Devenir périnatal issu des grossesses rapprochées étude retrospective Marocaine / Perinatal outcome of closely spaced pregnancies: a Moroccan retrospective study

Introduction: déterminer les complications périnatales associées aux grossesses rapprochées. Méthodes: une étude cas-témoin rétrospective menée du 1er juin 2020 au 1er juin 2021 au centre hospitalier provincial de Settat. Au total, 670 patients ont été recrutés. Six cent trente personnes ont été réparties en deux groupes. Un groupe de patientes avec des intervalles intergénésique <9 mois (N = 443) et un groupe témoin >9 mois (N = 187). Résultats: la prématurité, la dénutrition et l'anémie p<0,05 étaient les principales complications et les principaux facteurs de risque de grossesse imminente étaient l'âge >35 ans (OR = 19,079 (4,98; 73,06) p<0,005) et le milieu rural (OR = 0,468)) (0,28; 0,78) p<0,005), niveau socio-économique bas (OR = 3,465 (2,06; 5,81) p<0,005); absence de prescriptions contraceptives postnatales (OR = 15,77 [7,31; 33,99]; p<0,005); absence d´allaitement avant la grossesse (OR = 49,462 [15,78; 155,03]; p<0,05). Conclusion: des soins préventifs et ciblés sont nécessaires en matière de planification familiale pour éviter les complications périnatales.

Introduction: the purpose of this study is to provide Moroccan data, study maternal risk factors and identify perinatal complications related to closely-spaced pregnancies. Methods: we conducted a retrospective case-control study at the Provincial Hospital Center in the city of Settat since June 1, 2020 to June 1, 2021. A total of 1,200 patients were admitted, but only 630 were included in the study. They were divided into 2 groups: a group of patients whose interpregnancy interval was <9 months (N = 443) and a control group whose interpregnancy interval was >9 months (N = 187). Results: prematurity, hypotrophy and anemia p<0,05 were the main complications, the main risk factors for closely-spaced pregnancies were age >35 years (OR =19,079 (4,98; 73,06) p < 0,005), coming from a rural area (OR = 0,468 [0,28; 0,78] p < 0,005), having a low socioeconomic status (OR =3,465 [2,06; 5,81]; p < 0,005); the absence of contraceptive prescription in the postpartum period (OR =15,77 [7,31; 33,99]; p < 0,005); and breastfeeding breaks before getting pregnant (OR = 49,462 [15,78; 155,03]; p<0,05). Conclusion: prevention and specific family planning methods are necessary to avoid perinatal complications.

Facteurs imputables aux services de santé limitant la pratique de l´allaitement exclusif dans la région du Centre au Burkina Faso: une étude transversale / Factors attributable to health services limiting the practice of exclusive breastfeeding in the Center Region of Burkina Faso: a cross-study

Introduction: l´organisation mondiale de la santé affirme que l´allaitement revêt une importance fondamentale pour la survie et le développement de l´enfant. Le but de la présente étude a été d´apprécier le niveau de connaissance et les attitudes du personnel soignant dans la promotion de l´allaitement exclusif afin d´identifier les facteurs limitants qui sont imputables aux services de santé. Méthodes: il s´est agi d´une étude transversale réalisée de juillet à novembre 2021 auprès de 74 agents de santé du district sanitaire de Boulmiougou. La collecte de données a été basée sur l´observation directe et l´administration d´un questionnaire. Le niveau de connaissance et les performances ont été évalués par le calcul des moyennes et le score de satisfaction a été fixée à au moins 80%. Résultats: il ressort de cette étude que les sages-femmes et les maïeuticiens représentaient 48,65% et que la majorité 78,37% des personnes interviewées avaient plus de cinq ans d´ancienneté. Pour l´opérationnalité des services, un score de satisfaction global de 21,25% a été retrouvé par rapport à l´existence de directives et de documentations sur l´allaitement. En matière de connaissance, le score de performance le plus élevé (62,06%) a été obtenu par une sage-femme et le plus bas (27,58%) obtenu par une accoucheuse auxiliaire. Conclusion: l´étude a permis de mettre en exergue la situation catastrophique dans la promotion de l´allaitement exclusif d´où il parait urgent de revoir la politique sanitaire en la matière pour redynamiser les activités afin de réduire la mortalité néonatale et infantile.

