Evaluation database

Evaluation report

2000 BHG: Breastfeeding in Republika Srpska



Author: Loliæ, A.; Loliæ, B.; Stijak, M.; Tanjga, R.

Executive summary

Background

UNICEF and WHO have initiated a Global Initiative for promotion, support and protection of breastfeeding: in 1981, the International Code of Marketing for replacement food for mother’s milk was created, in 1990 Declaration Innocenti was passed, in 1992 Baby Friendly Hospital Initiative was introduced.  In the Republic of Srpska, this initiative has been existed from 1997 in the form of a national program for promotion, support and protection of breastfeeding. The Clinic for Gynecology and Obstetrics of the Clinical Center in Banja Luka was declared a Baby Friendly Hospital on October 6, 1998.

Purpose / Objective

Health statistics in Republic of Srpska so far did not include data on breastfeeding. However, there was a need for the overall survey on breastfeeding, which would allow insight on the current situation and enable better planning of breastfeeding promotion activities. Pilot project - Breastfeeding in the Republic of Srpska was prepared as a necessary prerequisite for such a survey in October 1999. Report on its realization was submitted to UNICEF and obtained data were used for the preparation of project "Breastfeeding in the Republic of Srpska."

Specific goals of the project are:

- Check relevant factors that influence breastfeeding
- Based on the survey result, give proposal of measures for the promotion of breastfeeding in the Republic of Srpska

Methodology

Households with children up to 5 years are defined as the target population. According to the assessment, Republic of Srpska has a population of 1,404,569, out of which 158,301 are children younger than 6 years (11.27%). Out of 494,691 households, 2,900 were interviewed (0.57%). 1,256 children were included. 47.43% are in villages and 52.57% in cities.

People that conducted this survey were selected and trained in the one-day educational seminar. During the seminar, they got written instructions for filling in survey questionnaire and two record lists.

Key Findings and Conclusions

In the 2,900 households sampled, 1,256 children under 5 were found and, out of that, 166 were infants (children up to one year old). 47.5% families have 1 child; 40.42% families have 2 children; 9.42% families have three children while only 3.65% families have more than three children. 88.93% of the mothers delivered between 19 to 36 years of age, 4.62% were younger than 19 years and 6.45% were older than 36 years.

72.20% mothers in RS did not get home visits in the first month of their child's life. Most of the mothers (94.7%) have taken their child to a doctor for the first examination (whereas the child was not sick) during first two months of life. Data are quite uniform for regions (somewhat unfavorable for the region of Doboj 90%).

Most of the mothers in RS get information on breastfeeding from health workers (48.39%), and from mothers and mothers-in-law (32.92%). In the region of Banja Luka, 72.23% mothers get first information from doctors or medical nurses; 14.99% from mother or mother-in-law; 6.13% through television, radio or newspapers. In the region of Doboj, the information from health workers is much lower. The rest is the same as for the region of Banja Luka.

Giving preparations with D3 or AD3 vitamins is the same in all regions and coverage is quite good (97.37%). According to the preliminary research regarding the frequency of nutritional anemia in pre-school children, every third child is anemic. Overall, 24.52% are taking preparations with iron. In the region of Banja Luka 29.49%; in Srpsko Sarajevo, almost not at all at 2.23%; and in the region of Trebinje, 1.18%. It can only be considered sufficient in the region of Doboj 45.52% but we should define the length of therapy and dose, which was not possible in this survey.

Data on breastfeeding:
- 95.78% children breastfed at least once, data by region does not differ significantly
- 1.46% children were exclusively breastfeeding up to 4 months old [elsewhere, report says 1.64% - unclear which one is the typo]
- 0.58% children were exclusively breastfeeding up to 6 months
- 68.39% children were mainly breastfeeding up to 4 months
- 54.62% children were mainly breastfeeding up to 6 months
- 23.46% children were continually breastfeeding during the first year
- 27.57% children were breastfed in the first 2 hours after birth
- 57.5% within 24 hours after birth
- 13.87% within 24 hours after birth.

- 46.45% children started with supplemented nutrition on time
- Average age of children when they stopped breastfeeding is 7.16 months
- 48.11% children were breastfed upon request
- 41.69% children were breastfeeding with nipple bottle
- 21.18% children were using adapted milk
- Average age of children when they started getting water was 27.15 days
- Average age of children when they started getting tea was 13.13 days

As to the reason for stopping breastfeeding, most of the mothers in RS answered "the milk was not enough" (41.27%) then "personal choice" (33.42%). In Srpsko Sarajevo and in Trebinje, the first choice was "personal choice of mother."

Researchers compared the number of women who breastfed their babies within two hours of birth from before and after the implementation of the Baby Friendly Hospital Initiative and no significant difference was found. However, a statistical difference was found in placing the baby with the mother from birth.

Recommendations

Establish home visit services in all places in Republic of Srpska and strengthen their staff.

Continue with the implementation of the program "School for pregnant women in Republic of Srpska", "Implementation of the international codex of marketing - replacement for mother's milk in Republic of Srpska" and "Prevention of nutritional anemia in children under 5 years in Republic of Srpska."



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Report information

Date:
2000

Region:
CEE/CIS

Country:
Bosnia-Herzegovina

Type:
Survey

Theme:
Health - Pre/Post Natal Care

Partners:

PIDB:

Follow Up:

Language:
English

Sequence Number:
2000/003

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