledge on exclusive

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

their wives to practice EBF according to the survey.

Conclusion: Based on the findings from the study, recommendations were made to

government, health workers, community and religious leaders. Such recommendations

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

women and this survey is no exception.

Firstly we would like to express our utmost appreciation to our principal………….whose

support throughout the 3year stay in the college was under his leadership.

We sincerely appreciate the guidance and support received from our

supervisor……………... Thank you …………. for the encouragement to stay focused and

complete this project on time.

We would like to say thank you to all our respondents for their enthusiasm to join in this

project and for sharing with us their experience.

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.

God bless you all

 DEDICATION

Dedicated to our respondents, loved ones, friends, family and colleagues who made this work

a reality.

God bless you.

viii
 TABLE OF CONTENT

CONTENT PAGE

DECLARATION …………………………………………………………………………

ABSTRACT ……………………………………………………. …………..……………

ACKNOWLEDGEMENT ……………………………………………………………..

DEDICATION…………………………………………………………………………...

TABLE OF CONTENT ………………………………………………………………...

LIST OF TABLES AND FIGURES …………………………………………………….

BACKGORUND OF THE STUDY……………………………………………………….

1.1 Background of the study……………………………………………………..…….
1.2 Statement of the problem……………………………………………………..……
1.3 Purpose of the study……………………………..…………………………………
1.4 Objectives of the study…………………………………………………….……. ...
1.5 Research questions……………………………………...……..………….…….…
1.6 Significance of the Study ………………………………………………………..

1.7 Scope/Delimitation………………………………………………………………

1.8 Operational definitions/ acronyms ………..…………………………………...…..

1.09 Organization of chapters…………………………………………………………

ix
CHAPTER TWO

LITERATURE REVIEW……………..…………………….………….………..………..

2.0 Introduction…………………………………………………………………………

2.1Knowledge on Exclusive breastfeeding……………………………………………

2.2Practice of exclusive breastfeeding……………………………………………….

2.3 Factors influencing the practices of exclusive breastfeeding ……………………

2.4 Challenges, Problems, Impediments To Exclusive Breastfeeding………………

2.5 Summary ………………………………………………………………………..

CHAPTER THREE

MATERIALS AND METHODS…………………………………..…………....….…..….

3.0 Introduction…………………….…………………………………………….………
3.1 Research design…………………….………….…………………………………..…..
3.2 Research setting………...………….………………………..…..….……………….
3.3 Sampling technique And Sampling Size……….………………………...………...
3.4Study population……………………...………………………………………...…….
3.5 Method Of Data Collection And Tool …………………………………………….
3.6 Data Analysis …...…………………………………………………..…………….
3.7 Limitations of the Study…………………………………………………….………..
3.8 Ethical Considerations……………………………………………………………….

CHAPTER FOUR

DATA ANALYSIS AND RESULTS ……………………….……………..……....……...

4.0 Introduction …………………………………………………..………………….
4.1 Demographic data………………………………………………………………….
4.2 Knowledge on exclusive breastfeeding…………………...………………………

x
 4.3 Practice of exclusive breastfeeding ……………….…………………..
4.4 Problems associated with exclusive breastfeeding.…………………….

CHAPTER FIVE

DISCUSSION, CONCLUSIONS AND RECOMMENDATIONS…………………….…

5.0 Introduction…………………………………………………..………..…………...
5.1Discussion of findings ………………………………………..…………………..

5.2 Recommendations……………………………………………………...………….

5.3 Conclusion…………………………………….…………………………………...

REFERENCES …………………………………………………………………...….…….

QUESTIONAIRES……………………………………………….………………………...

xi
 LIST OF TABLES

TABLE PAGE

1. Age Groups of Respondents

2. Occupation of respondents

3. Level of education

4. Religion of respondents

5. Income level of respondents

6. Marital status of respondents

LIST OF FIGURES

1. A Line chart showing respondents number of children

2. A bar chart showing the source of information about exclusive information.

3. A bar chart showing the duration of EBF by respondents

4. A bar chart showing if respondents had practiced EBF

5. A bar chart showing the period that EBF should be commenced.

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

1.1 Background Information

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

of the infant life.

