Abstract
BackgroundMany low-and-middle-income countries, including South Africa, have high rates of teenage pregnancy. Following the World Health Organisation recommendations, South African health policy on infant feeding promotes exclusive breastfeeding until six months of age, with gradual weaning. At the same time, South Africa’s education department, in the interest of learners, promotes adolescents’ early return to school post-partum. Yet infant feeding at school is currently not perceived as a realistic option.MethodsRecognising his this policy tension, we aimed to explore how policies are interpreted and implemented by the health and education sectors through interviews with key informants who produce, interpret and implement these policies. Using an interview guide developed for this study, we conducted in-depth interviews with 24 health policy makers, managers in both sectors, school principals and nursing staff who manage adolescent mothers (aged 16-19) and their babies. Data was analysed using thematic analysis.ResultsInformants from both sectors expressed discomfort at pregnant learners remaining in school late in pregnancy and were uncertain about policy regarding when to return to school and how long to breast-feed. Educators reported that new mothers typically returned to school within a fortnight after delivery and that breastfeeding was not common. While health professionals highlighted the benefits of extended breastfeeding for infants and mothers, they recognised the potential conflict between the need for the mother to return to school and the recommendation for longer breastfeeding. Additionally, the need for ongoing support of young mothers and their families was highlighted.ConclusionsOur findings suggest educators should actively encourage school attendance in a healthy pregnant adolescent until delivery with later return to school, and health providers should focus attention on breastfeeding for the initial 4-6 weeks postpartum, followed by guided support of formula-feeding. We encourage the active engagement of adolescents’ mothers and extended families who are often involved in infant feeding and care decisions. Education and health departments must engage to facilitate the interests of both the mother and infant: some exclusive infant feeding together with a supported return to school for the adolescent mother.
Highlights
Many low-and-middle-income countries, including South Africa, have high rates of teenage preg‐ nancy
The main issues that emerged from the interviews with key informants in both the education and health sectors centred on discussion about how long the pregnant learner should remain in school; when the young mother should return to school; perceptions of how adolescent mothers experienced and approached breastfeeding; challenges regarding breastfeeding at school and in policy; as well as support for breastfeeding
Some informants indicated that a Learner Pregnancy Policy required that pregnant learners needed to obtain a medical certificate about their condition, regarding how long to stay in the classroom before giving birth, which was determined in discussion with the learner and her parent/s: if the learner finds out that she’s pregnant, it is requested that the learner must produce a medical certificate to say whether it’s advisable to remain at school or withdraw from school
Summary
Many low-and-middle-income countries, including South Africa, have high rates of teenage preg‐ nancy. Following the World Health Organisation recommendations, South African health policy on infant feeding promotes exclusive breastfeeding until six months of age, with gradual weaning. The ‘first 1000 days of life’ – the time from conception to a child’s second birthday – is the critical window of opportunity for the optimal development of children [1] This perspective acknowledges that country policies, social contexts and interventions that promote the well-being of mothers, promote child health [2]. Following WHO and UNICEF recommendations [3], in South Africa (SA), exclusive breastfeeding is advocated until six months of age, with gradual weaning [4], regardless of HIV status and age Despite this policy, breastfeeding rates in SA are low among HIV positive and negative women of all ages [5, 6]. 95% live in low-and-middle income countries [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
