Beliefs about Supporting Mothers to Exclusively Breastfeed for 6 Months: An Elicitation Study of Health Professionals Working in Maternal-Child Health Clinics in Nairobi, Kenya.
BACKGROUND
Exclusive breastfeeding rates remain low in Kenya and determinants influencing mothers' practice are documented. Little is known about factors underlying health professionals' intention to support mothers to continue exclusive breastfeeding. Effective behavior modification requires designing interventions at multiple levels of influence, informed by theory-based research to identify relevant determinants.


OBJECTIVE
To identify salient beliefs held by health professionals about support of mothers to exclusively breastfeed for 6 months and to explore definitions of the term support.


METHODS
This qualitative study was conducted in 6 public health facilities in Nairobi, Kenya. We used open-ended questions based on the reasoned action approach to elicit salient consequences, referents, and circumstances perceived by 15 health professionals about support for mothers to exclusively breastfeed for 6 months.


RESULTS
The most frequently mentioned consequences were healthier babies (87%) and reduced childhood ailments (67%). The main disadvantage was human immunodeficiency virus transmission through breast milk (33%). Colleagues (80%) and managers (67%) were perceived as approving referents, whereas some mothers/couples (40%) and the breast milk substitute industry (20%) were perceived as disapproving. Facilitating circumstances included lighter workload, better training, and more time. Definitions of support were varied and included giving information and demonstrating positioning and attachment techniques.


CONCLUSIONS
Overall, health professionals perceived positive consequences toward supporting exclusive breastfeeding continuation and identified a number of approving referents. However, they reported challenging circumstances in the work environment, which managers need to address to help health professionals provide the support needed by Kenyan mothers to continue exclusive breastfeeding.
Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA sakoen75@yahoo.com.
Susan A
SA
Nyawade
Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, USA.
Susan E
SE
Middlestadt
Department of Counseling and Educational Psychology and Department of Statistics, Indiana University, Bloomington, IN, USA.
Chao-Ying Joanne
CY
Peng
D001291:Attitude of Health Personnel; D001942:Breast Feeding / Q000523:psychology*; D002983:Clinical Competence; D003466:Cultural Characteristics; D005260:Female; D006801:Humans; D007630:Kenya; D008297:Male; D000068101:Maternal-Child Health Services; D009035:Mothers; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012944:Social Support
Kenya; beliefs about support; breastfeeding; exclusive breastfeeding; health professional support; reasoned action approach