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

vitamins, minerals and medication until sixth moths. (Adelekan,2003)

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

more likely to die compared to breastfed infants ( WHO, 2010).

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

children under five years of age die each year.

www.who.int/nutrition/topics/exclusive_breastfeeding/en/

Sub-Saharan Africa has been the worst affected with the highest proportion of disease burden

associated to suboptimal breastfeeding. The World Health Organization (WHO) recommends

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

appropriate complementary feeding.

To promote EBF, Ghana adopted the Baby-Friendly Hospital Initiative (BFHI) in 1991 and

subsequently formed a BFHI authority to oversee its implementation, development of

breastfeeding policy and training of health workers to promote and support the practice of

breastfeeding. Furthermore, Ghana enacted and implemented the Ghana Breastfeeding

Promotion Regulation 2000 otherwise known as Legislative Instrument [LI] 1667) to curb the

aggressive marketing of breastmilk substitutes. (Tampah-Naah, Kumi-Kyereme 2013).

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

short of the WHO’s recommendation of 90 % coverage (Lancet, 2003). Mother's knowledge

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 among mothers.

1.2 Problem Statement

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

associated with it, some mothers still do not practice it.

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

moved from 46.3% in 2010 to 52% in 2012. (www.modernghana.com, accesed on 15th,

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

have flaccid and sunken breast.

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

exclusive breastfeeding, (Okeh, 2010).

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

of Brong Ahafo in Ghana.

1.3 Purpose Of The Study

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.

1.4 Objectives of the Study

1.4.1 General Objective

The main objective of the study is to find out the practice of exclusive breastfeeding among

mothers.

1.4.2 Specific Objectives

1. To access the knowledge level of breastfeeding mothers on exclusive breastfeeding.

2. To determine if mothers practice exclusive breastfeeding.

3. To identify problems faced by mothers during exclusive breastfeeding.

1.5 Research Questions

 What is the level of knowledge on exclusive breastfeeding among breastfeeding

mothers?

4
  Do mothers practice exclusive breastfeeding?

 What are the problems breastfeeding mothers face during exclusive breastfeeding?

1.6 Significance of the Study

The study is of great importance as it could provide:

(a) Useful information about the practice, knowledge level and problems on exclusive

breastfeeding amongst mothers;

(b) Inform public debate that could lead to the development of appropriate policies on

how to encourage exclusive breastfeeding amongst mothers

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

District of Brong Ahafo. All respondents were women.

1.8 Operational definition /Acronyms

For the purpose of this research, the following words are defined as;

Exclusive breastfeeding (EBF):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

vitamins, minerals and medication until sixth months

Practice; the observance or pursuit of breastfeeding a baby for the required number of

months.

5
1.09 Organization of chapters

The study is divided into five 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,

scope/delimitations and finally operational definition/ acronyms.

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

analysis and ethical clearance.

Chapter four (Presentation of results/findings) shows visually presentation of data

collected by means of tables.

Chapter five (discussions, summary of findings, conclusion and recommendations)

encompasses the comparison of findings with the literature review, summary and

recommendations deduced from the research.

6
 CHAPTER TWO

LITERATURE REVIEW

1.0 Introduction

This chapter focuses on the work of other writers and research already conducted about

practice of exclusive breastfeeding.

2.1 Knowledge on exclusive breastfeeding

What is exclusive breastfeeding?