Introduction: the World Health Organization states that breastfeeding is of fundamental importance for child survival and development. The purpose of this study was to assess the level of knowledge and attitudes of health care personnel in the promotion of exclusive breastfeeding in order to identify the limiting factors that are attributable to health services. Methods: this was a cross-sectional study carried out from July to November 2021 among 74 health workers in the Boulmiougou health district. Data collection was based on direct observation and the administration of a questionnaire. The level of knowledge and performance were assessed by calculating averages and the satisfaction score was set at at least 80%. Results: it appears from this study that midwives and midwives represented 48.65% and that the majority 78.37% of those interviewed had more than five years of seniority. For the operationality of the services, an overall satisfaction score of 21.25% was found in relation to the existence of guidelines and documentation on breastfeeding. In terms of knowledge, the highest performance score (62.06%) was obtained by a midwife and the lowest (27.58%) obtained by an auxiliary midwife. Conclusion: the study made it possible to highlight the catastrophic situation in the promotion of exclusive breastfeeding from which it seems urgent to review the health policy in this area to revitalize activities in order to reduce neonatal and infant mortality.

Determinants of developmental milestones among children 0- 23 months at Kabale Hospital, Uganda

BACKGROUND :Approximately 200 million children globally fail to fulfil their development potential due to malnutrition, poor health, and unstimulating environments. Children in Kabale, Uganda, may be at particularly high risk as the rate of malnutrition in the region is likely to impact development. The study aimed to identify possible determinants influencing developmental milestones of breastfed and non-breastfed children aged 0-23 months. MATERIALS AND METHODSThe study was conducted at the young child clinic of Kabale hospital, among 250 children aged 0-23 months and their caregivers, for two months. The study adopted a comparative cross-sectional design, and systematic random sampling was used to select the respondents for the study. The socio-demographic characteristics, nutritional status, and feeding practices were assessed using structured pretested questionnaires. Developmental milestones of the children (communication, motor, fine motor, problem-solving, and social skills) were assessed using the modified ages and stages questionnaires. The data collected was tabulated, analysed statistically, and the results interpreted. RESULTS :Developmental scores were not associated with breastfeeding and minimum meal frequency. A milestone achievement of communication skills was associated with caregiver's education, caregiver's age and length-for-age. Gross motor scores were associated with the caregiver's age, weight-for-age, and length for age. Achievement of fine motor skills was associated with caregiver's education, caregiver's age, child's age, length for age, and children who met the minimum dietary diversity score. Problem-solving scores were associated with child's age, weight for age, length for age, and children who met the minimum dietary diversity. Personal social scores were associated with lower caregiver's age and normal weight for age Conclusion: Developmental scores were not associated with breastfeeding and minimum meal frequency. Development in early childhood was mainly associated with caregiver's age, caregiver's education, child's age, weight for age, length for age, and minimum dietary diversity score. Children under the care of younger caregivers and those who attained normal nutrition status had significantly more developed motor and social skills compared to children with older caregivers and undernourished children, respectively.

Support experiences of mothers with breastfeeding problems: A qualitative study

Understanding mothers with problems regarding support is important for planning care, directing interventions, and ensuring the continuity of breastfeeding. This is a qualitative analytic study. Data were collected by using questions about socio-demographic characteristics and semi-structured interview questions. The research sample consisted of 15 mothers who met the participation criteria and volunteered to participate. Most of the mothers stated that they want to be supported when they need it, they want positive support, they do not want to be compared with other mothers and they care about professional support. Social support given without ignoring the feelings and expectations of the woman during the breastfeeding process will positively affect the process. (Afr J Reprod Health 2022; 26[7]: 102-111).

