scholarly journals Breastfeeding and employed mothers in Ethiopia: legal protection, arrangement, and support

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ermiyas Mulu Kebede ◽  
Benyam Seifu
Keyword(s):  
Return To Work ◽  
Low Income ◽  
Informal Economy ◽  
Maternal Employment ◽  
Maternity Leave ◽  
Legal Protection ◽  
International Standards ◽  
Breastfeeding Duration ◽  
Low Income Countries ◽  
Employed Mothers

Abstract Background Breastfeeding is the single, most cost-effective intervention to reduce worldwide child mortality. Women empowerment interventions have positive impacts on child and maternal nutritional, and health status. Women’s employment and economic participation in Ethiopia have shown progress over the past three decades. However, consistent evidence indicated that maternal employment is often negatively associated with optimal breastfeeding in Ethiopia. The existence and enforcement of breastfeeding law, arrangement, and support in the workplace have vital roles in protecting employed mothers’ ability and right to breastfeed upon return to work from maternity leave. This commentary compared the breastfeeding laws, policies, and arrangements in Ethiopia with international standards, recommendations, and evidence-based practices. Workplace breastfeeding policies in Ethiopia Public legislations of Ethiopia poorly protect the breastfeeding right of most new mothers. Ethiopian revised Labor Proclamation (No.1156/2019) incorporates most of the International Labour Organization maternity protection recommendations. However, it poorly safeguards breastfeeding rights and abilities of employed women. The provided maternity leave period is also shorter than the recommended exclusive breastfeeding duration. The revised Federal Civil Servant Proclamation of Ethiopia (NO.1064/2017) mandates the establishment of a nursery in government institutions where female civil servants could breastfeed and take care of their babies in a private room. Though, it protects only a small proportion of working mothers in Ethiopia, as majority women employed in the agriculture and informal economy sectors. So far, there are no notable workplace breastfeeding arrangements and support for employed mothers by employers and other initiatives. The ILO recommendation and experience of other middle income and low-income countries can be legal and practical grounds for establishment of breastfeeding-friendly workplace in Ethiopia. Conclusions The lack of workplace breastfeeding laws, arrangements, and supports in Ethiopia limits mothers’ right to practice optimal breastfeeding. Policymakers, the government, and all concerned bodies should give due attention to enacting and enforcing sound laws and arrangements that will enable employed mothers to practice optimal breastfeeding upon return to work.

scholarly journals Midwives’ challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo—an interview study

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Malin Bogren ◽  
Malin Grahn ◽  
Berthollet Bwira Kaboru ◽  
Marie Berg
Keyword(s):  
Work Environment ◽  
Low Income ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Quality Of Healthcare ◽  
International Standards ◽  
Low Income Countries ◽  
Professional Status ◽  
Republic Of Congo ◽  
Main Category

Abstract Background The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of the mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service is therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods Data were collected in two out of 26 provinces in the DRC through ten focus group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis. Results The midwives’ challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category—Loving one’s work makes it worthwhile to remain in one’s workplace, despite a difficult work environment and low professional status—consisting of three generic categories: Midwifery is not just a profession; it’s a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions. Conclusion Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including (i) conducting midwifery education programmes following international standards, (ii) prioritising and enforcing policies to include adequate remuneration for midwives, (iii) involving midwives’ associations in policy and planning about the midwifery workforce, and (iv) ensuring that midwives’ working environments are safe and well equipped.

Effectiveness of Workplace Lactation Interventions on Breastfeeding Outcomes in the United States: An Updated Systematic Review

2018 ◽  
Vol 35 (1) ◽  
pp. 100-113 ◽  
Author(s):  
Julia H. Kim ◽  
Jong C. Shin ◽  
Sharon M. Donovan
Keyword(s):  
United States ◽  
Low Income ◽  
Exclusive Breastfeeding ◽  
Maternity Leave ◽  
The United States ◽  
Breastfeeding Duration ◽  
Breastfeeding Initiation ◽  
White Ethnicity ◽  
Observational Study Design ◽  
The Impact