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

infants should receive complementary foods with continued breastfeeding up to 2 years of

age or beyond. (WHO, 2010)

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:

 Initiation of breastfeeding within the first hour of life

 Exclusive breastfeeding – that is the infant only receives breast milk without any

additional food or drink, not even water

 Breastfeeding on demand – that is as often as the child wants, day and night

 No use of bottles, teats or pacifiers (Kramer M et al 2001)

Importance To The Mother

Temboury’s (1994) studies into exclusive breastfeeding showed that, it acts as a protective

mechanism for mother also improves mother and baby relationship.

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

involution (Davis, Stichler and Poeltler, 2012).

8
Breastfeeding reduces the risk of type 2 diabetes and cardiovascular diseases (Davis, Stichler

and Poeltler, 2012).

Importance To The Child

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

six months of life.

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

illness. (Davis, Stichler and Poeltler, 2012)

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)

since the breast milk is being supplemented with other liquids.

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-

income women enrolled in a peer counselling breastfeeding support program, breastfeeding

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

been found to be major determinants of exclusive breastfeeding practices among women in

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

culture and good counselling on lactation.(Aidam et al., 2005).

2.4 Challenges, Problems, Impediments To Exclusive 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

supplementation. (Hill & Humerick, 1989).

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

et al, 1990) thus affecting exclusive breastfeeding.

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

practicing exclusive breastfeeding

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

breastfeeding is insufficient to confidently recommend exclusive breastfeeding for six months

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

potential transmission of HIV can be halved from 14% to 7% by exclusive breastfeeding in

the first three months. (Lliff PJ et al, 2005).

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

families and communities (Doherty T et al, 2006)

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

conditions during breastfeeding may not be supportive of exclusive breastfeeding. Other

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.

b. Breastmilk is an incomplete food that does not increase infants weights .

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

breastfeeding so they can have sex with their partners.

(ncbi.nlm.nih.gov/m/pubmed/15973270/ accessed on the internet February, 2018)

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,

nutritional, immunologic, developmental, social, economic and environmental benefits. The

vital role of breastfeeding has been recognized by professionals and institutions around the

world. Universal efforts to promote breastfeeding continue to exist. Beliefs, attitudes,

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

and how information was gathered.

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.

3.1 Research Design

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

specifically cross – sectional survey was used in this study.

3.2 Research Setting

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

with few other ethnic groups in the area due to migration.

16
A map showing the location of Gyedu

Source: Ghana Statistical Agency(2010)

17
 3.3 Sampling Technique / Sample Size

The non – probability convenience sampling method was employed.

This study was carried out among mothers at Gyedu with a sample size of fifty (50).

3.4 Study Population

Data was collected from 50 mothers in Gyedu, in the Asutifi North District.

3.5 Method Of Data Collection And Tool

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

respondents which were collected as soon respondents finished filling it.

3.6 Data Analysis

For meaningful and simplified data, pie charts, frequency tables and percentages were used in

analysing the data.

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

(mothers).Inadequate population size due to financial constraints (hence 50 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

may not have given us the actual facts.

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

through the opinion leaders.

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

1. Age group of respondents

Table 1 A percentage table showing the age group of respondents

Age group Number of respondents Percentage (%)

15-25 18 36

26-36 23 46

37-45 9 18

Total 50 100

Source: Field data

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

Table 2 A percentage table showing the occupational status of respondents

Occupation of respondents Number of respondents Percentage (%)

Self employed 30 60

Government worker 8 16

Unemployed 12 24

Total 50 100

Source: Field data

The table above indicates that 30 respondents (60%) were self employed, government

workers were 8(16%) and unemployed respondents were 12 (24%).

3. Level of education

Table 3 A percentage table showing the level of education of respondents

Level of education Number of respondents Percentage (%)

Primary 11 22

JHS 9 18

SHS 9 18

Tertiary 7 14

Illiterate 14 28

Total 50 100

Source : Field data

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

Table 4 A percentage table showing the level of education of respondents

Religion Number of respondents Percentage (%)

Christianity 35 70

Islam 14 28

Traditionalist 1 2

Others ( Specify) (no 0 0

religious affiliation)

Total 20 100

Source: Field data

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

5. Income level of respondents

Table 5 A percentage table showing the level of education of respondents

Income level of respondents Number of respondents Percentage (%)

0-500 31 62

600-900 9 18

1000-1500 10 20

Total 50 100

Source: Field data

The table above shows that most respondents (31, 62%) earned between GhC 0-500, 18% (9)

respondents earned GHC 600-900 and 10 (20%) earned 1000-1500.