Infant feeding knowledge and practice among HIVpositive mothers attending HIV treatment centres in Lagos

Background: Twenty five to forty percent of children will be infected with HIV in the absence of any form of intervention which is Prevention of Mother to Child Transmission (PMTCT). Objectives: This study determined the infant feeding knowledge and practices among HIV positive mothers attending HIV treatment centers in Lagos. Methods: A descriptive crosssectional design was used for the study. A multistage sampling technique was used to select / recruit 290 HIV positive mothers with babies between the ages of 2weeks to 18months, attending PMTCT services into the study Pre-tested interviewer administered structured questionnaire was used to collect data and analysis was done using Epi-info software. Chi-square and Fischer exact tests were used to determine association between the dependent and independent variables. The pvalue was set at 0.05. Results: Majority of the respondents (58.9%) were within the age range of 31 ­ 40 years and about half had a secondary school level of education. Exclusive formula feeding (40.3%) and exclusive breast feeding (42.4%) were feeding options known by the majority of the respondents. More than half (55.5%) of the mothers had a good knowledge of infant feeding options. Exclusive breastfeeding (EBF) was practiced by majority (55.5%) of the respondents, 21.4% practiced exclusive formula feeding (EFF) while only 6% practiced mixed feeding (MF). Knowledge of infant feeding options and the attitude towards exclusive breast feeding being enough in the first 6 months of life were associated with infant feeding options practiced; those with good knowledge of infant feeding options did not practice MF (9.7%) (p = 0.013). Conclusion: knowledge of infant feeding options was good and poor knowledge was associated with exclusive formula feeding. Majority practiced EBF. Educational programmes targeted at improving the knowledge of HIV and infant feeding options as well as strengthening of counseling sessions at PMTCT clinic would help reduce the risk of HIV transmission to the child.

Correlates of exclusive breast feeding among nursing mothers attending child health clinic at a general hospital in Rivers State Nigeria

Background: Early initiation of breast feeding and feeding exclusively for six months have great implication for the survival, well-being and growth of new borne. Factors such as maternal age, occupation, religion, spouse age, spouse occupation, parity, antenatal care (ANC) attendance, mode of delivery (MOD) and birth order are significantly associated with exclusive breast feeding (EBF) Methodology: The study is a descriptive cross-sectional study conducted among nursing mothers attending child health clinic in General Hospital Bonny, in Bonny Island, Rivers State, Nigeria. All eligible nursing mother who presented at the clinic were enlisted for the study. Enlistment of eligible participants was done on every child welfare clinic day. Data was collected using a pretested, interviewer administered, structured questionnaire which was adapted and prepared in English Language. Categorical data was analyzed using multinomial logistic regression model with statistical significance set at 0.05. Result: Results from this study identified significant association between EBF and some maternal variables such as age, occupation and religion. Spouse age and occupation were significantly associated with EBF. ANC attendance, gestational age, MOD, parity and birth order were also significant variables associated with EBF. Conclusion: Maternal variables such as age, occupation, religion, parity, MOD, ANC attendance including spouse age and occupation significantly influence EBF of new borne.

Twenty years of prevention of mother to child HIV transmission: research to implementation at a national referral hospital in Uganda

Background: Over 90% of new paediatric HIV infections are acquired through mother to child transmission. Prevention of mother to child HIV transmission (PMTCT) research in sub-Saharan Africa informed WHO guidelines which enabled implementation of PMTCT programs globally. Objectives: To describe Makerere University-Johns Hopkins University (MU-JHU) perinatal HIV prevention research and implementation of the Mulago National Referral Hospital (MNRH) PMTCT program. Methods: Perinatal HIV prevention studies conducted at MU-JHU between 1997­2016 were summarized. Program aggregated data was extracted and analyzed using STATA 15. Results: In 1999, the HIVNET 012 study demonstrated that single-dose nevirapine (sdNVP) to the mother at onset of labor and to her newborn, reduced MTCT by nearly 50%. In 2016, the PROMISE study documented the safety and efficacy of ART during pregnancy and breastfeeding period. Program implementation at MNRH started in 2000. Uptake of HIV testing increased from 70% to 99% from 2006 onwards. sd NVP was the initial ARV regimen but by 2012, MOH recommended Option B+(triple therapy). MTCT rates reduced from 16.9% in 2001 to 2.3% in 2020. Conclusion: Perinatal HIV prevention clinical trials conducted at MU-JHU provided evidence to inform WHO PMTCT guidelines. MNRH program evaluation demonstrated the significant decline in MTCT rates over the last two decades.

