Breastfeeding training improves health worker performance in rural Nigeria

East Afr Med J. 1997 Aug;74(8):510-3.

Abstract

The training of health workers in breastfeeding and lactation management is to enable them make correct breastfeeding recommendations to mothers. This study aims to provide answers to two research questions: what components of breastfeeding training are easily achieved with extension health workers, and what health worker variables affect these outcomes. Multivariable analysis of the outcomes of a controlled breastfeeding training programme for community health workers (CHW) in rural communities of Osun State, Nigeria, was performed by logistic regression. The results show that the training was the most powerful predictor of correct CHW recommendations on breastfeeding (OR = 60.25, p-0.0000), and of 'perfect' breastfeeding knowledge (OR = 192.49, p = 0.0000). Younger CHWs (in the age bracket 20 to 29 years) were significantly more likely to make correct recommendations on exclusive breastfeeding (OR = 3.02, p = 0.0304). Other CHW variables such as sex, experience, job status, and marital status did not make consistently significant independent contributions to the outcomes. The results suggest that breastfeeding education can enhance CHW professional recommendations on breastfeeding and should be extended to all categories of health workers.

PIP: Health worker training is a key component of Nigeria's National Breast Feeding Program. Problematic, however, have been situations where the current recommendation of exclusive breast feeding conflicts with local knowledge and practices. This conflict can be resolved only by convincing rural community health workers (CHWs) of the legitimacy and benefits of exclusive breast feeding. A study conducted in the Ife South Local Government area of Nigeria's Osun State evaluated the impact of intensive breast feeding training on CHWs. The intervention was guided by focus group discussions among health workers, lactating mothers, and grandmothers. A total of 66 CHWs received the Ife South Breast Feeding Project (ISBFP); another 67 CHWs were not exposed to the training. Logistic regression analyses indicated that ISBFP training was the strongest predictor of CHW recommendations of exclusive breast feeding and against early supplementation (odds ratio, 60.25). Younger CHWs (20-29 years) were 3.02 times more likely than their older counterparts to promote exclusive breast feeding, but no other sociodemographic characteristics of health workers were significant. Recommended, in light of these findings, is expansion of health worker training to include breast feeding and lactation management and on-the-job retraining of current CHW cadres. If outreach to pregnant women is handled in a culturally sensitive way, clients of trained CSWs should be able to overcome the constraints of local tradition.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adult
  • Breast Feeding*
  • Clinical Competence / standards*
  • Community Health Workers / education*
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mothers / education
  • Multivariate Analysis
  • Nigeria
  • Program Evaluation
  • Rural Health*