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How to strengthen the sustainability of the ten steps to successful breastfeeding and the three items in mother baby friendly (MBFI) accredited facilities in Sekhukhune district, Limpopo Province

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  1. How to strengthen the sustainability of the ten steps to successful breastfeeding and the three items in mother baby friendly (MBFI) accredited facilities in Sekhukhune district, Limpopo Province (Action Research Foundation for Professional Development in affiliation with Yale school of Public Health) for completion of Advanced Health Management Program Presented by TebogoMorotoba Department of Health Limpopo Sekhukhune District

  2. Presentation outline • Aim of the Study • Background of MBFI in Sekhukhune • Why did the researcher do the action research • Findings • Recommendations • conclusion • Acknowledgements

  3. The aim of the study • To address the decline in breastfeeding practices at mother baby friendly accredited facilities in Sekhukhune District, Limpopo Province, South Africa

  4. Background of MBFI in Sekhukhune District

  5. Why Action Research? • MOUs that accredited mother baby friendly initiative (MBFI), six months after assessment when they are re-assessed internally step 3, 4, 5, 10 and item 2 and 3 are no longer 100% practised (according to 2013/14 internal assessment report).

  6. Findings of internal assessment • 2 out of 10 mothers had information about the benefits and management of breastfeeding(step 3) • Skin to skin were not frequently practised and if practised, mothers were not given reasons for the practise (step 4)

  7. Findings of internal assessment • 8 out of 10 Mothers were unable to demonstrate how to position and attach the baby to the breast, and also Milk expression technique (step 5) • The above necessitated Action Research to enable researchers to implement the study as part of their day-to-day work

  8. What did the action researcher do? • Seven failed facilities were selected randomly for action research and mothers/caregivers were conveniently sampled during their clinic visit • Gave feedback results and discuss with each individual facility( 1 week and two days). • Action plans were drawn with each facilities(1 week and two days). • The study was conducted through a period of one year and is still continuous as part of work

  9. Breastfeeding in-service training We changed from the way we used to conduct training in a standard classroom format . We visited facilities and conduct in-service trainings in the morning before they start their daily routine.

  10. Roadshows • Roads shows aimed at reaching out to other community members that include: fathers, grandmothers, traditional healers and faith based healers • It was also making pregnant women aware of what should they expect from health workers during child birth at hospitals and clinics

  11. Roadshows

  12. Stakeholder’s Involvement The district executive manager was leading in stakeholder involvement by briefing stakeholders about importance of breastfeeding to the community breastfeed. There was a lot of support from the municipalities, counsellors started to talk about the importance of breastfeeding during community meetings.

  13. Breastfeeding walks The roadshows included breastfeeding walks in communities. The senior managers and health went out to communities to sent breastfeeding messages

  14. Door to Door campaigns • Convenience sampling was used to visit mothers/caregivers of 0 – 59months at their homes. • Sixteen teams we deployed and reached 120 households • Data collection, education/counselling were done.

  15. Door to door campaigns The reason for the home visit was to explore why mothers mixed feed immediately after discharge and after three months Common reasons for mixed feeding were cultural beliefs and crying child

  16. Door to door campaigns Door to Door campaigns included counselling of exclusive breastfeeding of infant and young child feeding messages Education on road to health booklet

  17. Re-Assessment • Six months after the implementation of community mobilization • Facilities were re-assessed • Results were compared with the baseline • There was a huge improvements

  18. Impact of the action research

  19. New facilities that were accredited in 2014/2015 after the community mobilization

  20. Recommendations • It is recommended that community mobilization in a form of dialogues, door to door, stakeholder involvement and roadshows be taken in high recognition as some of the great interventions that improves the community breastfeeding practices.

  21. conclusion • In this small convenience sample of facilities selected, we have seen improvements in breastfeeding practices through community mobilization as the intervention to address the decline in breastfeeding practices.

  22. Acknowledgement • FPD for giving me the opportunity to study with them • Team of breastfeeding assessors in Sekhukhune district • CHC workers who participated during the roadshows and door to door campaign • DEM and HSP senior manager for their support during the action research • The district nutrition team for their dedicated effort in making sure facilities and communities understand MBFI • Facility management and staff

  23. THANK YOU

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