Gwanda District Research Articles

Gender differentials in primary processing and market participation by mopane worm harvesters in Zimbabwe: insights from the COVID-19 pandemic phase

BackgroundGender disparities in access to inputs, markets, financial inclusion, and participation in strategic value chains are major developmental challenges in emerging economies. Participation in the edible insect value chain has become an essential source of income, food, and nutrition in some African countries. This paper uses a bivariate probit model to examine the gender differentials for primary mopane worm harvesters’ participation in primary processing and market participation during COVID-19 in Southeastern Zimbabwe. Using a structured questionnaire, the data were gathered from 393 primary harvesters in five purposively selected wards in the Gwanda District of Zimbabwe. This study examines the gender differentials for primary mopane worm harvesters’ participation in primary processing and market participation during COVID-19 in Southeastern Zimbabwe.ResultsResults show that women are likelier to participate in primary value addition to preparing for the lean season opportunities. There are gender differentials in the participation in markets during COVID-19. Results show a significant negative relationship between participants' ages and female engagement in mopane processing and a positive correlation with female involvement in lean COVID-19 season marketing. Male harvesters’ participation in the lean market during the COVID-19 pandemic was significantly correlated positively with age and education level, while the choice to participate in the lean market was negatively correlated with the dependency ratio.ConclusionsCollaborative, community-centric, and gender-accommodative development of the mopane worm value chain is important. Focal issues are on supporting primary value addition for lean season market participation and during market shocks such as COVID-19. This can be a leap towards gender equality and improving livelihoods of women and men in mopane harvesting areas. The study recommends marketing and district-specific policies explicitly addressing mopane worm harvesting and marketing affects market participation and primary value-addition decisions.

Exploring the Impact of COVID-19 on Cervical Cancer Screening Services: A Qualitative Study of Healthcare Providers’ and Women’s Perspectives and Experiences

A qualitative exploration was conducted to analyse the reasons behind the low utilisation of cervical cancer screening services in Gwanda district, Zimbabwe, focusing on the impact of the COVID-19 pandemic. The study involved 5 focus group discussions with 36 women, utilising maximum variation sampling to explore the effects of COVID-19 on screening coverage. Additionally, in-depth interviews were conducted with 25 health-care providers from primary health facilities and the provincial hospital offering screening services. The results suggest a decline in the progress of the cervical cancer screening programme due to the disruptions caused by COVID-19 which subsequently reduced women’s access to screening and treatment services. It was anticipated that restoring women’s confidence in adherence to screening would require time post-pandemic. Moreover, findings highlighted the potential progression of undetected precursor lesions to advanced cancer stages during non-screening periods, which may increase future cervical cancer morbidity and mortality. The findings underscore the importance of integrating cervical cancer screening messaging within broader health communication strategies to emphasise the significance of health interventions for overall well-being. This study recommends the adoption of more efficient screening methods, such as Human-Papillomavirus self-sampling to mitigate future disruptions in screening services, thereby guiding policymakers towards implementing best screening approaches.

Women and health providers' perspectives on male support for cervical cancer screening in Gwanda district, Zimbabwe.

Several studies have shown that male involvement increases the uptake of sexual and reproductive health programmes for improved family health outcomes. The role of men in reducing the burden of cervical cancer has however not been researched in Zimbabwe. It is for this reason that this study explores male support for cervical cancer screening programmes from the perspective of women and health providers in the Gwanda district of Zimbabwe. A qualitative approach that engaged thirty-six women aged 25-50 years in focus group discussions, and twenty-five health providers with different roles in the cervical cancer screening programme in in-depth interviews was used to determine their perspectives on male support for cervical cancer screening. Data were analysed thematically using ATLAS.ti Computer Assisted Qualitative data analysis software. Key findings reflected that men lacked knowledge on cervical cancer and its risk factors and prevention. Subsequently, they engaged in sexual behaviours that increased their partners' risk of acquiring Human Papillomavirus infection, the virtually necessary cause of cervical cancer. Furthermore, men did not provide the necessary emotional and financial support for their women to access screening and treatment. Participants were optimistic that innovative awareness creation strategies and intense, sustained cervical cancer education efforts targeting men could increase male partner support. Involvement of community leaders was seen as crucial in the facilitation of male involvement for programme acceptance and improved uptake of cervical cancer screening. Male involvement is seen as an integral component of the cervical cancer prevention and control programme that has to be implemented in Gwanda district to minimise male partner-related barriers to cervical cancer screening. Further research focusing on men is required to identify specific knowledge gaps that would enable development of appropriate strategies that best involve men in cervical cancer prevention and control interventions.