Background Returning to work is one of the main barriers to breastfeeding duration among working mothers in the United States. However, the impact of workplace lactation programs is unclear. Research Aim The aim of this study was to evaluate the effectiveness of workplace lactation programs in the United States on breastfeeding practices. Methods A systematic search was conducted of seven databases through September 2017. Articles ( N = 10) meeting the inclusion criteria of describing a workplace lactation intervention and evaluation in the United States and measuring initiation, exclusivity, or duration using an experimental or observational study design were critically evaluated. Two reviewers conducted quality assessments and reviewed the full-text articles during the analysis. Results Common services provided were breast pumps, social support, lactation rooms, and breastfeeding classes. Breastfeeding initiation was very high, ranging from 87% to 98%. Several factors were significantly associated with duration of exclusive breastfeeding: (a) receiving a breast pump for one year (8.3 versus 4.7 months), (b) return-to-work consultations (40% versus 17% at 6 months), and (c) telephone support (42% versus 15% at 6 months). Each additional service (except prenatal education) dose-dependently increased exclusively breastfeeding at 6 months. Sociodemographic information including older maternal age, working part-time, longer maternity leave, and white ethnicity were associated with longer breastfeeding duration. Conclusion Workplace lactation interventions increased breastfeeding initiation, duration, and exclusive breastfeeding, with greater changes observed with more available services. More evidence is needed on the impact of workplace support in low-income populations, and the cost-effectiveness of these programs in reducing health care costs.

Microinsurance and Rural Health

2019 ◽  
Author(s):  
Syed Abdul Hamid
Keyword(s):  
South Asia ◽  
Low Income ◽  
Informal Economy ◽  
Financial Risk ◽  
Access To Healthcare ◽  
Low Income Countries ◽  
Financial Protection ◽  
Health Shocks ◽  
Financial Risk Protection ◽  
Risk Protection

Health microinsurance (HMI) has been used around the globe since the early 1990s for financial risk protection against health shocks in poverty-stricken rural populations in low-income countries. However, there is much debate in the literature on its impact on financial risk protection. There is also no clear answer to the critical policy question about whether HMI is a viable route to provide healthcare to the people of the informal economy, especially in the rural areas. Findings show that HMI schemes are concentrated widely in the low-income countries, especially in South Asia (about 43%) and East Africa (about 25.4%). India accounts for 30% of HMI schemes. Bangladesh and Kenya also possess a good number of schemes. There is some evidence that HMI increases access to healthcare or utilization of healthcare. One set of the literature shows that HMI provides financial protection against the costs of illness to its enrollees by reducing out-of-pocket payments and/or catastrophic spending. On the contrary, a large body of literature with strong methodological rigor shows that HMI fails to provide financial protection against health shocks to its clients. Some of the studies in the latter group rather find that HMI contributes to the decline of financial risk protection. These findings seem to be logical as there is a high copayment and a lack of continuum of care in most cases. The findings also show that scale and dependence on subsidy are the major concerns. Low enrollment and low renewal are common concerns of the voluntary HMI schemes in South Asian countries. In addition, the declining trend of donor subsidies makes the HMI schemes supported by external donors more vulnerable. These challenges and constraints restrict the scale and profitability of HMI initiatives, especially those that are voluntary. Consequently, the existing organizations may cease HMI activities. Overall, although HMI can increase access to healthcare, it fails to provide financial risk protection against health shocks. The existing HMI practices in South Asia, especially in the HMIs owned by nongovernmental organizations and microfinance institutions, are not a viable route to provide healthcare to the rural population of the informal economy. However, HMI schemes may play some supportive role in implementation of a nationalized scheme, if there is one. There is also concern about the institutional viability of the HMI organizations (e.g., ownership and management efficiency). Future research may address this issue.

scholarly journals Solidarity and social behaviour: how did this help communities to manage COVID-19 pandemic?

2020 ◽  
Vol 40 (9/10) ◽  
pp. 1183-1200
Author(s):  
Paul Agu Igwe ◽  
Chinedu Ochinanwata ◽  
Nonso Ochinanwata ◽  
Jonathan Olufemi Adeyeye ◽  
Isaac Monday Ikpor ◽  
...  
Keyword(s):  
Low Income ◽  
Informal Economy ◽  
Sampling Procedure ◽  
Social Solidarity ◽  
Low Income Countries ◽  
Job Seekers ◽  
Content Type ◽  
Resource Pooling ◽  
Work From Home ◽  
Poor Households

