Date of Award

12-2023

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Shela Hirani

Second Advisor

Ms. Zohra Kurji

Third Advisor

Dr. Rozina Karmaliani

Department

Community Health Sciences

Abstract

Background: Pakistan suffers from one of the highest infant mortality rates in the world, which is 42 per 1,000 live births, while the SDGs aim for 12 per 1,000 live births, one of the reasons being, insufficient rates of breastfeeding. The prime intervention for decreasing under[1]five child mortality is to increase breastfeeding behavior which is crucial for the achievement of many SDGs by 2030, to help upgrade the child and maternal mortality, economy, nutrition and human capital. PDHS 2017-18 shows the practice of using formula milk has increased majorly due to the increase in number of mothers deciding to go to work, as breastfeeding policies at organization’s level do not exist in Pakistan that enable employed women to take breaks to breastfeed or express breast milk during working hours. The purpose of the research was to explore the experience of working mothers to breastfeed their children, through qualitative study and to identify the barriers, to suggest for the healthcare facility- based interventions to increase the rate of exclusive breastfeed to optimal level, along with their respective job responsibilities. Resuming work after maternal leave affects exclusive breastfeeding duration and intensity. The absence of a separate, private and comfortable place to breastfeed at work, inflexible working hours for milk expression and lactation and lack of a breastfeeding support policy have been indicating a considerable drop in duration of exclusive breastfeeding in women after resuming work. The rationale was based on the fact that no such study was undertaken in healthcare settings especially in private and public healthcare settings, that are often busy (with high influx of patients), has limited flexibility and space for breastfeeding mothers who are employees. It was also intended to know the physical support, (feeding rooms with facilities to express and store breast milk) and support in letting the working mothers take breaks in between duty hours to feed their babies under two different hospital settings. This study will also enable the researcher to make recommendations based on the findings from both public and private healthcare facilities.
Objectives: 1) To understand the availability of exclusive breastfeeding support to working mothers in tertiary healthcare facilities in Karachi. 2) To understand the challenges faced by the management of the tertiary health facilities in providing optimal support in facilitating Exclusive breastfeeding support to working mothers in tertiary healthcare facilities.
Methodology: The study design is qualitative exploratory, comprising of in-depth, open ended semi structured questions, taken from 20 full time purposively selected working mothers 6 having children aged more than 3 months and less than 1yr, from one public tertiary and one private tertiary hospital of Karachi. In-depth interviews were also conducted from 10 key informants of both public and private tertiary health facilities, by the author and the colleague, with the help of audio recorder. The participant was given unique identification number, against which the information was transcribed and translated in verbatim. The hard copy of the information will be stored in lock and key until seven years as per Aga Khan University policy.
Results: 5 themes emerged from the study; Attributes of working mothers, challenges in breastfeeding, breastfeeding support, Career growth and EBF strengthening recommendations. Based on these themes, it was found that challenges in EBF came due to mother’s inadequate knowledge, inadequate formal and informal support from workplace., while it was facilitated by family and friends and support from workplace. It also showed increase work life balance of the working mothers.
Conclusion: Inflexible working hours, insufficient physical facilities, inadequate knowledge of mothers in regards to combating challenges in EBF, coupled with scarcity of both formal and informal support at the workplace significantly puts a hurdle in the way of maximum EBF. Proper antenatal education of the women, presence of a support systems of the family, friends, colleagues and supervisors, presence of physical facilities not only boost up the intention and confidence of a working mother to tackle challenges associated with EBF at workplace but also increases their work productivity, loyalty to their employment and enables them to be self-reliant.

First Page

1

Last Page

140

Download

Share

COinS