Sociodemographic factors associated with mixed-feeding practices among a cohort of mothers with infants aged 4 - 14 weeks in Tlokwe subdistrict, North West Province, South Africa

Background. Exclusive breastfeeding for the first 6 months of an infant's life is the recommended gold standard for infant feeding; however, mixed feeding (MF) is common in various settings. In South Africa (SA), especially in the Tlokwe subdistrict of North West Province, there is little information on the association between sociodemographic factors and infant MF practices.Objective. To identify the sociodemographic factors associated with MF practices in a cohort of mothers of infants aged 4 - 14 weeks in the Tlokwe subdistrict of North West.Methods. The study setting was 8 health facilities in the Tlokwe subdistrict. Participants comprised postpartum women with infants aged 4 - 14 weeks. Data analysis used SPSS version 25.0. Normal data are presented as means (standard deviation (SD)), skewed data as median values (25th, 75th percentiles) and categorical values as percentages and frequencies.Chi-square tests and logistic regression analysed the association between sociodemographic factors and MF practices at time point 2 (10 - 14 weeks).Results. The majority of the mothers were aged between 25 and 29 years, and 37% had at least 2 live children. MF increased with infant age. There was no significant association between any of the sociodemographic variables and MF practices. Logistic regression analysis showed a significant association between increased parity and MF. There was also a significant association between changes in infant-feeding practices after receiving the child support grant at 10 - 14 weeks. Conclusion. The high proportion of mothers who mixed-fed indicates that it is still the norm, as in other SA contexts. Therefore, strengthened breastfeeding education regarding appropriate infant-feeding choices in the promotion of infant development and survival for the short and long term should be emphasised. S Afr J Child Health 2022;16(4):192-197. https://doi.org/10.7196/SAJCH.2022.v16.i4.1808Sociodemographic factors associated with mixed-feeding practices among a cohort of mothers with infants aged 4 - 14 weeks in Tlokwe subdistrict, North West Province, South Africa N M Semenekane,1 MSc (Nutrition); C B Witten,1,2 PhD (Nutrition); E Swanepoel,3 MSc (Dietetics);H S Kruger,1 PhD Nutrition 1 Centre of Excellence for Nutrition, North-West University, Potchefstroom, South Africa2 Division of Health Professions Education, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa3 School of Physiology, Nutrition and Consumer Sciences, North-West University, Potchefstroom, South Africa

Duration of breast feeding and outcome of HIV-exposed infants seen at a tertiary health facility in Sokoto

