An Assessment of Knowledge of Health Workers in Hospitals of Southern Province of Zambia, Towards Marketing of Breastmilk Substitutes Regulations

Abstract

Background: Optimal breastfeeding practices have been undermined by unregulated marketing of breastmilk substitutes worldwide, resulting in about 820, 000 preventable deaths per year among children under five years globally. The International Code (thereafter called the Code) of Marketing Breastmilk Substitutes was developed by the World Health Organization, the United Nations Children's Emergency Fund and stakeholders to protect, promote and support breastfeeding. Member states are expected to domesticate the Code. Zambia enacted Statutory Instrument No. 48 of 2006, Regulations on marketing of breastmilk substitutes. Successful implementation calls for a good level of knowledge among health workers. However, we found no study, in Zambia on the marketing of breastmilk substitutes Regulations. Objective: To assess the level of knowledge of health workers on Zambia’s Regulations on marketing breastmilk substitutes. Study design and methods: A mixed-method cross-sectional study. Data was collected online and in person. Probability proportional to size calculation yielded an estimated sample size of 384. A sample size of 410 after adjusting upwards assumed non-response rate, 401 participants responded. Quantitative data were analyzed using the Social Statistical Package for Social Sciences. Knowledge results were described by frequencies and percentages. Tests were conducted using univariable linear and multivariable regression analysis. A p-value of <0.05 was considered statistically significant. Thematic analysis was used for qualitative data analysis. Results: The mean overall level of good knowledge of health workers was 0.339 or 34% [SE: 0.0221; 95%CI: (0.2959, 0.3828)]. Conclusion: The level of knowledge among health workers in hospitals of Southern Province, Zambia was poor.