Kimani_Murage_et_al-2014-Maternal_&_Child_Nutrition.pdf (341.45 kB)
Factors affecting actualization of the WHO breastfeeding recommendations in urban poor settings in Kenya
journal contribution
posted on 2015-06-15, 15:22 authored by Elizabeth W. Kimani-Murage, Frederick Wekesah, Milka Wanjohi, Catherine Kyobutungi, Alex C. Ezeh, Rachel N. Musoke, Shane A. Norris, Nyovani J. Madise, Paula GriffithsPaula GriffithsPoor breastfeeding practices are widely documented in Kenya, where only a third of children are exclusively
breastfed for 6 months and only 2% in urban poor settings.This study aimed to better understand the factors that
contribute to poor breastfeeding practices in two urban slums in Nairobi, Kenya. In-depth interviews (IDIs),
focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with women of childbear-
ing age, community health workers, village elders and community leaders and other knowledgeable people in the
community. A total of 19 IDIs, 10 FGDs and 11 KIIs were conducted, and were recorded and transcribed
verbatim. Data were coded in NVIVO and analysed thematically. We found that there was general awareness
regarding optimal breastfeeding practices, but the knowledge was not translated into practice, leading to
suboptimal breastfeeding practices. A number of social and structural barriers to optimal breastfeeding were
identified: (1) poverty, livelihood and living arrangements; (2) early and single motherhood; (3) poor social and
professional support; (4) poor knowledge, myths and misconceptions; (5) HIV; and (6) unintended pregnancies.
The most salient of the factors emerged as livelihoods, whereby women have to resume work shortly after
delivery and work for long hours, leaving them unable to breastfeed optimally. Women in urban poor settings
face an extremely complex situation with regard to breastfeeding due to multiple challenges and risk behaviours
often dictated to them by their circumstances. Macro-level policies and interventions that consider the ecological
setting are needed.
Funding
This study was funded by the Wellcome Trust (Grant No. 097146/Z/11/Z). This research was also made possible through the generous core funding for APHRC by the William and Flora Hewlett Foundation (Grant No. 2009-40510) and the Swedish International Cooperation Agency (SIDA) (Grant No. 2011- 001578). PG is supported by a British Academy Mid-Career Fellowship (Ref: MD120048).
History
School
- Sport, Exercise and Health Sciences
Published in
Maternal and Child NutritionCitation
KIMANI-MURAGE, E.W. ... et al, 2015. Factors affecting actualization of the WHO breastfeeding recommendations in urban poor settings in Kenya. Maternal and Child Nutrition, doi: 10.1111/mcn.12161Publisher
John Wiley & Sons Ltd. (© 2014 The Authors)Version
- VoR (Version of Record)
Publisher statement
This work is made available according to the conditions of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. Full details of this licence are available at: http://creativecommons.org/licenses/ by/4.0/Publication date
2015Notes
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.ISSN
1740-8695eISSN
1740-8709Publisher version
Language
- en