Abstract of Dissertation

Keyword : ASHAs; Breastfeeding; Complementary feeding; IYCF

Objective : ï‚· To study the knowledge, attitude, and practices of ASHAs regarding Infant and Young Child Feeding Practices. ï‚· To assess the impact of education on knowledge of ASHAs regarding IYCF.

Background : Promotion and support of breastfeeding is a globally most pressing and an important child survival intervention. Accredited social health activist (ASHAs) can play a striking role in promotion of breastfeeding. Breastfeeding has been accepted as the most vital intervention or reducing infant mortality and ensuring optimal growth and development of children. This holds more importance in context of infant and young child feeding (IYCF) in developing countries like India, where breast milk is the safest and mostly available and the most economical form of feeding options for the infant. An analysis showed that appropriate breastfeeding and complementary feeding practices can alone prevent under-five deaths by 19%.

Methodology : Study design: descriptive study cross sectional study Study area and duration: the study would be carried out for 3 months February – May) in Uttar Pradesh Study subjects: Accredited social health activists (ASHA) Sample size: 4 UPTSU Blocks namely (Banki, Siddhaur, Siraulli, Nindoora) of a district Barbanki of Uttar Pradesh and 25 ASHAs from each block. Total of 80 ASHAs from these four blocks. Data collection tool: a closed ended questionnaire would be used for interviewing the ASHAs for assessing their knowledge regarding Infant and Young Child Feeding practices. Statistical treatment: data entry and data analysis is done with the help of SPSS

Findings : Eighty one percent of the ASHAs know the age up to which child should be exclusively breastfed only 28 percent of ASHAs were able to answer the correct frequency of breastfeeding the study reveals that eighty three percent of ASHAs said complementary feeding should be started at the age of six months. The study predicts that more than half of the ASHAs said a child can receive breast milk up till two years even if complementary feeding is started According to the study forty one percent of ASHAs said water should be given in between breastfeeds which means they were following incorrect feeding practices. Almost 78 percent of ASHAs knew that breastfeeding reduces episodes of diarrhoea and pneumonia. Forty three percent of ASHAs said pre-lacteal feeds should be given to baby before initiation of breastfeeding. More than half of ASHAs said breastfeeding should not be continued when child is having fever or diarrhoea. Almost 86 percent of ASHAs know that colostrum should be given to baby. Majority of ASHAs said they should motivate the lactating mothers to take iron and calcium tablets. Almost 83 percent of ASHAs said low birth weight babies should be breastfed more frequently. The study suggested that Fifty nine percent of ASHAs said it is not necessary to take consultation from doctor before taking medicines if they were breastfeeding Sixty six percent of ASHAs said breastfeeding mothers should keep religious fasts. The study implicates that seventy one percent of ASHAs said additional diet should be given to breastfeeding mothers.

Recommendations : Majority of the ASHAs don’t have knowledge about the importance of breastfeeding when child is sick, how many times a child should be breast fed and whether it is necessary or not necessary for lactating mothers to take consultation from doctors if they have to take any medication. 66 percent of ASHAs said lactating mothers should keep religious fasts. Also, according to the study ASHAs with higher educational status were able to answer that breastfeeding reduces the episodes of diarrhoea and pneumonia and also majority of them responded that lactating mothers should take consultation from the doctor before taking any medication but some ASHAs despite of having higher educational status were not able to answer correctly that lactating mothers should not keep religious fasts. In order to enhance the knowledge of ASHAs on Infant and Young Child Feeding Practices below mentioned measures can be taken: ï‚· Orientation programs or refresher trainings should be conducted in order to enhance the knowledge of ASHAs to promote correct practices.\ ï‚· Capacity building of frontline workers by on the job mentoring and by providing them hand holding support. ï‚· Workshops related to IYCF should be conducted. ï‚· Behaviour change in ASHAs regarding IYCF by effective IEC methods and development of job aids. ï‚· Incorporation role plays to make them better understand the importance of breastfeeding for infants as well as mothers. ï‚· Supervisory visits should be planned

What is the existing knowledge among ASHAs regarding Infant and Young Child feeding practices?