Background: Appropriate infant feeding is still a challenge to HIV-positive mothers especially in the developing world despite their desire to breast feeding beyond the WHO recommended 12 months' duration. Objective: To determine the duration of breast feeding and correlate with outcome of HIV-exposed infants in UDUTH, Sokoto. Methods: This descriptive observational study was conducted among HIV-exposed infants attending Paediatric ART(PMTCT) clinic, UDUTH, Sokoto. The demographics, infant post-exposure prophylaxis, duration of breast feeding and results of early infant diagnosis (EID) of the infants using HIV-DNA PCR machine; and maternal highly active antiretroviral therapy (HAART) history were documented. The data were analyzed using SPSS version 24.0. A p-value of ≤0.05 was taken as significant. Results: One hundred and sixty-three HIV-positive mother-infant pairs were studied, 103(61.7%) of the HIV-positive mothers were aged 25-34 years, 105(62.9%) were of lower socio-economic class and 94(56.3%) had informal education. One hundred and fifteen (62.5%) were on TDF/3TC/EFV and 143 (85.6%) were on HAARTs prior to the index pregnancy. One hundred and sixty-three of the HIV-exposed infants studied were breast-fed and 165 (98.8%) had nevirapine as infant PEP. The mean duration of breast feeding among HIV-exposed infants was 13.2(±3.5) months with a range 6 ­ 20 months. Ninety-eight (60.1%) infants were breastfed beyond 12months. All the HIV-exposed infants were not infected at the end of breastfeeding for 12 months or more. Conclusion: Majority of the HIV-positive mother's breastfed beyond WHO recommended 12 months and their infants were uninfected. This may support the upward review of the duration of breast feeding of HIV-exposed infants in our community

Breastfeeding support practices in designated workplaces in the Breede Valley sub-district, Western Cape, South Africa

Background. Globally, mothers have identified employment as one of the leading barriers to exclusive and continued breastfeeding. The workplace and employment setting has been highlighted as one component of an enabling environment for breastfeeding.Objectives. To assess breastfeeding support practices in designated workplaces in the Breede Valley sub-district, Western Cape, South Africa.Methods. A quantitative, cross-sectional design study was used. An online survey was conducted amongst human resource managers and/or company managers to determine breastfeeding support practices in designated workplaces.Results. Fourteen participants completed the online survey. Breastfeeding support practices in designated workplaces were limited and inadequate, with few supportive breastfeeding practices. Onsite or nearby crèche facilities (n=2; 14.3%), breastfeeding counsellors (n=1; 7.1%), promotion of the benefits of breastfeeding to employees (n=2; 14.3%) and provision of private space for expressing (n=2; 14.3%) were not common practices. Workplace breastfeeding policies (n=4; 28.6%) were not common practice, and were mostly found in the public sector. Forty-three percent of workplaces (n=6; 42.9%) did not provide time for expressing at work.Conclusion. There is an urgent need to create advocacy regarding the benefits of breastfeeding support in the workplace for employers, employees and society as well as the breastfeeding rights of women in the workplace. The legislated breastfeeding break times need to be monitored to ensure better compliance in workplaces

Mothers' knowledge of mother-to-child transmission of HIV and infant feeding practices in Juba, South Sudan

Introduction: While exclusive breastfeeding for the first six months of life is recommended for HIV-infected mothers, this may not be practiced fully in South Sudan; exclusive formula feeding, which is the best alternative to breastfeeding, may not be practical. Objective: To assess the knowledge of mother-to-child transmission of HIV (MTCT) and practices of feeding infants in the first six months of life among HIV-infected mothers attending Antiretroviral Therapy Centres in Juba Teaching Hospital (JTH) and Juba Military Hospital (JMH). Method: A cross-sectional study in which 304 HIV-infected mothers with children aged 6-18 months were interviewed between October and December 2016 using structured questionnaires. Key informant interviews (KIIs) and focus group discussions (FGDs) were also conducted using interview guides. Quantitative data was analysed using Statistics Package for Social Sciences software. Chi-square test was used to test the presence of significant association between the variables and the association is statistically significant when the p-value is < 0.05. Multiple logistic regression analysis was used to identify which predictor variables have major effect on the dependent variable. Qualitative data was transcribed in English and summarized according to the key themes, and the information obtained was used to supplement and interpret the findings of the quantitative data. Results: Only 120 (40%) of the HIV-infected mothers had a good knowledge of MTCT; 213 mothers (70.1%) practiced mixed feeding, 70 (23.0%) practiced exclusive breastfeeding and 20 (6.6%) practiced exclusive formula feeding. The factors that were found to have a positive effect on choice of infant feeding methods were having more than one child (odds ratio = 0.303, 95% Confidence interval: 0.161-0.571, p = 0.001) and participation in the prevention of motherto-child transmission of HIV programme (PMTCT) (odds ratio = 2.260, 95% Confidence interval: 1.251-4.084, p = 0.007). Stigma (p = 0.248) and mothers' knowledge of MTCT (p = 0.072) were not statistically significantly associated with the mothers' infant feeding practices. Conclusion: Knowledge of MTCT is low. Mixed feeding before six months of age is predominant among the HIV-infected mothers. It is therefore recomm;ended that HIV-infected mothers receive adequate information from counsellors regarding MTCT and exclusive breastfeeding for the first six months of an infant's life