22
 6. Number of children of respondents

Figure 1 A line graph showing respondents’ number of children.

respondents number of children

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

Source: Field data

The table above shows that 25 respondents (50%) were married, 15 (30%) of respondents
were separated, Single respondents were 6(12%) , and widowed and divorced were 2(4%)
each.

SECTION B

KNOWLEDGE ON EXCLSUIVE BREASTFEEEDING

8. Whether respondents have heard of exclusive breastfeeding

Table 7 A percentage table showing whether respondents had heard of exclusive

breastfeeding or not .

Informed on exclusive Number of respondents Percentage (%)

breastfeeding

Yes 50 100

No 0 0

Total 50 100

Source: Field data

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.

Source of information on EBF

Relatives , 2, 4%
Media, 7, 14%

Friends, 1, 2%

Health personel, 40,

80%

Media Friends Health personel Relatives

Source: Field data

Figure 2 Shows that 40 respondents had heard of EBF from health personel, 7 heard it from

media, 2 heard it from close relatives and friends was 1.

10. Benefits of EBF to the mother.

When respondents were asked about the benefits of EBF to the mother, the following answers

were given by the respondents

a. It prevents unwanted pregnancies 25 respondents

25
 b. Helps to reduce weight after birth 12 respondents

c. Prevents cancer 3 respondents

d. Reduces blood loss after birth 10 respondents

11. Benefits of exclusive breastfeeding to the baby.

The following are the benefits of EBF to the baby according to respondents

a. It helps the baby to grow well

b. It helps the baby to grow intelligent

c. It helps to bond the baby to the mother

d. It helps to prevent diseases such as diarrhoea in the baby

12. Duration of EBF

Figure 3. A bar chart showing the duration of EBF by respondents .

DURATION OF EBF 28
NUKMBER OF RESPONDENTS

12

6
4

3 MONTHS 4 MONTHS 5MONTHS 6 MONTHS

NUMBER OF MONTHS

Source: Field data

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

for 4 months and 4 respondents said it should be practice for 3 months.

SECTION C PRACTICE OF EXCLUSIVE BREASTFEEDING

13. Practice of exclusive breastfeeding

Figure 4 A bar chart showing if respondents had practiced EBF

35

31
30

25
NUMBER OF RESPONDENTS

20 19

15

10

0
Yes No
RESPONSE OF RESPONDENTS

Source: Field data

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

IMMEDIATELY AFTER A DAY OR DAY AFTER AFTER THE YELLOW

BIRTH BIRTH ASPECT HAS BEING
EXPRESSED
response of respondents

Source: Field data

The figure shows that 47 respondents taught EBF should commenced immediately after birth,

3 said it should start a day or days 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.

How Often to Feed baby

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

Source: Field data

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.

17. Cultural and religious belief and EBF practice

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.

Challenges faced by Respondents.

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

as problems and 24%(12 respondents) complained of work related problems.

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

they didn’t have the support of their husbands.

33
 20. Promotion of EBF practice among women

When respondents were asked about what can be done to ensure that all newly babies are

exclusively breastfed, the following was put out by the respondents.

a. Education by the media

b. Family members and husbands should be educated to support breastfeeding

c. Health workers must improve upon their education to ensure all women know the

benefits of EBF.

34
 CHAPTER FIVE

DISCUSSION OF FINDINGS, CONCLSUION AND RECOMMENDATIONS

5.0 Introduction

This chapter discusses the study based on the findings from respondents on the various

objectives outlined in relation to the literature review.