Effects of post-harvesting practices on heavy metal levels of mopane caterpillar (Gonimbrasia belina) products and associated risk assessment

Abstract Mopane caterpillars (Gonimbrasia belina) are one of the most consumed edible insects in Southern Africa, and they contribute nutritional benefits to human health. However, their contribution to the food and nutritional security can be hindered by food safety concerns due to heavy metal contamination associated with harvesting, processing and poor post-harvest practices. This study investigated the effectiveness of post-harvest practices (degutting, charcoal roasting and sun drying, boiling, frying and open pan roasting) in reducing the heavy metal contaminants (cadmium (Cd), mercury (Hg), lead (Pb), nickel (Ni), aluminium (Al), zinc (Zn), copper (Cu) and iron (Fe)) in mopane caterpillar sourced from Gwanda district in Zimbabwe. The post-harvest practice categories used in this study included: unprocessed (ungutted and naturally degutted samples), processed (manually degutted, and charcoal roasted and sun-dried), and cooked (boiled and salted; boiled, salted and roasted, and boiled, salted and fried) samples. An atomic absorption spectrometry (AAS) was used for quantification of metals and the values detected were used to assess health risks to consumers using a quantitative risk assessment calculation method. The unprocessed and manually degutted samples showed higher levels Cd and traces of Pb, while charcoal roasting and sun drying resulted in elevated levels of Al, Zn, Cu and Fe. Hg and Ni were not detected in any of the unprocessed, processed or cooked samples. Cooking processes resulted in reduction of the concentrations of detected metals to levels within the permissible values. The health risk assessment disclosed noncarcinogenic risks based on the high hazard index (HI) values (HI > 1) in unprocessed, processed, boiled and salted, and boiled, salted and roasted samples, indicating that caution should be taken. The overall findings from the study shows that by cooking mopane caterpillars through boiling and frying, health risks associated with heavy metal contamination can be reduced.

Effects of seasonal variation and geographical location on the nutritional composition of mopane worm (Gonimbrasia belina)

Mopane worm (Gonimbrasia belina) consumption contributes to the sustainable supply of protein and several other nutrients for low socio-economic communities. However, mopane worm are bivoltine, producing two generations per rainy season which is postulated to affect their nutritional value. This research investigated the effect of emergence season and geolocation on the nutritional composition of mopane worms. Proximate, mineral composition and fatty acid profile were analysed on degutted mopane worm samples collected over three mopane worm emergence seasons (November-December 2020, April-May 2021, and November-December 2021) from three locations in Gwanda district, Zimbabwe. Crude protein and crude fat ranged between 52.5-58.8 and 12.0-18.6% DM respectively. Potassium (1,195.3-1,759.9), magnesium (104.6-225.5) and calcium (51.2-145.5) were the most abundant macroelements (mg/100 g DM) whilst iron (10.6-21.6) and zinc (13.8-17.9) were the most abundant microelements (mg/100 g DM). Using an attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR), mopane worm fat was found to be highly saturated with oleic (ω-9), linoleic (ω-6) and palmitoleic (ω-7) fatty acids. Furthermore, the results revealed a significant (Bonferroni-correction α<0.002) influence of geolocation (sampling location) on mineral content of mopane worms whilst emergence season had a significant influence on fat, protein, ash crude fibre and mineral content. These findings indicate that mopane worm due to their high content of both macro- and micronutrients could contribute significantly to the alleviation of protein, zinc, and iron deficiencies in target communities. More so, the findings on nutritional variation due to emergence season and geolocation provide information that is key in domestication of the mopane worm for realisation of its optimum nutrient content.