Breastfeeding and common childhood diseases in Zambia: does breastfeeding have a protective effect against diarrhea, fever and acute respiratory infections among children in Zambia?

Background: This paper aimed at answering two specific questions: does breastfeeding reduce the occurrence of ARIs, Fever and Diarrhea in children who are breastfeeding; and is the occurrence of these common childhood diseases affected by duration (period) of breastfeeding? Data source and Method: Secondary analysis of the 2013 Zambia Demographic and Health Survey (ZDHS) was applied by using the children recode dataset (ZMKR61FL). Analysis was done at three levels: Descriptive, bivariate and multivariate (Binary and Multinomial Logistics regressions). Results: Results in this paper show that breastfeeding does not protect children against Diarrhea (OR 1.3; 1.1-1.4) but does so against Fever and ARIs (OR 0.9; 0.8-1.0). Children whose mothers were employed were more likely to suffer from all the three disease outcomes compared to those not employed (OR Diarrhea 1.2; Fever 1.5; ARIs 1.2). Conclusion: Diarrhea seems to be more pronounced in children who are breastfeeding than those not breastfeeding, especially those breastfed beyond 6 months

Breastfeeding knowledge and practices among mothers of children younger than 2 years from a rural area in the Limpopo province, South Africa

Background. Exclusive breastfeeding is rarely practised in most rural areas of developing countries. Poor breastfeeding practices may stem from negative attitudes or poor knowledge about the value of breastfeeding. Objective. To determine breastfeeding knowledge and practices among mothers of infants younger than 2 years in a rural area of the Limpopo province, South Africa (SA). Methods. A cross-sectional questionnaire-based survey was conducted among 360 women with children younger than 2 years from the Ha-Khakhu area in the Vhembe district, SA. Snowballing was used to select 360 participants. Results. The mean age of the respondents was 29.3 (8.1) years (range 18 - 45 years). The majority (75%) of the respondents agreed that infants should be breastfed up to the age of 6 months. Two-thirds of the respondents initiated breastfeeding within an hour of giving birth. During the time of data collection, 83% of the respondents were still breastfeeding, while 17% had stopped. The majority of the respondents (75.8%) agreed that complementary feeding should start at the age of 6 months. Conclusion. The respondents' breastfeeding practices did not correspond to their high level of knowledge about breastfeeding. It is recommended that health education initiatives be intensified to promote breastfeeding

Prévalence et description des pratiques d'allaitement maternel exclusif dans une zone semi-rurale au sud du Bénin

Introduction : Dans un contexte de non atteinte des recommandations de l'OMS et de l'UNICEF con-cernant l'allaitement maternel exclusif, cette étude avait pour objectif de décrire les pratiques et habi-tudes d'allaitement maternel dans une population semi-rurale au sud du Bénin. Matériel et méthode : Cette enquête s'est déroulée à Sèmè-Kpodji située à 15 km au sud-est de la capitale Porto-Novo. Les pratiques d'allaitement maternel exclusif de 0 à 6 mois ont été observées et notées chez 339 femmes ayant accouché entre janvier 2015 et janvier 2016. Résultats : La plupart des enfants (71,40%) ont été mis au sein dès la première de vie ; l'âge moyen de sevrage était de 4,5 mois. Le taux d'allaitement maternel exclusif était de 53,9% et a diminué pro-gressivement en fonction de l'âge de l'enfant. Les taux d'allaitement maternel prédominant et complété ont varié de 25,4% à 49,6% et de 0 à 40,7% respectivement. La durée moyenne des tétées est passée de 24,1 à 15,1 minutes et la fréquence des repas de 9,5 à 6,4 repas par jour. Conclusion : Cette enquête confirme la nécessité de continuer les interventions de santé publique visant à promouvoir l'allaitement maternel exclusif afin d'améliorer les indicateurs de santé materno-infantile