5.1 DISCUSSION OF FINDINGS

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

and only 9 (18%) respondents were aged between 37-45 years.

On occupational status of respondents, 60%(30) were self-employed, 24%(12) were

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

respondents each were either divorced or widowed.

Knowledge on exclusive breastfeeding

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

that mothers knew about and acknowledged the importance of EBF.

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

workers. According to respondents the benefits of EBF were it prevents unwanted

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

it also reduces the risk of ovarian and breast cancer.

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

36
improves children’s intellectual, mental and physical health. This showed that respondents

had idea about the importance of EBF to the child.

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

without food or water. (Kramer et al, 2001).

Practice of exclusive breastfeeding.

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

health organisation recommendation of 90% coverage for EBF(lancet, 2003).

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

child wants, day and night . Kramer M et al (2001).

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.

Problems of exclusive breastfeeding

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

breastfeeding which may influence the practice of exclusive breastfeeding negatively.

According to respondents the main challenge facing them when practising EBF is insufficient

breastmilk production (60%, 30 respondents), work related problems (24%, 12 respondents),

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

mothers for supplementation.

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.

38
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.

Government, media, policy makers

 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

mothers to practice EBF.

 The media must help in eradication of such cultural and religious belief that impedes

and discourages the practice of EBF

 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

profession do not discourage them from practicing EBF.

 Policy makers must advocate for provision of serene place where mothers can

breastfeed their babies when they are at work.

 NGO’s, government and policy makers must make regulations that ensures that

supplements are not aggressively marketed.

Health care workers.

 Health care workers must ensure inter- personnel counselling for mothers and skilled

support for breastfeeding mothers

 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.

 Nurses must portray a positive, non-judgement attitude towards breastfeeding. Nurses

must provide accurate, consistent and evidenced based information on the benefits

and health consequence of practicing EBF to the mother.

39
  Nurses must collaborate with individuals, groups, policy makers and organisations in

all sectors as necessary to protect, promote and support breastfeeding mothers.

Opinion leaders, religious leaders

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

religious belief that acts as a stumbling block in the practice of EBF.

5.3 Summary and conclusion

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

breastfed or was breastfeeding babies.

40
 REFERENCE

Adelekan, D.A. 2003. Childhood nutrition and malnutrition in Nigeria. Nutrition.

19(2): 179-181. Eedee Press, Lagos

Aryeetey RN 2013 .Factors influencing the practice of exclusive breastfeeding in rural

communities of Osunstate, Nigeria. European Journal of Business and

Management. 5(15): 49-53

Baker, J.L., Gamborg, M., Heitmann, B.L., Lissner, L., Sorensen, T.I. & Rasmussen, K.M.

2008. Breastfeeding reduces postpartum weight retention. The American Journal of

Clinical Nutrition. 88(6): 1543-1551.

Davis, S.K., Stichler, J.F. &Poeltler, D.M. 2012. Increasing Exclusive Breastfeeding Rates in

the Well‐Baby Population. Nursing for Women's Health. 16(6):

Hill and Humerick 1989. Introduction to health behavior theory. NewyorkJones & Bartlett

Publishers (ncbi.nlm.nih.gov/m/pubmed/15973270/ accessed on the internet 2017

Jager, M.D, Hartley, K., Terrazas, J. & Merrill, J. 2012.Barriers to breastfeeding-a global

survey on why women startand stop breastfeeding;Belarus Journal of Obstetrics and

Gynaecology. 7(1): 25-30.

(www.tensteps.org/benefits -of-breastfeeding-for-the-environment-society.shtml accessed on

the internet 2017)

Kramer, 2003. Optimal duration of exclusive breastfeeding (Review). TheCochrane Library;

8: 1-40. JohnWiley& Sons, Ltdhttp://www.thecochranelibrary.com

Lewis, T.O., Olawuyi, J.F. &Onadeko, M.O. 1994. Factors associated with exclusive

breastfeeding in Ibadan, Nigeria. Journal of Human Lactation: Official Journal of

International Lactation Consultant Association. 17(4): 321-325.

