title: Determinants of exclusive breastfeeding: a study of two sub-districts in the Atwima Nwabiagya District of Ghana.
abstract: BACKGROUND
  Optimal breastfeeding rates have not been encouraging globally with sub-optimal feeding being customized in Sub-Saharan Africa. However, in the Atwima Nwabiagya district of Ghana, the message of Exclusive Breastfeeding (EBF) has caught up well with many nursing mothers. we examined the determinants of EBF vis-à-vis performance of a community based growth promotion strategy in the Atwima Nwabiagya district of the Ashanti region of Ghana.
  
  
  METHODS
  The study employed a cross-sectional comparative study design to analyze the impact of a community based growth promotion strategy on exclusive breast feeding in Abuakwa and Barekese, both in the Atwima Nwabiagya district of Ghana. Simple random sampling was used to select three communities each from the two sub-districts. Data collection tool employed was a standard questionnaire consisting of closed-ended questions. The variables were EBF knowledge level of mothers, cultural practices affecting EBF practice, occupational hindrances and the level of community participation in EBF activities.
  
  
  RESULTS
  In all three hundred (300) nursing mothers of babies (0-12 months) were purposively interviewed. Results showed that mother's level of knowledge about EBF was good as such the practice was high. In addition, cultural practices in the area did not deter mothers from practicing exclusive breastfeeding. Two factors were associated with EBF in the univariate logistic model. Unmarried mothers were less likely to practice EB compared with mothers who were married (OR = 0.46, 95% 0.28, 0.77). Also the duration of breast feeding was associated wit EBF. The adjusted odds ratio was 0.41(95% CI: 0.32, 0.54) in favor of three months compared with six months.
  
  
  CONCLUSIONS
  The Community Based Growth Promotion strategy has had a positive impact on the practice of EBF in the district. It is recommended that the collapsed initiative be reawaken if the stakes are to be maintained. There is also the need to address mothers' occupational needs and effective breastfeeding practices as this emerged as a major set-back to the practice of EBF among the participants.
authors.affiliation: Faculty of Public Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Box 363, Sunyani, Ghana.
authors.forename: Alice
authors.initials: A
authors.lastname: Ayawine
authors.affiliation: Kintampo Health Research Centre, Ghana Health Service, Box 200, Kintampo, Ghana.
authors.forename: Kenneth Ayuurebobi
authors.initials: KA
authors.lastname: Ae-Ngibise
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Atwima Nwabiagya; Exclusive breastfeeding; mothers