Thesis:

Determinants of exclusive breastfeeding among mothers with infants aged under six months in Wadajir district, Banadir region- Somalia

Breastfeeding plays a vital role in achieving Sustainable Development Goals (SDGs), particularly SDG 2 on nutrition and SDG 3 on child mortality reduction. It provides essential nutrients and protection against illnesses. The World Health Organization (WHO) aimed to increase exclusive breastfeeding (EBF) rates in infants under six months to at least 50% by 2025 (Jones et al., 2015). Research linked over two-thirds of malnutrition-related under-five deaths to improper breastfeeding. In Somalia, the EBF rate was reported at 34% in 2020 Somali Demographic Health Survey (SDHS), contributing to a high under-five mortality rate of 111.5 per 1,000 live births. The United Nations Decade of Action on Nutrition (2016–2025) emphasizes optimal breastfeeding as a key priority, necessitating ongoing research and intervention. This study aimed to determine the prevalence and the determinants of EBF among infants under six months in Wadajir district, Banadir region, Somalia. The specific objective of this study was to assess the influence of knowledge and practices on exclusive breastfeeding practices among mothers with infants aged under six months in Wadajir District, Banadir Region – Somalia. A hospital-based cross-sectional study was conducted among mother-infant pairs seeking healthcare at Wadajir Health Center. Data were collected using structured questionnaires. Participants were informed about the study, assured of confidentiality, and voluntarily provided consent. SPSS was used for data analysis, and multiple analyses examined correlations between independent variables. The prevalence of Exclusive Breastfeeding (EBF) was 65%, below the WHO target. Maternal education significantly influenced EBF, with 73% of educated mothers correctly identifying the recommended duration. Key barriers included beliefs about insufficient breast milk (40%) and negative perceptions of colostrum (26%). Skin-to-skin contact was more prevalent among housewives (73%) than salaried employees (68%). Antenatal care visit (ANC) visits played a role, with 87% receiving health and nutrition messages, mainly from healthcare workers. Social factors such as lack of family support and early bottle feeding also impacted EBF. The study revealed that exclusive breastfeeding (EBF) regarding knowledge and practices; Housewives practicing skin-to-skin contact after birth were more likely to exclusively breastfeed for 5–6 months. About 73% of housewives reported skin-to-skin contact versus 68% of employed mothers. Conversely, 32% of employed mothers did not practice it, compared to 27% of housewives, highlighting lifestyle and time availability differences. Key barriers included maternal misconceptions about milk sufficiency, negative perceptions of colostrum, and cultural influences, while antenatal care (ANC) visits and skin-to-skin contact positively influenced EBF practices. Strengthening breastfeeding education, integrating comprehensive counseling in ANC visits, and involving family members in breastfeeding promotion can help overcome these barriers. Additionally, advocating for breastfeeding-friendly workplace policies and conducting further research on socio-cultural barriers will be essential in improving EBF rates and reducing child mortality in Somalia.