Assessment of Exclusive Breastfeeding Practice among Palestinian Mothers in the Gaza Strip: A Mixed Methods Design

Abstract

Aims: This study was conducted to assess breastfeeding (BF) among the mothers in the Gaza Strip, particularly to determine the prevalence and the associated factors of Exclusive Breastfeeding (EBF), and to explore mothers’ EBF perceptions and practices. Study Design: A mixed methods design. Place and Duration of Study: This study was carried out among mothers in the households between April and October 2012 in three areas in the Gaza Strip, namely, El Remal urban area, Jabalia camp, and Al Qarara rural area. Methodology: A multi-stage cluster sampling method was used to recruit 357 mothers of children aged 2-5 years in the Gaza Strip. Purposive sampling was used for a qualitative study. Descriptive statistics were applied to quantitative data (p<0.05), and content analysis was used for qualitative data. Results: Almost all mothers practiced BF (97.8%), whereas the low proportion of mothers (24.4%) practiced EBF for 6 months. Results showed 75.6% of the mothers introduced complementary food to their infants at an early age. Results revealed that the practice of EBF was statistically significant among young age of mothers (CI -3.34,-0.25; p=0. 022), low child’s order (CI -1.19,-0.07; p=0. 028), and mothers with few children (CI -0.99,-0.03; p=0. 037). The qualitative findings showed the primary constraints to EBF to be the perceptions of mothers that breastmilk was not enough for baby's growth, and mothers –in- law influenced the mothers’ EBF practices. Conclusion: In this study, the prevalence of EBF for six months remains low among the mothers in the Gaza Strip. The associated factors of EBF among the mothers were an age of mother, child's birth order, and the number of children. Health care workers should educate and emphasis mothers, grandmothers, and mothers-in-law on the importance of EBF.