A new study conducted by a group of Zimbabwean nutritionists has gathered that Zimbabwean working class women would prefer substituting breast feeding with breast milk from donors as compared to formulas.
By Michael Gwarisa
The study titled “Acceptability of donor breastmilk banking among health workers: a cross-sectional survey in Zimbabwean urban settings,” was conducted by a team of seven nutritionists namely Dexter Chagwena, Felistas Mugariri, Steady Mataga, Ruvimbo Danda, Tonderayi Matsungo and Charles Maponga.
The concept of donor human milk banking was acceptable among health workers. One-third (31%) of the study participants reported that they would accept donor breastmilk for their children while 56% of them would encourage their clients to donate breastmilk.
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“Acceptance of donor human milk banking was associated with a high level of knowledge on breastmilk banks (p = 0.009) and the study participants’ health profession (p = 0.001). Clinical staff were more receptive to donor human milk banking compared to non-clinical health workers. Donor human milk banking was not associated with religion (p = 0.498) or marital status (p = 0.714),” said the study.
The results also showed that health workers and policy informers would accept the establishment of breastmilk banks subject to resource availability. Commitment to the establishment of breastmilk banks was moderately acceptable among opinion leaders responsible for spearheading health and nutrition policies.
“The WHO recommendation that donor breastmilk is the next best option when mother’s own milk is unavailable has highlighted the concept of donor breastmilk banking in developing countries. However, successful implementation of donor human milk (DHM) banks in settings with high HIV prevalence has been questionable especially when compounded by cultural issues.
“In countries where DHM banks have been successfully established the crucial role played by health workers to ensure acceptability and success of DHM banks has been stressed. Breastfeeding benefits both the child and the mother resulting in improved future intelligence, economic development and reduced mortality [7–12]. Breastmilk, whether mother’s own milk or DHM, is viewed as superior to infant formula even in HIV prevalent areas.”
The study was conducted at Parirenyatwa Group of Hospitals, Harare Central Hospital and Mpilo Central Hospital in the two major cities of Zimbabwe between October 2017 and October 2018. These are the major referral hospitals in the country and these hospitals are potential pilot locations for establishing breastmilk banks in the country.
“Harare is the capital city of Zimbabwe and has a total population of 2,123,132 (according to the 2012 Census) with a proportion of women of child bearing age of 58.6%, and children below the age of five at 14.1%. Bulawayo is the second largest city in the country.
“A cross-sectional survey was conducted among health workers at three tertiary health institutions. A mixed methods approach was applied using both quantitative and qualitative methods. Key informant interviews were conducted with hospital management to explore the readiness of Zimbabwe tertiary hospitals to implement donor breastmilk banks, in addition to opinion leaders involved in health and nutrition policies.”
The three referral hospitals were purposively selected, and a systematic random sampling method used to select health workers to be interviewed from maternal, medical and paediatric wards as well as nutrition departments. Sample size was based on Naing’s formula using α = 0.05 and 95% significance level and 50% estimated prevalence of knowledge, attitude and perceptions.
A sample size of 384 health workers from the three hospitals was found to be adequate. Fifteen key informants were purposively selected so as to include all relevant. International Breastfeeding ournal (2020) 15:37 Page 2 of 11 administrative departments at each health institution and national management in the Ministry responsible for Health and Child Care.
Health workers working at Parirenyatwa Group of Hospitals, Harare Central Hospital and Mpilo Central Hospital at the time of data collection were eligible to participate in the study. Health workers were grouped based on their professional roles; doctors, nurses, midwives, nutrition and general staff.