Factors associated with prelacteal feeding practices in a rural northern Nigerian setting

Introduction: Prelacteal feeding practice contravenes the recommendation of World Health Organisation that breastfeeding be initiated within an hour of childbirth. Consequently, the health, social, emotional and economic benefits of optimal breastfeeding are limited. Therefore, to break this vicious cycle of prelacteal feeding and suboptimal breastfeeding, factors associated with the practice must be identified. Objective: To assess prelacteal feeding practices and its associated factors in a rural community with the view to generate data for community-level interventions that will promote optimal breastfeeding.Methods: Data was collected during a community-based surveillance for maternal, newborn and child health project in Tsibiri,a rural community in north-western Nigeria. The survey questionnaire was uploaded into mobile devices running on an android operating system. Trained female interviewers collected the data over a period of one week in 2011.Results: A total of 270 out of 309 interviewed women had experienced childbirth and were included in the analysis. Majority (85.2%) of respondents utilised prelacteal feeds for their newborns. Plain water was the most common prelacteal feed (44.7%).Prelacteal feeding was associated with births assisted by unskilled birth attendants (AOR 5.322, 95%CI 1.634-17.333); while operative delivery reduced the likelihood of the practice (AOR 0.168, 95%CI 0.060-0.470). No statistically significant association was found between use of prelacteal feed and women's age, education or access to income.Conclusion: The predominance of prelacteal feeding practices underscores the need for innovative strategies that create awareness among mothers and health care providers, with emphasis on health facility deliveries, advantages of breastfeeding and risks of prelacteal feeding

Mothers' knowledge on essential newborn care at Juba Teaching Hospital, South Sudan

Introduction: Globally neonatal mortality remains high and in South Sudan is estimated at 52/1000 live births. Objective: To identify the gaps in the knowledge and practices of essential newborn care among postnatal mothers at Juba Teaching Hospital and to determine the socio-demographic factors that influenced these.Methodology: A hospital-based cross-sectional study among 384 postnatal mothers using consecutive sampling, a pretested questionnaire to assess knowledge and a three point Likert scale to find out to which practices mothers did, or did not, agree. Results: 45% of mothers were aged between 25-34 years; 23.9% had some secondary school education; 70% were multiparous and 82% had attended an antenatal care clinic. 90% knew about breastfeeding on demand and 74% about exclusive breastfeeding. Only 18.2% of mothers knew the cord should be cared for while uncovered; 90% used warm clothing and 33% kangaroo care for thermoregulation. Only 20.8% identified BCG and OPV as birth vaccines; 3.4% believed vaccines were harmful.Hypothermia was the danger sign least frequently identified by the mothers (41.4%). Conclusion: Adequate knowledge was found regarding breastfeeding, with knowledge gaps existing in cord care, immunization, eye care and thermoregulation. Positive practice was found about breastfeeding, cord care, eye care and immunization. Socio-demographic factors were not found to be associated with maternal knowledge on newborn care

Evaluation de l'allaitement maternel exclusif chez les enfants de 0 à six mois dans le district de Tchaoudjo (Togo)