PurposeDuring the coronavirus (COVID-19) pandemic lockdowns, stay at home or work from home, many have argued that the westernised non-pharmaceutical interventions (NPI) do not provide remedial in low-income countries like Nigeria, where informal job seekers, street traders, informal labourers and artisans depend mainly on the informal economy. By applying social solidarity (SS) and community-based approach (CBA), the authors evaluate individual acts (trust, altruism and reciprocity) during the lockdown and how these practices evolve from individual approaches to collective actions.Design/methodology/approachThis study reflects on pragmatism research paradigm that enables researchers to maintain both subjectivity in their reflections and objectivity in data collection and analysis. The authors adopt a qualitative method through purposeful and convenience sampling procedure. Data were analysed thematically to identify elements of SS, individual acts, collective or community actions and perceptions.FindingsThe findings reveal that COVID-19 had a disproportionate impact (lack of food and a fall in daily income) on workers, informal job seekers, informal businesses operators and the poor households. As such, the study developed a reflective model of solidarity exhibited by individual acts and collective acts (practices of resource pooling, information sharing, women empowerment, distribution of palliatives and donations) within trusted circles that helped people cope with the lockdown experiences.Practical implicationsSolidarity represents beliefs, practices of values and norms. The SS exhibited by people through NPI would have implications on planning and monitoring the effectiveness of public health programmes during a pandemic in the future.Social implicationsThe findings of citizens and community actions have implications related to the process of building communities – coming together – and solidarity that enhances social development with implications on community health policy agenda during disasters, emergencies and health pandemic.Originality/valueThis is one of the first studies to analyse the relationship between trust, altruism, reciprocity, SS and CBA during the COVID-19 pandemic. Also, it seems reasonable to clarify the concept of SS given the lack of clarity about the definitions from previous studies.

scholarly journals Midwives’ challenges and factors that motivate them to remain in their workplace in the Democratic Republic of Congo – An interview study

2020 ◽  
Author(s):  
Malin Bogren ◽  
Malin Grahn ◽  
Berthollet Bwira Kaboru ◽  
Marie Berg
Keyword(s):  
Work Environment ◽  
Low Income ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Quality Of Healthcare ◽  
International Standards ◽  
Low Income Countries ◽  
Professional Status ◽  
Republic Of Congo ◽  
Main Category

Abstract Background: The Democratic Republic of Congo (DRC) has high maternal mortality and a low number of midwives, which undermines the achievement of Goal 3 of the Sustainable Development Goals (SDGs) for 2030, specifically the health of mother and newborn. Scaling up the midwifery workforce in relation to number, quality of healthcare, and retention in service, are therefore critical. The aim of this study was to investigate midwives’ challenges and factors that motivate them to remain in their workplace in the DRC. Methods: Data were collected in two out of 26 provinces in the DRC through ten focus-group discussions with a total of 63 midwives working at ten different healthcare facilities. Transcribed discussions were inductively analysed using content analysis.Results: The midwives’ challenges and the factors motivating them to remain in their workplace in the DRC are summarised in one main category – Loving one’s work makes it worthwhile to remain in one’s workplace, despite a difficult work environment and low professional status – consisting of three generic categories: Midwifery is not just a profession; it’s a calling is described in the subcategories Saving lives through midwifery skills, Building relationships with the women and the community, and Professional pride; Unsupportive organisational system is expressed in the subcategories Insufficient work-related security and No equitable remuneration system, within Hierarchical management structures; and Inadequate pre-conditions in the work environment includes the subcategories Lack of resources and equipment and Insufficient competence for difficult working conditions. Conclusion: Midwives in the DRC are driven by a strong professional conscience to provide the best possible care for women during childbirth, despite a difficult work environment and low professional status. To attract and retain midwives and ensure that they are working to their full scope of practice, we suggest coordinated actions at the regional and national levels in the DRC and in other low-income countries with similar challenges, including: i) conducting midwifery education programmes following international standards; ii) prioritising and enforcing policies to include adequate remuneration for midwives; iii) involving midwives’ associations in policy and planning about the midwifery workforce; and iv) ensuring that midwives’ working environments are safe and well equipped.

scholarly journals Experiences of workplace breastfeeding in a provincial government setting: a qualitative exploratory study among managers and mothers in South Africa

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Bongekile P. Mabaso ◽  
Ameeta Jaga ◽  
Tanya Doherty
Keyword(s):  
South Africa ◽  
Return To Work ◽  
Maternity Leave ◽  
National Level ◽  
Provincial Government ◽  
Snowball Sampling ◽  
Breastfeeding Support ◽  
Senior Managers ◽  
Major Barrier ◽  
Employed Mothers

