| dc.description.abstract | The Successful Breastfeeding steps of Baby Friendly Hospital Initiative (BFHI) is the model
of the international standard of promoting breastfeeding rates. Nonetheless, sub-optimal
breastfeeding is one of the greatest public health concerns that cause almost a half of all the
deaths of children worldwide. The situation is especially acute in the area where this study was
conducted; Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) that has
reported the lowest rate of exclusive breastfeeding; only 50 per cent, which is way below the
BFHI standard of 80 per cent. Although this is but one of the reported steps to successful
breastfeeding (Exclusive breastfeeding), the gap points at key failures in implementing
successful breastfeeding. Thus, this research was conducted to evaluate the knowledge of
mothers and identify the practice of the key clinical steps of Successful Breastfeeding and
establish the relationship between the knowledge and practice of these steps. The design used
was a cross-sectional one and comprised of 79 breastfeeding mothers in JOOTRH selected by
systematic sampling. A researcher-administered questionnaire and an observational checklist
were used to collect data. The patterns of knowledge and practice were described by descriptive
statistics (frequencies and percentages), whereas binary logistic regression was used to assess
the correlation between knowledge and practice, with maternal age, education, and marital
status as control variables. The results indicated a strong knowledge-practice gap. The
knowledge of the mothers on most of the steps was according to the WHO/UNICEF
requirements. These include step 3 (94.9%), step 6 (93.7%), step 7 (94.9%), step 8 (92.4%),
and step 9 (81%), However, this success masked a severe deficit in actionable skills on step 3
(11.4%), step 4 (72.2%), step 5 (38%), and step 10 (21.5%). Furthermore, there was no
statistically significant relationship between knowledge and corresponding practices for any of
the steps (p > 0.05) according to the Logistic regression analysis results. However, negative
directional associations were observed in step 3 (AOR =0.132) and step 6 (AOR =0.702) while
other steps showed a while positive directional association (AOR > 1). The findings show that
mothers’ knowledge was not sufficient to translate into skills to promote successful
breastfeeding. Strengthening BFHI implementation should therefore prioritize hands-on, skill
based coaching by nurses and integrate post-discharge breastfeeding support through
Community Health Volunteer (CHV) programs to ensure sustained practice and improved
child survival outcomes. There is a need for longitudinal studies to assess the sustainability of
breastfeeding post-discharge. | en_US |
