Socio-demographic characteristics
The average age of the participants was 26.8 years and the majority of the respondents had a high school education. Some authors have mentioned the same subject as us. In these studies, the average age ranged from 26 to 30 years 8,9,16,17. This average age difference could be due to the fact that these authors conducted their studies in rural areas. In urban areas, women tend to study and most often stop at the secondary level because of their pregnancy. Public servants, in our case, represented only 10.9% of the respondents. This could be explained by the fact that in urban areas they have less conception and tend to send their children for post-natal consultations by others.
Knowledge, Attitudes And Practices Of Mothers Of Children
Mothers' level of knowledge of EBF is considered unsatisfactory (78.4%). The main reason is the lack of information on this concept. Indeed, some mothers 147/357 or 48.1% mentioned the only source of information : health services, which do so intermittently. Also, by intuition 49/357 or 13.7% of mothers had cited the protection of the child from illness as one of the advantages of exclusive breastfeeding. Some authors have given better results than ours 12,16, ranging from 16.9–99.3%. This difference could be explained by the fact that the women interviewed in these different studies were aware of the benefits of exclusive breastfeeding. Moreover, the mothers' favourable attitude does not contrast with their practice of EBF because only 33.9% practiced it. This explains why most of the respondents were shopkeepers or students and had unsatisfactory knowledge of the subject. Exclusive breastfeeding is practiced by 33.9% of the women surveyed. This is consistent with the results reported by UNICEF and some authors regarding the low prevalence of EBF in sub-Saharan Africa 7,8,9,16,17,18, and even in North Africa 15. In contrast, this prevalence is higher in Western countries, ranging from 57% to more than 70% 17–20. In our case, the lack of awareness among women could explain this low prevalence, even though we have not explored the other deep reasons for the poor practice of EBF.
Influence Of Socio-demographic Characteristics On Knowledge
Factors related to a higher level of satisfactory knowledge about EBF were being between 26 and 35 years of age, being a civil servant and also being multiparous. Kazaura's work in Tanzania has similar results to ours 9. These results differ from those of Ihudiebube-Splendor et al. in Nigeria, which showed that neither age, marital status nor function were associated with a satisfactory knowledge of EBF 21. This difference is explained by the fact that our study concerned all women, unlike Ihudiebube-Splendor, who worked only on primiparous women. In addition, civil servant mothers have more access to information about EBF by having sources of information other than health services such as the media. Multiparous mothers had already been in contact with health workers several times, particularly midwives, compared to other mothers.
Influence Of Knowledge On Mothers' Attitudes Towards Ebf
Satisfactory knowledge did not necessarily imply attitudes favourable to EBF in our study. Some authors have been able to establish factors influencing the positive attitude towards EBF, namely the mother's age and occupation 22, and even in some sub-Saharan African countries where the prevalence of EBF is quite high 23. This difference could be explained by Noumbissi's theory, which points out that apart from the knowledge that people may have about a given fact or in the adoption of a given behaviour, there are other intermediate factors such as social values, representations and beliefs that are likely to explain the attitude of these people towards that fact 24.
Influence of mothers' knowledge and attitudes on the practice of EBF
Taking the mother's education, occupation and parity into account in the multiple logistic regression, the mothers' knowledge level influences their practice on EBF. However, we observed that the attitude does not necessarily imply good practice of the EBF. This study did not address the reasons or obstacles to the impracticality of EBF as discussed by several authors in sub-Saharan Africa or developing countries 10,25,26,27,28. There may be other obstacles that prevent the implementation of a positive attitude in practice. These obstacles are present when the mother has to make a decision, as the Noumbissi research points out that practices are sometimes influenced by beliefs, representation and society 24.
Limitations Of The Study
There was the retrospective nature of some of the questions asked to mothers, which could lead to memory bias. Although the mothers' consent was obtained before the questionnaire was administered, some of them were reluctant, which could lead to information bias. Finally, the study took place only in health facilities and not in the community. For mothers who gave something else with breast milk, the study did not specify when they introduced the breast milk supplement.