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Exploring women’s views on infant feeding and mobile health to promote exclusive breastfeeding in Roatán, Honduras, a location of high infant mortality

University of California San Francisco School of Medicine1, Universidad Catolica de Honduras2, Universidad Nacional Autonoma de Honduras3, UC Davis School of Medicine4Daniela I. Brissett1, Lyolya Hovhannisyan1, Noely Larios2, Ana Murillo3, Francisco Panchame2, Jihey Yuk4, Lisa Rasmussen4, Arup Roy-Burman1, Julie Herlihy4, Karla Cerritos3,Caroline Chantry4

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An exclusively breastfed (EBF) child is 14xless likely to die in the first 6 months than anon-breastfed child (UNICEF, 2015). InHonduras, the infant mortality is 3x that of theUnited States (CIA, 2015). 39% of infantsunder six months of age in the developingworld are exclusively breastfed compared to31% in Honduras (UNICEF, 2013). Maternaland Child Nutrition series showed that EBFand early initiation of breastfeeding promotionprograms could prevent 13% of under-fivechildren deaths and almost 20% of neonataldeaths (Lancet, 2013)

• Breastfeeding is a common practice inRoatan, Honduras; however exclusivebreastfeeding under the age of 6 monthsis not.

• Mothers acknowledged breastfeedingprovides the best infant nutritionthough specific benefits were unknown.

• Barriers to exclusive breastfeedinginclude beliefs that formula makesstronger infants and herbal teas (i.e.Anise) are soothing for infantile colic.

• All participants supported the plannedmobile messaging intervention with themajority of women possessing mobilephones.

• Perceived barriers included limitedmobile internet to access animatedmessages.

39%

The WorldLatin America and

the Caribbean29%

West and Central Africa

Eastern and Southern Africa

East Asia and the Pacific

1. To explore women’s experiences withand opinions regarding, infant feeding

2. To assess women’s views of ourproposed SMS messaging platform toincrease rates of exclusive breastfeeding

Aims

To design a culturally informed supportand educational messages to addresscultural norms, barriers and promoteexclusive breastfeeding via SMSplatform.

Future Aims

32%

Worldwide Rates of Exclusive Breastfeeding

16%

32%

20%

28%

4%0%

5%

10%

15%

20%

25%

30%

35%

<1 week 1 week-1 month 1-2 months 2-4 months 4-6 months

Figure 2. Rates of exclusive breastfeeding around the world. Note, the study site, Roatán, Honduras is highlighted with a star. Statistics provided by UNICEF.

Background Conclusion

A.

D.C.

B.

A.

D.

C.

Figure 1. Map of participating clinic sites on Roatán, Honduras. A. Public Hospitalof Roatán B. Los Fuertes Clinic C. French Harbor Clinic D. Oak Ridge Clinic

Figure 6. Proposed SMS intervention study. Image created by UCSF investigator, Trevor Brooks

Study Financial Considerations: Funded by UCSF Research Grant with support from Global Healing 501 (c)(3) Berkeley, CA.

Middle East and Northern Africa

31%

South Asia

12 Focus Groups 4 Public Health Clinics in Roatán, Honduras

36 Pregnant women and/or women with infant feeding experience within the last 2 years

Used a semi-structured questionnaire on knowledge, attitudes, and practices of

infant feeding

“That babies grow up healthy, not sick, and not malnourished.”

“To me it was my baby's health, as mother the first thing you have to know, the most important thing is your baby's health and when you breastfeed they don't get sick.”

“She hurt my boobs and I had blood, that's why I didn't want to breastfeed. And my grandma told me to, that I had to stand

it because her health was more important.”

“I relied more on doctors because they know about breast milk, they know what to

do or not to do, where to go when something happens to the kids.”

“[Anise] is good for the babies because it cleans their stomach and sometimes

they need that when they’re sick from it, anis helps them a lot”

“ Yes [ it is a good intervention] because that way we would be advised

on how to improve”

Breastfeeding support

Supplemental Alimentation

Breastfeeding Benefits

Receptiveness to SMS-Messaging Intervention

Motivation to breastfedBarriers to breastfeeding

Better immunity

More vitamins and minerals

Easier Digestion

Better weight gain and growth

Health professional

SpouseMother

Healthier infant Difficulty with milk letdown

Mastitis Work

Cost effective

Participant Demographics

50% Had less than 6th grade education

33% First time Mothers

Average household salary $260;Honduran average monthly household salary $466 (World Bank, 2011).

Correlation between infant age and rates of exclusive breastfeeding

Alternative alimentation used for infants less than 6 months of age

Water

Tea

Anise

Infant formula

Natural Fruit Juice

Processed Fruit Juice

Figure 5. The most common alternative alimentation (to breast milk) was anise. Anise is traditional herb tea supplemented with water given to infants as early as one of age, a tradition that has spanned generation on Roatan, Honduras. Additionally, infant formula was commonly introduced.

57%

35%

59%

Focus Group Representative Responses to Common Themes

Honduras

Figure 3. The education level, parity, and average household salary of participants.

Figure 4.

Methods

31%

B.

Poster submission for UN SDG conference

Hi,

My name is Jihey Yuk, a pediatric resident at Davis.  Please find a�ached the poster from our research projectbased out of Roatan, Honduras.  

We are conduc�ng a study to inves�gate the efficacy of text messaging pla嶍�orm in improving rate of exclusivebreas嶍�eeding among new mothers on the island of Roatan, Honduras.  Prior to star�ng interven�on part of thestudy, we have conducted a qualita�ve study to understand mother's experiences and thoughts on breas嶍�eeding‐ this poster is based on the findings from the focus groups.

Thank you for your considera�on.

Best,Jihey Yuk

Jihey Yuk, MD PGY‐3UC Davis Pediatricsjyuk@ucdavis.edu808‐372‐7146

Jihey Yuk

Sat 12/31/2016 9:41 AM

Inbox

To:SDGConference <sdgconference@ucdavis.edu>;

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