BREASTFEEDING STATUS AMONG FEMALE TEACHERS IN PUBLIC PRIMARY SCHOOLS IN KAMPALA CAPITAL CITY

Abstract

Background: Breastfeeding is key in a child’s survival however it is a challenge among working mothers. The status of breastfeeding among teachers in public primary schools in Kampala is not known. Objective: To investigate the prevalence, perceptions and factors associated with breastfeeding among female teachers in public primary schools in Kampala Capital City Authority (KCCA). Methods: A cross sectional study was conducted in public primary schools in Kampala Capital City among female teachers with a child aged ≤24 months. A census was conducted among 79 public primary schools and yielded 121 respondents. The quantitative data was collected using a coded structured and semi-structured questionnaire. Qualitative data was collected by conducting in-depth interviews with seven female teachers with children aged less than 3 months and those with children aged 18 months and above while key informant interviews were conducted with five head teachers and an official from UNATU (Uganda National Teacher’ Association) and KCCA. Modified Poisson regression was performed to determine factors associated with breastfeeding using STATA version 13.0. Results: All teachers (100%) had ever breastfed the index child and most (58%) were still breastfeeding their children. Majority (63%) had initiated breastfeeding within one hour after delivery while 35.54% were or had practiced exclusive breastfeeding. The prevalence of breastfeeding among teachers that worked for more than 40 hours a week was 0.74 times lower than that of teachers that worked for less than 40 hours a week (APR= 0.74;95% CI: (0.56-0.97). The prevalence of breastfeeding among teachers with children aged 6-≤24 months was 0.52 times lower than that of teachers with children aged less than six months (APR= 0.52;95% CI: (0.41-0.65). Teachers had a positive attitude towards breastfeeding except for expression of breast milk and agreement with mix feeding. Majority (71%) disagreed with feeding children on expressed breast milk and 97% agreed with mixed feeding if the child is below 6 months. Most teachers were willing to support breastfeeding. Most schools had no facilities to support breastfeeding except one school. No school had a breastfeeding policy. Teachers’ code of conduct prohibits teachers from coming with their children to school. Maternity leave policy was being implemented but there was no plan for continuation of breastfeeding till at least 24 months. Conclusion: The prevalence of ever breastfed was 100% while 58% were breastfeeding at the time of the study therefore teachers have good breastfeeding practices but their chances reduce as the child grows older and according to the circumstances surrounding the workplace. Age of child influences teachers’ choice to continue breastfeeding or not thus age is an important predictor reflecting the value that female teachers attach to breastfeeding early on in life. Workload influences teachers’ time available to breastfeed thus it is an important determinant too and working conditions are key when promoting breastfeeding among working mothers. Teachers had a positive attitude and perception towards breastfeeding therefore given a conducive environment, they have a potential to breastfeed reflecting the value that working mothers attach to breastfeeding despite the circumstances that may not be conducive. Strategies to promote breastfeeding among teachers should address promotion of breastfeeding after maternity leave such as flexible working hours, day care centers as well as addressing the negative attitude of teachers towards expressing breast milk.