Fathers’ involvement in child feeding and the adoption of exclusive breastfeeding by mothers in rural Zimbabwe: a quasi-experimental study
Introduction: Exclusively breastfeeding a child is considered as giving an infant the best start to life. It is proven to be the best way to nourish infants before reaching the age of six months to ensure good health, growth, and development. It has been proven to have a host of health benefits for both the mothers and infants alike. However, a large proportion of children in Zimbabwe and the world over are not exclusively breastfed or are exclusively breastfed for less than the recommended period. Women’s decision making around child feeding can be complex and can be influenced by people from within their social networks and communities where they reside, to have it done one way or another. Paternal or male partner involvement and engagement in child feeding has been offered as a potential solution in promoting the uptake of exclusive breastfeeding. The study thus sought to establish the existence of an association between spousal or male partner involvement and the adoption of EBF by women. It also sought to determine whether the Amalima Male Champions Campaign had improved partner involvement through exposing men to its interventions. Methods: A quasi-experimental approach was taken to measure male involvement and exclusive breastfeeding outcomes among women from Male Champion intervention areas and from suitable comparison areas within the District. Outcomes from 471 women with children aged under two years from comparison wards in Tsholotsho District were compared to 355 women with children aged under two years from the intervention wards in the District. Data was obtained using a researcher-designed and interviewer administered questionnaire. Breastfeeding was measured using the WHO framework using the 24-hour recall along with questions enquiring about foods given to the infant at other times since the child was born. Male involvement was measured through women’s satisfaction with spousal or partner support. Data was analysed in STATA-16 using measures of central tendency, the Chi-square test, Cramer’s V test and Ordinal Logistic Regression Models. Results: The overall prevalence of exclusive breastfeeding was 53.5%. The prevalence of exclusive breastfeeding was 61.8% among women with children under six months in age, while 51.2% of mothers with children above six months had exclusively breastfed for six months. A significant difference in EBF rates between intervention and control was not found. The results revealed a significant association between women’s satisfaction with perceived spousal or partner support and the adoption of EBF. The results of the logistic regression showed that women with high satisfaction in the intervention area were 4.7 times (OR 4.7) more likely to EBF than women with low satisfaction. In the control group, women with high satisfaction were 3.1 times (OR 3.1) more likely to EBF than their contemporaries with low satisfaction. Among women with children above six month, those that were highly satisfied with the support from their partners or husbands were 1.7 times (OR 1.7) more likely to EBF than women who had low satisfaction. Among these women, both those in the intervention and the control areas who were highly satisfied with the support from their husbands were 1.8 times ([Control – OR 1.8] [Intervention – OR 1.8]) more likely to exclusively breastfeed than their contemporaries who were less satisfied. Conclusion: The findings suggest that when women are highly satisfied with the support for exclusive breastfeeding from their spouses or partners, they are more likely to adopt exclusive breastfeeding. It is therefore recommended to actively promote the engagement of male partner or spousal support to garner exclusive breastfeeding support for women.
A research report submitted to the Faculty of Health Sciences, The University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Masters degree in Public Health, Social Behaviour Change Communications, 2021