Abstract Background Return to employment is a major barrier to breastfeeding continuation, globally and in the Southern African context. The Lancet Breastfeeding Series revealed an explicit need for research exploring breastfeeding as a workplace issue in low- and middle-income countries. A dearth of research on workplace breastfeeding in South Africa calls for attention to this topic. This study sought to explore breastfeeding at work experiences from the perspective of employed mothers and senior managers in a provincial government setting in South Africa. Methods The study adopted an exploratory qualitative design with multi-perspective semi-structured interviews. Snowball sampling was employed to recruit twelve participants, senior managers (n = 4) and employed mothers (n = 8), from two provincial government departments in Cape Town, South Africa. Interviews were conducted between April and August 2018 to capture participants’ experiences with breastfeeding in the workplace. Thematic analysis was used to analyse data. Results Four key themes that described experiences of workplace breastfeeding emerged which further traversed three critical maternity periods: pregnancy, maternity leave, and return to work. The prevalent themes were: 1) Knowledge about the legislation and breastfeeding support benefits. Most participants only knew about the legislated four months maternity leave and time off for prenatal visits but lacked knowledge about comprehensive maternity benefits; 2) Perceptions and experiences of breastfeeding in the workplace. Breastfeeding was perceived to be a mother’s responsibility and a private issue. As a result, most participants stopped breastfeeding prior to or immediately upon return to work after maternity leave; 3) Barriers to breastfeeding continuation, such as the absence of a conversation about infant feeding plans between managers and mothers; and 4) Recommendations to improve breastfeeding support at work from an individual, organisational and national level. Conclusions Our study contributions emphasise that breastfeeding support from managers should begin prior to the mother taking maternity leave, and that in addition to providing supportive facilities (such as private space and breastmilk storage), immediate supervisor support may be critical in fostering breastfeeding-friendly workplaces for mothers. Management implications for advancing workplace breastfeeding support in the public sector are presented.

Genesis of Development Macroeconomics and National Accounts in Developing Countries

2020 ◽  
pp. 127-138
Author(s):  
Giovanni Andrea Cornia
Keyword(s):  
Developing Countries ◽  
Low Income ◽  
Economic Performance ◽  
Informal Economy ◽  
Public Policies ◽  
Low Income Countries ◽  
Fiscal Policies ◽  
Demand Side ◽  
National Accounts ◽  
The Impact

The chapter discusses the reasons whycKeynesian policies and development macroeconomics in low-income countries received any attention relatively late, as well as the factors that led to a gradual acceptance of demand-side measures. It also discusses the data, conceptual, and accounting problems encountered when measuring economic performance in low-income countries, including the importance of self-consumption, barter, unilateral transactions, and unrecorded monetary transactions in the informal economy. All this reduces the impact of monetary and fiscal policies and underline the importance of structural policies. The chapter also discusses the accounting conventions and practices used to overcome such problems, and the impact all this has on the estimates of the main macroeconomic aggregates and the evaluation of the impact of public policies.

Does tourism activity reduce the size of the informal economy? Capturing long-term heterogeneous linkages around the world

2021 ◽  
pp. 135481662110498
Author(s):  
Aldo Salinas ◽  
Cristian Ortiz ◽  
Pablo Ponce ◽  
Javier Changoluisa
Keyword(s):  
Low Income ◽  
Informal Economy ◽  
Least Square ◽  
Low Income Countries ◽  
Global Level ◽  
Causality Test ◽  
Country Group ◽  
Long Run ◽  
Tourism Activity

This paper investigates the long-term and causal relationship between tourism activity and the informal economy in 76 countries from 1995 to 2015. We explore this relationship at the global level and by country group, using panel, co-integration techniques that indicate the existence of a long-run co-integration relationship between tourism and informal economy for the whole sample and at the level of country groups. Additionally, the paper analyzes the long-run coefficients of the model by using fully modified ordinary least square regressions (FMOLS). The results from FMOLS evidence a negative and significant impact of tourism on the informal economy at the global level and in high, upper-middle, and lower-middle income countries, but a positive link in low-income countries. However, the results reveal a heterogeneous long-run relationship within country groups. Also, the result of the Dumitrescu-Hurlin Granger causality test indicates bidirectional causality in the global sample, but the direction of causality varies by country group. The main policy implication derived from our findings suggests that in order to reduce the size of informal economy, policy-makers should foster tourism activities. JEL Classification : J01, L83, C23, O57, C00, C01

scholarly journals Influences of Exclusive Breastfeeding Among Low-wage, Working Mothers in Kenya: Perspectives from Managers, Healthcare Providers, Daycare Directors, Mothers, and Fathers (OR30-02-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Scott Ickes ◽  
Hannah Sanders ◽  
Hellen Lemein ◽  
Joyceline Kinyua ◽  
Benson Singa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Maternal Employment ◽  
Maternity Leave ◽  
Healthcare Providers ◽  
Community Outreach ◽  
Care Providers ◽  
Funding Sources ◽  
Employed Mothers ◽  
Immunization Services