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

State University Teaching Hospital, Abakaliki. African Journal of Primary

Health Care& Family Medicine. 2(1): doi: 10.4102/phcfm.v2i1.97

Tampah-Naah, AM., & Kumi-Kyereme. 2013. Determinants of exclusive breastfeeding

among mothers in Ghana: a crosssectional study. International Breastfeeding

Journal

Temboury, K.L. 1994. Factors associated with exclusive breastfeeding among infants under

six months of age in peninsular Malaysia. Int Breastfeed

Watson, J.I, Platt, B.A (1997), Breastfeeding at its Best Health Journal, Page 3-4.

WHO. Early Initiation of Breastfeeding: WHO, Geneva; 2010.

WHO. http://www.who.int/nutrition/topics/exclusive_breastfeeding/en/. 2014. [Accessed on

January 2018].

42
 QUESTIONAIRES
Dear Respondent,

We are students of College of Nursing, Ntotroso, conducting a survey on the practice of

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

honest options. Thank you.

Kindly tick the right option and write the correct answer where necessary.

SECTION A: DEMOGRAPHIC DATA

1. Age

a. 15-25 ( )

b. 26-36 ( )

c. 37-45 ( )

2. Occupation

a. Self-employed ( ) specify________________

b. Government Worker ( ) specify________________

c. Unemployed ( )

3. Level of Education

a. Primary ( ) b. JHS ( ) c. SHS ( )

d. Tertiary ( ) e. Illiterate ( )

4. Which religion do you belong to?

a. Christianity ( ) b. Islam ( ) c. Traditionalist ( )

e. other(specify)__________

43
5. Income level

a. Ghc 0-500 ( )

b. Ghc 600-900 ( )

c. Ghc 1000-1500 ( )

6. Number of children of respondents

1 { } 2 { }

3 { } 4 { }

5 { } Above 5 { }

7. Marital status of respondents

Married { } Single { }

Divorced { } Widowed { } Separated { }

SECTION B

KNOWLEDGE ON EXCLUSIVE BREASTFEEDING

8. Have you heard of exclusive breastfeeding?

Yes { } No { }

9. What was your source of information about exclusive breastfeeding?

Media { } Friends { } Health personnel { } Relatives { }

10. Give the benefits of exclusive breastfeeding to the mother?

…………………………………………………………………………………………………

………………………………………………………………………………………………..

11. Give the benefits of exclusive breastfeeding to the baby?

…………………………………………………………………………………………………

12. How long should exclusive breastfeeding be practised?

3 months ( ) 4 months ( ) 5 months ( ) 6 months ( )

44
SECTION C: PRACTICE OF EXCLSUIVE BREASTFEEDING

13. Have you practiced exclusive breastfeeding before?

Yes { } No { }

14. When should exclusive breastfeeding commence

Immediately after birth ( ) A day or days after birth ( )

After the yellow aspect of the breast milk has being expressed out. ( )

15. How often were you breastfeeding the baby in a day?

Demand feeding ( ) when baby is awake ( ) 4- 5 five times daily ( )

16. Does your work allow you to practice exclusive breastfeeding when you are at work?

Yes ( ) No ( )

SECTION D: PROBLEMS OF EXCLUSIVE BREASTFEEDING.

17. Do cultural and religious belief affect exclusive breastfeeding or not?

Yes { } No { }

18. What challenges do you face when practicing exclusive breastfeeding?

Insufficient breast milk ( ) Child refusal ( ) Work related problems ( )

Others (specify)……………………….

19. Does your family and husband support you on exclusive breastfeeding?

Yes ( ) No ( ) Unconcern ( ).

45
20. What do you think can be done to promote exclusive breastfeeding?

......................................................................................................................................

46