Abstract

Exclusive breastfeeding’s coverage is low in Indonesia, because attitude, subjective norm and perceived behavioral control fail affecting exclusive breastfeeding intention and behavior. Objectives of research were to formulate exclusive breastfeeding behavior and to explore the relationship of attitude, subjective norm, and behavioral control to exclusive breastfeeding intention and behavior. Mixed method was conducted in rural areas of Karanganyar Regency, Indonesia. Firstly, this was a survey research with attitude, subjective norm, and perceived behavioral control being independent variables. Dependent variables were exclusive breastfeeding intention and behavior. Population of research consisted of 873 lactating mothers. Sampling technique employed was multistage random sampling, with 126 lactating mothers being the sample. Data was collected using questionnaire, data analysis using path analysis. Secondly, case study was conducted through in-depth interview, focus group discussion (FGD), document review, and observation. In-depth interview and FGD was conducted with 49 participants: 30 lactating mothers and 19 health workers. Data analysis was conducted content analysis. The result showed that attitude, affective norm, and perceived behavioral control correlated with exclusive breastfeeding intention (ß = 0.09; p = 0.084; ß = 0.09; p = 0.027; ß = 0.51; p <0.001, respectively). Perceived behavioral control and intention correlated with exclusive breastfeeding behavior (ß = 0.08; p = 0.059; ß = 0.09; p = 0.068, respectively). Exclusive breastfeeding behavior model included attitude, subjective norm, perceived behavioral control, and exclusive breastfeeding behavior. Attitude, subjective norm, and perceived behavioral control collectively correlated with intention; intention and perceived behavioral perception were direct determinants of exclusive breastfeeding behavior.

Highlights

  • The benefit of breastfeeding for health has been published widely

  • Exclusive breastfeeding’s coverage is low in Indonesia, because attitude, subjective norm and perceived behavioral control fail affecting exclusive breastfeeding intention and behavior

  • The secondary data showed that the level of exclusive breastfeeding in Karanganyar Regency, Central Java in 2013 was low at 14.93%, increased to 25.12% in 2014, and declined to 18.2% by 2015 (Karanganyar Regency Health Office, 2017)

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Summary

Introduction

Breastfeeding clearly benefits the child health in short term, protection against infectious disease-induced morbidity and mortality (Horta et al, 2007). Infants breastfed exclusively for 6 six months develop less gastrointestinal infection-induced morbidity than those fed with formula milk in at 3 or 4 month-age, and do not have growth deficit in both developing and developed countries (Kramer & Kakuma, 2002). To optimize infant growth and development, WHO and United Nations’ Children Fund (2003) recommend globally the optimization the exclusive breastfeeding up to six month and continued with lactating up to 2 years or more. In most countries the proportion of mother breastfeeding their infant exclusively up to six months is still low (Imdad et al, 2011)

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