Influencing women's attitudes and intentions to enhance exclusive breastfeeding in Kenya: Value of health education and peer counseling

Abstract

Background: Exclusive breastfeeding (EBF) rates are low in Kenya. Knowledge of the motivators and deterrents of EBF can facilitate development of strategies to promote EBF. We use the `Theory of Planned Behavior' (TPB) to understand factors and identify strategies that influence women's beliefs, attitudes, perceived power, intentions and actual practice of EBF. Methods: We conducted 22 focus group discussions with women and men enrolled in a before-and-after trial to determine whether intensified breastfeeding counseling enhanced EBF. The constructs of TBP were used to deductively identify prominent themes. Results: Findings indicate that breastfeeding is not a problem; rather the exclusive part of it is challenging. Reasons for not exclusively breastfeeding: lack of education; compliance with cultural norms; and negative beliefs and attitudes to breastfeeding. Access to health education, peer counseling, desire to prevent infant HIV transmission, and male partner support motivate women to exclusively breastfeed. Conclusions: Consistent with the constructs of TPB, strategies that foster favorable beliefs and attitudes toward EBF ultimately promote women's intentions to practice EBF. Introducing interventions that enhance positive attitudes toward EBF could potentially increase EBF practice.