Introduction : le lait maternel seul est l'aliment de prédilection des enfants de moins de six mois. Ce mode d'alimentation n'est pas toujours bien respecté ; d'où cette étude pour évaluer la pratique de l'allaitement maternel exclusif chez les nourrissons de 0 à six mois dans le district de Tchaoudjo. Méthodes : Il s'agissait d'une étude transversale, descriptive et analytique conduite du 02 mai au 29 juillet 2017 auprès des mères de nourrissons de 0 à six mois. La technique par sondage aléatoire simple était utilisée pour choisir les cibles. Résultats : L'étude avait concerné 374 mères. L'âge moyen des mères était 27,5 ans avec des extrêmes de 15 et de 49 ans, le niveau primaire (38,8%) et les ménagères (71,1%) étaient majoritaires, 72,2 % avaient pratiqué l'AME. Les facteurs influençant positivement la pratique de l'AME étaient, l'accouchement dans un centre de santé, l'assistance de l'accouchement par un personnel qualifié, la prise de décision d'allaiter au cours de la grossesse et le soutien du conjoint à l'AME. Conclusion : La pratique de l'AME était de 72,2% chez les nourrissons de 0 à six mois à Tchaoudjo et des facteurs l'influençant ont été identifiés en vue de l'améliorer

Facteurs associés à la qualité de la pratique de l'allaitement maternel chez les mères d'enfants de 0-24 mois à Klouekanme, au sud-est du Bénin

Introduction : La malnutrition chez les enfants est un problème de santé publique, particulièrement en Afrique de l'ouest et du centre, où environ 56% des décès des enfants pourraient être évités si ces enfants n'étaient pas malnutris. Au Bénin, bien qu'environ 94% des enfants de 0-24 mois soient allaités au sein, la pratique de façon exclusive jusqu'à 6 mois est plus faible, avec 34% des enfants concernés.La présente étude avait pour objectif d'étudier les facteurs associés à une bonne pratique de l'allaitement maternel chez les mères d'enfants de 0-24 mois dans la commune de Klouékanmè au Sud - Est du Bénin.Méthodes : Il s'agissait d'une étude transversale, à visée descriptive et analytique. Elle a été réalisée dans des ménages ayant au moins un enfant de 0-24 mois. Les données ont été collectées en 2016 auprès des mères volontaires et présentes le jour de l'enquête. L'adéquation des pratiques actuelles d'allaitement maternel a été appréciée à l'aide d'un score de pratique de l'allaitement maternel créé sur la base des réponses obtenues pour les variables indicatrices de la pratique d'allaitement du jeune enfant. Le test de chi2 a été utilisé pour rechercher les associations entre les variables explicatives et la pratique adéquate de l'allaitement maternel. Le seuil de significativité a été fixé à p<0,05.Résultats : Au total, 204 couples mère-enfant ont été inclus dans l'étude. Près de 85% des enfants de 0-24 mois était sous allaitement maternel la veille de l'enquête. L'analyse de la qualité des pratiques d'allaitement maternel révèle que 45% des enfants, quel que soit leur âge, ont été allaités de façon adéquate. La qualité de la pratique d'allaitement a été la moins adéquate dans le groupe des mères qui avait une faible connaissance de la "composition de l'alimentation de l'enfant 6 à 9 mois" (p=0,010). La pratique d'allaitement maternel était très inadéquate parmi les mères ayant des enfants de 0-6 mois et 18-24 mois. Les mères ayant une pratique peu adéquate proviennent de ménages à faible effectif (p=0,035). De même, les mères les plus jeunes de l'étude (15-25 ans) ont majoritairement une pratique peu adéquate en matière d'allaitement maternel (p=0,004). Par contre l'âge des enfants (p<0,0001) et le rang de naissance (p=0,023) étaient significativement associés à la qualité de la pratique d'allaitement. Conclusion : Les résultats de l'enquête auprès des mères de Klouékanmè révèlent qu'au niveau communautaire, il existe encore des pratiques alimentaires inadéquates (type d'aliments, fréquences,texture, quantité et diversité). L'âge des enfants étant significativement associé à la qualité des pratiques d'allaitement jusqu'à l'âge de 24 mois, les interventions devront être adéquatement structurées afin de fournir l'appui nécessaire à la mère et ce à chaque stade de la croissance de son enfant