title: Length of time in Ghana is associated with the likelihood of exclusive breastfeeding among Liberian refugees living in Buduburam.
abstract: While literature describing immigrant's breastfeeding practices exists, especially among those living within developed countries, there is a significant gap in knowledge on how the host culture may influence the EBF behaviors of refugees, especially those living in protracted situations within sub-Saharan Africa. A cross-sectional study was conducted in the Buduburam Refugee Settlement in Ghana from July-August 2008 to explore the association between the amount of time living in Ghana and exclusive breastfeeding practices among Liberian refugees and Ghanaians in surround villages. The study included 480 women: 239 Liberians living in 12 settlement zones (in two of which Liberians and Ghanaians co-exist), 121 Ghanaians living in two settlement zones, and 120 Ghanaians living in nearby urban village of Awutu. Liberian mothers who lived in Ghana at least eight years were significantly more likely to exclusively breastfeed (OR: 1.78, 95% CI: 1.02, 3.09) compared to Ghanaian mothers living in Awutu. These findings suggest that increased time living in Buduburam improved the chances of EBF success among Liberians, perhaps as a result of unique EBF education/support opportunities offered in the settlement to Liberian refugees that were not readily available to Ghanaians. Further research to understand the "mechanisms" explaining exclusive breastfeeding differences as a function of time spent in host country is needed for improving breastfeeding support in refugee settlements and host communities.
authors.affiliation: Division of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Meley
authors.initials: M
authors.lastname: Woldeghebriel
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Amber
authors.initials: A
authors.lastname: Hromi-Fiedler
authors.affiliation: Department of Nutrition and Food Science, University of Ghana, Accra, Ghana.
authors.forename: Anna
authors.initials: A
authors.lastname: Lartey
authors.affiliation: Boston University School of Public Health, Boston, Massachusetts, USA.|Buduburam Nutrition Program, National Catholic Secretariat, Accra, Ghana.
authors.forename: Daniel
authors.initials: D
authors.lastname: Gallego-Perez
authors.affiliation: Buduburam Nutrition Program, National Catholic Secretariat, Accra, Ghana.
authors.forename: Adam
authors.initials: A
authors.lastname: Sandow
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Pérez-Escamilla
mesh_terms: D015992:Body Mass Index; D001942:Breast Feeding / Q000523:psychology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003469:Culture; D004522:Educational Status; D054242:Emigrants and Immigrants / Q000523:psychology*; D005260:Female; D005869:Ghana; D006266:Health Education; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007988:Liberia; D009035:Mothers / Q000523:psychology; D012036:Refugees / Q000523:psychology*
keywords: breastfeeding; breastfeeding duration; maternal public health; public health; refugees