Dataset Information

Process-oriented training in breastfeeding for health professionals decreases women's experiences of breastfeeding challenges.

ABSTRACT:

Background

The World Health Organization recommends promoting exclusive breastfeeding for six months. Women often end breastfeeding earlier than planned, however women who continue to breastfeed despite problems often experience good support and counselling from health professionals. The aim of this study was to evaluate the effects of a process-oriented training in breastfeeding support counselling for midwives and child health nurses, on women's satisfaction with breastfeeding counselling, problems with insufficient breast milk and nipple pain in relation to exclusive breastfeeding shorter or longer than 3 months.

Methods

An intervention through process-oriented training for health professionals regarding support in childbearing and breastfeeding took part in the south west of Sweden. This study was conducted in Sweden, in 2000 - 2003. Ten municipalities were paired, and within each pair, one was randomly assigned to the group of five intervention (IG) municipalities and one to the group of five control municipalities. Primiparas (n?=?540) were invited to participate in a longitudinal study to evaluate the care they received. A survey was distributed at 3 days, 3 months and 9 months postpartum. Data collection for control group A (n?=?162) started before the intervention was initiated. Data for control group B (n?=?172) were collected simultaneously with the intervention group (IG) (n?=?206). Women were also divided into two groups depending on whether they exclusive breastfed?ResultsWomen in IG were more satisfied with the breastfeeding counselling (p?=?0.008) and felt the breastfeeding counselling was more coherent (p?=?0.002) compared to control groups, when exclusive breastfeeding was?ConclusionA process-oriented training for health professionals in support influenced women's ability to solve breastfeeding problems such as the experience of insufficient breast milk production. Women with exclusive breastfeeding lasting???3 months more often had breastfeeding duration in line with their planned breastfeeding duration, compared to women who had breastfeeding duration?Trial registrationACTRN12611000354987.

SUBMITTER: Blixt I

PROVIDER: S-EPMC4163059 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Project description:BACKGROUND: While evaluation is, in theory, a component of training programmes in health planning, training needs in this area remain significant. Improving health systems necessarily calls for having more professionals who are skilled in evaluation. Thus, the Université de Ouagadougou (Burkina Faso) and the Université de Montréal (Canada) have partnered to establish, in Burkina Faso, a master's-degree programme in population and health with a course in programme evaluation. This article describes the four-week (150-hour) course taken by two cohorts (2005-2006/2006-2007) of health professionals from 11 francophone African countries. We discuss how the course came to be, its content, its teaching processes and the master's programme results for students. METHODS: The conceptual framework was adapted from Kirkpatrick's (1996) four-level evaluation model: reaction, learning, behaviour, results. Reaction was evaluated based on a standardized questionnaire for all the master's courses and lessons. Learning and behaviour competences were assessed by means of a questionnaire (pretest/post-test, one year after) adapted from the work of Stevahn L, King JA, Ghere G, Minnema J: Establishing Essential Competencies for Program Evaluators. Am J Eval 2005, 26(1):43-59. Master's programme effects were tested by comparing the difference in mean scores between times (before, after, one year after) using pretest/post-test designs. Paired sample tests were used to compare mean scores. RESULTS: The teaching is skills-based, interactive and participative. Students of the first cohort gave the evaluation course the highest score (4.4/5) for overall satisfaction among the 16 courses (3.4-4.4) in the master's programme. What they most appreciated was that the forms of evaluation were well adapted to the content and format of the learning activities. By the end of the master's programme, both cohorts of students considered that they had greatly improved their mastery of the 60 competences (p<0.001). This level was maintained one year after completing the master's degree, except for reflective practice (p<0.05). Those who had carried out an evaluation in the intervening 12 months reported a negative gap between their declared mastery and their actual application. However, this is only statistically significant for reflective practice (p < 0.05). CONCLUSION: This study shows the importance of integrating summative evaluation into the learning process. Skills-based teaching is much appreciated and well-adapted. Creating a master's programme in population and health in Africa and providing training in evaluation to high-level health professionals from many countries augurs well for scaling up the practice of evaluation in African health systems.

Project description:OBJECTIVES:To explore women's experiences of breastfeeding beyond infancy (>1?year). Understanding these experiences, including the motivators, enablers and barriers faced, may help inform future strategies to support and facilitate mothers to breastfeed for an optimal duration. DESIGN:An exploratory qualitative study using an interpretive approach. Nineteen semistructured interviews were conducted (in person, via phone or Skype), transcribed and thematically analysed using the framework method. SETTING:Participants drawn from across the UK through online breastfeeding support groups. PARTICIPANTS:Maximum variation sample of women currently breastfeeding a child older than 1?year, or who had done so in the previous 5?years. Participants were included if over 18, able to speak English at conversational level and resident in the UK. RESULTS:The findings offer insights into the challenges faced by women breastfeeding older children, including perceived social and cultural barriers. Three core themes were interpreted: (1) parenting philosophy; (2) breastfeeding beliefs; (3) transition from babyhood to toddlerhood. Women had not intended to breastfeed beyond infancy prior to delivery, but developed a 'child-led' approach to parenting and internalised strong beliefs that breastfeeding is the biological norm. Women perceived a negative shift in approval for continued breastfeeding as their child transitioned from 'baby' to 'toddler'. This compelled woman to conceal breastfeeding and fostered a reluctance to seek advice from healthcare professionals. Mothers reported feeling pressured to breastfeed when their babies were young, but discouraged as children grew. They identified best with the term 'natural-term breastfeeding'. CONCLUSIONS:This study suggests that providing antenatal education regarding biological weaning ages and promotion of guidelines for optimum breastfeeding duration may encourage more women to breastfeed for longer. Promoting the concept of natural-term breastfeeding to mothers, and healthcare professionals, employers and the public is necessary to normalise and encourage acceptance of breastfeeding beyond infancy.

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Process-oriented training in breastfeeding for health professionals decreases women's experiences of breastfeeding challenges.

Background

Methods

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