scholarly journals Investigating the disjoint between education and health policy for infant feeding among teenage mothers in South Africa: a case for intersectoral work

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jo Hunter-Adams ◽  
Anna Strebel ◽  
Joanne Corrigall ◽  
Virginia Zweigenthal

Abstract Background Many low-and-middle-income countries, including South Africa, have high rates of teenage pregnancy. Following the World Health Organisation recommendations, South African health policy on infant feeding promotes exclusive breastfeeding until six months of age, with gradual weaning. At the same time, South Africa’s education department, in the interest of learners, promotes adolescents’ early return to school post-partum. Yet infant feeding at school is currently not perceived as a realistic option. Methods Recognising his this policy tension, we aimed to explore how policies are interpreted and implemented by the health and education sectors through interviews with key informants who produce, interpret and implement these policies. Using an interview guide developed for this study, we conducted in-depth interviews with 24 health policy makers, managers in both sectors, school principals and nursing staff who manage adolescent mothers (aged 16-19) and their babies. Data was analysed using thematic analysis. Results Informants from both sectors expressed discomfort at pregnant learners remaining in school late in pregnancy and were uncertain about policy regarding when to return to school and how long to breast-feed. Educators reported that new mothers typically returned to school within a fortnight after delivery and that breastfeeding was not common. While health professionals highlighted the benefits of extended breastfeeding for infants and mothers, they recognised the potential conflict between the need for the mother to return to school and the recommendation for longer breastfeeding. Additionally, the need for ongoing support of young mothers and their families was highlighted. Conclusions Our findings suggest educators should actively encourage school attendance in a healthy pregnant adolescent until delivery with later return to school, and health providers should focus attention on breastfeeding for the initial 4-6 weeks postpartum, followed by guided support of formula-feeding. We encourage the active engagement of adolescents’ mothers and extended families who are often involved in infant feeding and care decisions. Education and health departments must engage to facilitate the interests of both the mother and infant: some exclusive infant feeding together with a supported return to school for the adolescent mother.

2020 ◽  
Author(s):  
Virginia Zweigenthal ◽  
Anna Strebel ◽  
Joanne Corrigall ◽  
Jo Hunter-Adams

Abstract BackgroundMany low-and-middle-income countries, including South Africa (SA), have high rates of teenage pregnancy. Following the World Health Organisation recommendations, SA health policy on infant feeding promotes exclusive breast-feeding until six months of age, with gradual weaning. At the same time, SA’s education department, in the interest of learners, promotes teenagers’ return to school post-partum. Yet infant feeding at school is currently not perceived as a realistic option. MethodsThis article explores practice among policy makers and implementers in the education and health sectors in Cape Town, SA. We interviewed health and education officials, managers and policy makers, as well as school principals and nursing staff, who manage adolescent mothers and their babies. ResultsParticipants expressed discomfort at pregnant learners remaining in school late in pregnancy. There was uncertainty about policy regarding when to return to school and how long to breast-feed. Educators reported that new mothers typically returned to school within a fortnight after delivery and that breast-feeding was not common. While health professionals highlighted the benefits of extended breast-feeding for infants and mothers, there was recognition of the potential conflict between the need for the mother to return to school and the recommendation for longer breast-feeding. Additionally, the need for ongoing support of young mothers and their families was highlighted. ConclusionsOur findings suggest educators should actively encourage school attendance in a healthy pregnant adolescent until delivery with later return to school, and health providers should focus attention on breast-feeding for the initial 4-6 weeks postpartum, followed by guided support of formula-feeding. We encourage the active engagement of adolescents’ mothers and extended families who are often involved in infant feeding and care decisions. Education and health departments must engage in intersectoral work to focus on systems that facilitate the interests of both the mother and infant – some exclusive infant feeding together with a supported return to school for the teen mother.


Curationis ◽  
2000 ◽  
Vol 23 (3) ◽  
Author(s):  
VJ Ehlers ◽  
T Maja ◽  
E Sellers ◽  
M Gololo

A financial grant was received from the World Health Organization (WHO) during 1998 to establish whether adolescent mothers (aged 19 or younger at the birth of their babies) utilized contraceptive, emergency contraceptive and termination of pregnancy (TOP) services in the Republic of South Africa (RSA). This report refers to data obtained from 111 questionnaires completed by dolescent mothers between January 2000 and May 2000 in the Gauteng Province; 61 in the Pretoria and 50 in the Garankuwa areas, and excluding the 12 completed questionnaires used foi pretesting the research instrument. The biographic data of the 111 adolescent mothers indicated that the minority were married, employed or earned sufficient income to care for themselves and their babies. However, the minority used contraceptives prior to conception, none used emergency contraceptives or termination of pregnancy (TOP) services. The minority attended ante-natal clinics five or more times during their pregnancies, and a negligible number indicated that they had ever been treated for sexually transmitted diseases (STDs). These findings indicate that the 111 adolescent mothers in Gauteng who participated in this survey did not make optimum use of the available reproductive health (RH) care services. Education about sex, pregnancy and contraceptives should commence at the age of 10, but no later than the age of 12 as the majority of respondents did not have the necessary knowledge to make informed decisions about their futures. The accessibility of contraceptive, emergency contraceptive and TOP services for adolescents should be investigated in specific areas and attempts made to enhance such accessi- bility. This might necessitate offering these services over weeker| ds or during evenings when school girls could attend without fear of meeting their mothers, aunts or teachers at these clinics.