Health institutional dynamics in the management of malaria and bilharzia in Zimbabwe in the advent of climate change: A case study of Gwanda district

Health institutional dynamics in the management of malaria and bilharzia in Zimbabwe in the advent of climate change: A case study of Gwanda district

Association between consumption of edible insects with dietary diversity, and household food and nutrition security in Southern Zimbabwe

Edible insects are nutritious with potential to improve nutritional outcomes and livelihoods in low-income countries. However, it is not clear whether consumption of edible insects is positively correlated with improved dietary diversity and food security indicators. Therefore, this cross-sectional study was designed to investigate the relationship between consumption of edible insects and diet diversity and food security indicators among children and adults from Gwanda district, Matabeleland province in Southern Zimbabwe. The survey collected data on the following; household sociodemographic characteristics, household dietary diversity score (HDDS), food consumption score (FCS), and child dietary diversity score (CDDS). Logistic regression was used to examine the associations between edible insect consumption and food security indicators. A total of 303 households were surveyed. A high proportion were edible insect consumers (80.9%) and the rest non-consumers (19.1%). The most consumed insect was mopani worms (Gonimbrasia belina, madora, amacimbi) (74.8%). The consumption of mopani worms was highest in the age group 20-49 years (34.4%) and significantly associated with being married and age of the household head. There was no difference between the mean CDDS for consumers (5.9±1.7) and for non-consumers (6.0±2.0) (p=0.802). The median (IQR) FCS for consumers was lower at 49 (35, 65) than for non-consumers 53 (36.5, 64). This difference was not statistically significant (p=0.526). There also was no difference between the average HDDS for consuming households (6.2±1.7) and for non-consuming households 6.2±1.5 (p=0.866). There was no significant association between consumption of edible insects and CDDS (p=0.802), HDDS (p=0.866), and FCS (p=0.585). In conclusion, this study showed that Gonimbrasia belina (mopani worms, madora, amacimbi) were the commonly consumed insect mostly as relish due to their palatable taste. Overall, the consumption of edible insects did not seem to improve diet diversity and food security indicators in this setting. National level studies with bigger sample sizes that investigate the contribution of edible insects to overall nutrient intake and dietary diversity are required. Furthermore, interventions to promote the consumption of edible insects, including their commercialization should adopt a social ecological approach to maximise impact. Key words: Entomophagy, food security, mopani worms, stunting, gender, Zimbabwe

Fodder Preparation Practices Adopted by Community Subsistence Farmers in Zimbabwe in the Face of Climate Change: A Case Study of the Garanyemba Community Ward 13 in the Gwanda District, Matabeleland South Province.

The study identifies methods and practices adopted by communal subsistence farmers in preparing fodder for their livestock in the face of climate change. The purpose is to enhance fodder availability in the Garanyemba Ward 13, Gwanda District in Matabeleland South Province, Zimbabwe. Explored are challenges that affect methods / practices of fodder preparation on which livestock depends; without which communities cannot survive. The study employed a mixed methods research methodology; gathering data through face-to-face in-depth semi-structured interviews and questionnaire. Analysis was through descriptive statistics, thematic and content analysis methods. Findings suggest that Garanyemba communal farmers are overwhelmed with numerous problems that affect fodder availability. Mountains and inselbergs have deprived the Ward of its agricultural land and crop residues; a critical component of fodder. Climate change has caused droughts, low rainfall, water shortage, non-availability of grass and premature drying of rivers and wetlands which are the main sources of water. This has caused serious shortage of fodder; and affected livestock productivity. These challenges have driven communities to prepare fodder to protect livestock against feed shortage; and losses during dry seasons. Cutting grass, crop residues, the ‘cut and carry’ system, ‘emilageni’ – the ‘lagisa’ system; and novel initiatives comprise the main methods of fodder preparation. Water harvested through sand dams helps to grow fodder. Training has improved communities’ skills to make fodder. Recommendations include construction of micro–dams, more sand dams and piping water from the Thuli River to avail water; and start irrigation schemes to grow fodder. Workshops and refresher courses on fodder preparation are encouraged to skill communal subsistence farmers.