Abstract Objectives Kenya has legislation and policies on maternity leave and workplace support for breastfeeding (BF), and breastmilk expression. The extent to which this framework influences the BF practices of low-wage mothers is unknown. The purpose of this study was to understand the influences of EBF for 6 mo among mothers employed in the commercial agriculture and tourism industries. Methods We conducted in-depth interviews with employed mothers (n = 25), husbands of employed mothers (n = 10), managers of commercial flower farms and hotels (n = 8), daycare directors (n = 22), and health care providers (n = 20) in Naivasha, Kenya. Results Despite a widespread recognition of the recommended 6 months duration for EBF, employed mothers describe early cessation of EBF in preparation for their return to work, following a mandated 3-mo maternity leave. Husbands of employed women support EBF and would like to see the duration of EBF extended, but note similar challenges. Managers support lactating mothers through flexible work schedules and duties, yet few farms or hotels have designated lactation areas, and most recognize that mothers prefer to arrive later or leave early rather than visit children to feed during the workday. Daycare directors describe lack of refrigeration for expressed milk, and low interest from mothers in leaving expressed milk to feed their children during the workday. Employers with on-site housing and/or daycare report a more favorable environment to support EBF. Health care providers perceive low-wage, maternal employment as a challenge to 6 months of EBF, yet see childcare and a strengthened continuum of education from antenatal care to immunization services and community outreach as opportunities to improve EBF promotion. Conclusions Beliefs about optimal BF practices do not align with practice. Mothers employed in low-wage work receive some benefits from their employers to support child care responsibilities, but distance from daycare, a low efficacy for expressing and storing milk, and lack of support for milk expression currently make EBF unattainable for most mothers in these industries. Interventions to improve the desirability and feasibility of milk expression are needed to strengthen the opportunity for EBF for employed mothers. Funding Sources Fogarty International Center, National Institutes of Health.

scholarly journals Exclusive Breastfeeding Practice and Maternal Employment among Mothers of Infants: A Comparative Cross-Sectional Study

2021 ◽  
Vol 9 (01) ◽  
pp. 56-60
Author(s):  
Rubina Shrestha ◽  
Pradip Chhetri ◽  
Jyoti Priyanka ◽  
Chet Kant Bhusal
Keyword(s):  
Exclusive Breastfeeding ◽  
Maternal Employment ◽  
Family Income ◽  
Maternity Leave ◽  
Influencing Factor ◽  
Cross Sectional Study ◽  
Work Place ◽  
Sectional Study ◽  
Cross Sectional ◽  
Employed Mothers

INTRODUCTION Exclusive breastfeeding (EBF) practices during first six months of life are the most cost-effective intervention for reducing infant and child morbidity and mortality. However, adherence to EBF practices in developing countries remains unsatisfactory, where maternal employment has been identified as one of the influencing factor. The study aims to identify and compare EBF practices and its factors influencing among employed and unemployed mothers. MATERIALAND METHODS An institutional based comparative cross-sectional study was conducted among 362 mothers of infants visiting the immunization clinic of Universal College of Medical Sciences, Bhairahawa, Nepal, from December 2020 to March 2021 following ethical clearance (UCMS/IRC/114/20) and verbal consent from participants. Descriptive statistics was used to compare EBF practices and multivariate logistic regression to identify independent predictors of EBF. RESULTS Total 362 (181 employed and 181 unemployed) mothers were interviewed. Prevalence of EBF was 13.8% and 81.2% among employed and unemployed mothers respectively. Further EBF practice had significant association with working status of mothers (AOR= 15.44, 95% CI 6.76-35.25) and monthly family income (AOR=3.31, 95% CI 1.24-8.84). Among employed, EBF practice had significant association with carry infant to work place (AOR= 12.36, 95% CI 4.35-49.87) whereas type of delivery (AOR= 3.88, 95% CI 1.69-8.90) was significantly associated among unemployed mothers. CONCLUSION EBF practices among employed mothers were less than that of unemployed mothers. Provisions to provide additional supports, either by revising the period of maternity leave or adopting different alternatives to prolong the period of EBF may be beneficial for employed mothers and their children.

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