2021 ◽  
pp. 1-14
Author(s):  
Allison K. Groves ◽  
Luwam T. Gebrekristos ◽  
Luz McNaughton Reyes ◽  
Dhayendre Moodley ◽  
Valerie Raziano ◽  
...  

PEDIATRICS ◽  
1987 ◽  
Vol 79 (5) ◽  
pp. 689-695
Author(s):  
Alain Joffe ◽  
Susan M. Radius

Since the 1970s, breast-feeding as the preferred method of infant feeding has increased in overall popularity. However, certain populations, particularly poor, young, black, and less-educated women, have been slow to adopt this method. This prospective study was undertaken to identify factors relating to the choice of infant-feeding method among inner-city adolescents. Two hundred fifty-four pregnant adolescents completed a questionnaire supplying information regarding attitudes toward and knowledge about breast-feeding, social support, personal experience, and other variables hypothesized to correlate with their choice of infant-feeding method. Of the total sample, 17% said they were "probably" or "definitely" going to breast-feed their babies. Analyses revealed adolescents most likely to intend to breast-feed were those who perceived more benefits to breast-feeding, who desired more knowledge about it, who were themselves breast-fed, who reported supportive social environments, and who perceived relatively fewer barriers to breast-feeding their infants. Specific interventions based upon these findings are proposed. We conclude that adolescent mothers are interested in breast-feeding their babies and that interventions are feasible to increase breast-feeding within this population.


PEDIATRICS ◽  
1984 ◽  
Vol 74 (4) ◽  
pp. 603-614 ◽  
Author(s):  
Artemis P. Simopoulos ◽  
Gilman D. Grave

Breast-feeding makes a unique, fundamental contribution to the health and nutrition of infants. The World Health Organization International Code of Marketing of Breastmilk Substitutes is designed to encourage, promote, and protect breast-feeding in all WHO member states. The Code acknowledges that a number of social and economic factors affect the decisions of women to breast-feed and that breast-feeding has declined. Member states have been urged, therefore, to develop appropriate social support systems to overcome and adjust for factors associated with breastmilk substitutes. Although the Code does not so state, these factors are not fully understood. The reasons for unsuccessful breast-feeding and early termination are important concerns. So far only vague and rudimentary answers have been identified, eg, "the milk dried up"49 or "lack of satisfaction."7 The decision-making process involved in early weaning has yet to be carefully analyzed. Certainly, biologic variables are involved, such as maternal nutritional status, maternal nutrient intake, and volume and quality of milk produced. These factors have not been well studied, and they are presumably influenced by psychological, social, cultural, and economic factors. Vahlquist,55 writing in the introduction to the WHO Collaborative Study on Breast-Feeding, noted, "Whereas, up to the 1960's it had been widely held that the decline in breast-feeding was a `fact of modern life,' this premise began to be increasingly questioned, and it was wondered whether the trend was really irreversible." The stakes in reversing the trend are great, as breast-feeding is the safest, most economical way to promote infant health and sound nutrition. Since then, the literature on the determinants of infant-feeding choice has grown rapidly.


2004 ◽  
Vol 3 (1/2) ◽  
pp. 131-152
Author(s):  
Di McIntyre ◽  
Stephen Thomas ◽  
Susan Cleary
Keyword(s):  

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 133
Author(s):  
Perpetua Modjadji ◽  
Mpinane Pitso

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saiendhra Vasudevan Moodley ◽  
Muzimkhulu Zungu ◽  
Molebogeng Malotle ◽  
Kuku Voyi ◽  
Nico Claassen ◽  
...  

Abstract Background Health workers are crucial to the successful implementation of infection prevention and control strategies to limit the transmission of SARS-CoV-2 at healthcare facilities. The aim of our study was to determine SARS-CoV-2 infection prevention and control knowledge and attitudes of frontline health workers in four provinces of South Africa as well as explore some elements of health worker and health facility infection prevention and control practices. Methods A cross-sectional study design was utilised. The study population comprised both clinical and non-clinical staff working in casualty departments, outpatient departments, and entrance points of health facilities. A structured self-administered questionnaire was developed using the World Health Organization guidance as the basis for the knowledge questions. COVID-19 protocols were observed during data collection. Results A total of 286 health workers from 47 health facilities at different levels of care participated in the survey. The mean score on the 10 knowledge items was 6.3 (SD = 1.6). Approximately two-thirds of participants (67.4%) answered six or more questions correctly while less than a quarter of all participants (24.1%) managed to score eight or more. A knowledge score of 8 or more was significantly associated with occupational category (being either a medical doctor or nurse), age (< 40 years) and level of hospital (tertiary level). Only half of participants (50.7%) felt adequately prepared to deal with patients with COVD-19 at the time of the survey. The health workers displaying attitudes that would put themselves or others at risk were in the minority. Only 55.6% of participants had received infection prevention and control training. Some participants indicated they did not have access to medical masks (11.8%) and gloves (9.9%) in their departments. Conclusions The attitudes of participants reflected a willingness to engage in appropriate SARS-CoV-2 infection prevention and control practices as well as a commitment to be involved in COVID-19 patient care. Ensuring adequate infection prevention and control training for all staff and universal access to appropriate PPE were identified as key areas that needed to be addressed. Interim and final reports which identified key shortcomings that needed to be addressed were provided to the relevant provincial departments of health.


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