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Background: The protection, promotion and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality in all contexts, especially in humanitarian crisis.
During the Palestine-Israel conflict that started in the middle of the 20th century, healthcare services are understaffed and lack basic resources, with frequent power cuts and stock-outs of essential drugs and equipment. This case study seeks to answer the questions: (1) How does the protracted crisis in Gaza affect the breastfeeding practices of the most vulnerable population; and (2) What is the role that midwives can play in improving breastfeeding practices?
A mixed method (qualitative and quantitative) study was used to collect data. A total of 1044 respondents had a child less than 24 months at the time of the study. A total of 62.75 percent practice early initiation of breastfeeding and 42 percent confirmed that their new-borns were given liquids other than breast milk during the first three days of life. Fifty percent of mothers addressed breast milk insufficiency by drinking additional fluids and 40 percent by using infant formula. More than 50% of women said that they received most breastfeeding information during antenatal care visits. Only 18% of women said that they received breastfeeding information during contact with health professionals throughout labour, delivery, and subsequent post-natal care visits. Many mothers during the FGDs confirm using milk to top up or replace breast milk even if they know how important breastfeeding is for the children
Discussion: This study confirms the need to a) adapt the IYCF-E operational guidance in the Gaza strip and b) include breastfeeding counselling in the pre-service and in-service training for midwives. For vulnerable populations in humanitarian contexts, the impact of this cannot be underestimated.
Conducting research in humanitarian settings is particularly challenging. The experience included integration and linkage with security officers on the ground, co-ordination with authorities and communities, supportive supervision during data collection, allocation of buffer days in-country and remote assistance to data collection teams
Conclusions: This research focuses on a protracted emergency in insecure populated areas. The uncertain security situation, meant that the team adopted a flexible approach. Lessons learned throughout this exercise included the importance of a) allocating additional research time, to account for potential interruption b) daily coordination with security officers to ensure safe access to localities c) identification of extra sites, in case escalation of conflict d) training of additional enumerators in case conflict escalation e) negotiation with authorities to ensure compliance with requirements.
Keywords
Breastfeeding, Breastfeeding in emergencies, IYCF, IYCF-E, New-born care, Early initiation of breastfeeding, Infant feeding in emergencies, Midwife, Counselling, BFHI
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CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Editorial decision: Major revision
On 03 Feb, 2021
Review #1 received
Received 26 Jan, 2021
Review #2 received
Received 20 Jan, 2021
Reviewer #2 agreed
On 19 Jan, 2021
Reviewer #1 agreed
On 13 Jan, 2021
Reviewers invited
Invitations sent on 03 Jan, 2021
Editor assigned
On 22 Dec, 2020
Submission checks complete
On 22 Dec, 2020
Editor invited
On 22 Dec, 2020
Version 2
Posted 16 Oct, 2020
No comments provided
Editorial decision: Major revision
On 15 Nov, 2020
Review #2 received
Received 11 Nov, 2020
Review #1 received
Received 13 Oct, 2020
Reviewer #2 agreed
On 11 Oct, 2020
Editor assigned
On 06 Oct, 2020
Reviewers invited
Invitations sent on 06 Oct, 2020
Reviewer #1 agreed
On 06 Oct, 2020
Submission checks complete
On 05 Oct, 2020
Editor invited
On 05 Oct, 2020
No comments provided
Editorial decision: Major revision
On 02 Sep, 2020
Review #2 received
Received 01 Sep, 2020
Reviewer #2 agreed
On 24 Aug, 2020
Review #1 received
Received 14 Jul, 2020
Reviewer #1 agreed
On 24 Jun, 2020
Reviewers invited
Invitations sent on 22 May, 2020
Editor assigned
On 20 May, 2020
Submission checks complete
On 16 May, 2020
Editor invited
On 13 May, 2020
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A new preprint design is coming!
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See the published version of this preprint at BMC Public Health.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research in practice
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Public Health.
No community comments so far
Editorial decision: Major revision
On 03 Feb, 2021
Review #1 received
Received 26 Jan, 2021
Review #2 received
Received 20 Jan, 2021
Reviewer #2 agreed
On 19 Jan, 2021
Reviewer #1 agreed
On 13 Jan, 2021
Reviewers invited
Invitations sent on 03 Jan, 2021
Editor assigned
On 22 Dec, 2020
Submission checks complete
On 22 Dec, 2020
Editor invited
On 22 Dec, 2020
Version 2
Posted 16 Oct, 2020
No comments provided
Editorial decision: Major revision
On 15 Nov, 2020
Review #2 received
Received 11 Nov, 2020
Review #1 received
Received 13 Oct, 2020
Reviewer #2 agreed
On 11 Oct, 2020
Editor assigned
On 06 Oct, 2020
Reviewers invited
Invitations sent on 06 Oct, 2020
Reviewer #1 agreed
On 06 Oct, 2020
Submission checks complete
On 05 Oct, 2020
Editor invited
On 05 Oct, 2020
No comments provided
Editorial decision: Major revision
On 02 Sep, 2020
Review #2 received
Received 01 Sep, 2020
Reviewer #2 agreed
On 24 Aug, 2020
Review #1 received
Received 14 Jul, 2020
Reviewer #1 agreed
On 24 Jun, 2020
Reviewers invited
Invitations sent on 22 May, 2020
Editor assigned
On 20 May, 2020
Submission checks complete
On 16 May, 2020
Editor invited
On 13 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Public Health.
Background: The protection, promotion and support of breastfeeding is the most effective intervention to prevent child morbidity and mortality in all contexts, especially in humanitarian crisis.
During the Palestine-Israel conflict that started in the middle of the 20th century, healthcare services are understaffed and lack basic resources, with frequent power cuts and stock-outs of essential drugs and equipment. This case study seeks to answer the questions: (1) How does the protracted crisis in Gaza affect the breastfeeding practices of the most vulnerable population; and (2) What is the role that midwives can play in improving breastfeeding practices?
A mixed method (qualitative and quantitative) study was used to collect data. A total of 1044 respondents had a child less than 24 months at the time of the study. A total of 62.75 percent practice early initiation of breastfeeding and 42 percent confirmed that their new-borns were given liquids other than breast milk during the first three days of life. Fifty percent of mothers addressed breast milk insufficiency by drinking additional fluids and 40 percent by using infant formula. More than 50% of women said that they received most breastfeeding information during antenatal care visits. Only 18% of women said that they received breastfeeding information during contact with health professionals throughout labour, delivery, and subsequent post-natal care visits. Many mothers during the FGDs confirm using milk to top up or replace breast milk even if they know how important breastfeeding is for the children
Discussion: This study confirms the need to a) adapt the IYCF-E operational guidance in the Gaza strip and b) include breastfeeding counselling in the pre-service and in-service training for midwives. For vulnerable populations in humanitarian contexts, the impact of this cannot be underestimated.
Conducting research in humanitarian settings is particularly challenging. The experience included integration and linkage with security officers on the ground, co-ordination with authorities and communities, supportive supervision during data collection, allocation of buffer days in-country and remote assistance to data collection teams
Conclusions: This research focuses on a protracted emergency in insecure populated areas. The uncertain security situation, meant that the team adopted a flexible approach. Lessons learned throughout this exercise included the importance of a) allocating additional research time, to account for potential interruption b) daily coordination with security officers to ensure safe access to localities c) identification of extra sites, in case escalation of conflict d) training of additional enumerators in case conflict escalation e) negotiation with authorities to ensure compliance with requirements.
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