Naslov
Effectiveness of the UNICEF/WHO 20-hour Course in Improving Health Professionals’ Knowledge, Practices, and Attitudes to Breastfeeding: Before/After Study of 5 Maternity Facilities in Croatia

Autori
Zakarija-Grković, Irena ; Burmaz , Tea

Izvornik
Croatian medical journal (0353-9504) 51 (2010); 396-405

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
breastfeeding training; health professionals; knowledge; attitudes; practice; Croatia

Sažetak
Aim To assess the effectiveness of the UNICEF/WHO 20-hour course in improving the knowledge, practices and attitudes (KAP) of health professionals (HPs) to breastfeeding as well as to evaluate breastfeeding KAP among Croatian HPs. Methods Five out of nine maternity hospitals in Dalmatia, southern Croatia, which had completed the UNICEF/WHO 20-hour breastfeeding training course between December 2007 and February 2009, were included in the study. An anonymous questionnaire testing KAP was distributed to 424 HPs before training and to 308 HPs afterwards. HP attitudes were assessed using the validated Iowa Infant Feeding Attitude Scale (IIFAS). Results The pre-training response rate was >90%, but only 53% of data was analyzed ; the post- training response rate was 69%. Overall, there was significant improvement in breastfeeding KAP following the course. Only one-fifth of HPs prior to training knew that breast preparation in pregnancy was unnecessary, but this increased to 57% post-training (P<0.001). The proportion of HPs who recognized hospital practices that support breastfeeding and signs of poor positioning when breastfeeding nearly doubled after training (P<0.001). The proportion of HPs correctly recommending immediate ‘skin-to-skin’ contact post-Caesarean section under local anaesthesia did not improve significantly, and stratification analyses showed that younger respondents (<36 years) were more likely to support this practice. Although the proportion of HPs who correctly managed mastitis improved significantly as a result of the training, the proportion of those, post-training, who inappropriately recommended partial or complete cessation of breastfeeding, remained high at 47%. The number of staff with positive attitudes towards breastfeeding increased from 65% to 79%, whereas the number of staff with neutral attitudes dropped from 26.6% to 9.9% (P< 0.001). Even after training, a substantial proportion of HPs showed uncertainty in their attitude towards alcohol consumption and breastfeeding. Conclusion The UNICEF/WHO 20-hour course appears to be an effective tool for improving health professionals’ breastfeeding knowledge, attitudes and practices. Results from this research may be used to enhance and develop breastfeeding training programs.

Izvorni jezik
Engleski

Znanstvena područja
Javno zdravstvo i zdravstvena zaštita

POVEZANOST RADA