Service Accessibility as a Determinant of Cervical Cancer Screening in Gwanda District, Zimbabwe

Zimbabwe has one of the highest prevalence of cervical cancers in the world. The country has a low screening coverage despite the availability of cost-effective and evidence-based interventions for the prevention of the disease that include screening. This study therefore assessed service accessibility as a determinant of screening in Gwanda District, Zimbabwe. An explanatory sequential mixed-method design was employed firstly using a quantitative survey of 609 screening-eligible women selected through multi-stage random sampling. Subsequently, 36 women purposely selected from the quantitative phase were engaged in focus group discussions, and 25 health-care workers as key informants. About 74.4% of rural participants had never been screened compared to 62.1% of urban participants. Qualitative findings revealed that the district has two screening sites, both in urban locations. Rural based women access the service through outreach clinics which are inconsistent with no provision for treatment. Furthermore, treatment facilities are centralised to the provincial hospital at a fee. Financial constraints associated with travel expenses and treatment costs emerged as the key factor that hinders participation in screening. Improved access to services could greatly increase screening rates to match the high demand in the district. Decentralising screening to primary health facilities could ensure ready access of the service and enhance screening. Supplemental to that, outreach services to hard to reach areas need to be increased and sustained.

An Assessment of the Effectiveness of Community Participation in HIV and Aids Mitigation Programs a Case Study of Gwanda District, Zimbabwe

An Assessment of the Effectiveness of Community Participation in HIV and Aids Mitigation Programs a Case Study of Gwanda District, Zimbabwe

Mopane worm value chain in Zimbabwe: Evidence on knowledge, practices, and processes in Gwanda District.

Consumption of edible insects is a potential solution to the growing need for protein. However, the wild harvested edible insects' value chain faces several challenges including limited knowledge on indigenous practices in the harvesting and processing and lack of information on roles of the different actors in the chain. A case study of Gonimbrasia belina, colloquially referred to as the 'mopane worm', was conducted to understand and identify determinants of participation in the value chain of the edible caterpillar. A cross sectional study was conducted in Gwanda (a rural district in Zimbabwe) to (a) understand the indigenous knowledge on harvesting and processing methods, (b) explore value addition and the traditional beliefs surrounding the utilisation of the mopane worm. Results showed that consumers (81.7%), and harvesters (76.6%) were the main actors in the mopane worm value chain. Using the Ordinary Least Squares (OLS) model, the following were shown to be determinants of participation in the mopane worm value chain: (a) gender (b) household size (c) marital status (d) religion and (e) household assets. Two primary processing methods of harvested mopane worm were distinguished i.e., boiling and roasting on ambers. Results showed lack of diversity in mopane worm-based products. Current culturally acceptable processing techniques need improvement and standardization to support sustainable mopane worm processing while optimising nutrient bio-accessibility.

Socio economic challenges of women in Ntepe Village, Gwanda District, Zimbabwe

This study seeks to explore the socio-economic challenges rural women in Zimbabwe face. The research adopted a qualitative method technique. This study reveals several socio-economic challenges that rural women in Zimbabwe face. The results from the study also show that women are still marginalised in many facets of community development activities because of policies that do not take their needs into account. Furthermore, the study identified that rural women remain vulnerable and exposed to high poverty levels as they fail to get the maximum required support from their husbands, community leaders and national government through its policies that have isolated them.

Environmental Education efforts in a rural drought-prone district in Zimbabwe: Micro innovations with growth potential

In Sub-Saharan Africa, climate change is evident due to the frequency of drought cycles. This paper explores the Environmental Education (EE) efforts for reducing the impact of climate change in drought prone Gwanda district, Zimbabwe. The paper focuses on how climate change mitigation and adaptation stakeholders within the community can initiate EE programs which have the potential to be upscaled to macro innovations. A qualitative interpretive case study approach was used with three data generation tools (interviews, a focus group discussion and document analysis). The sample comprised 38 participants. The study was guided by the Sustainable Rural Livelihoods Framework (1998). The study revealed that for EE programmes to be effective, they have to harness local factors. The study found that formal field days, information and skills sharing among neighbours during letsema/lidaba and Indigenous Knowledge Systems were micro innovations with growth potential to build farmers’ generative resilience to climate change.

Sensitisation to Imbrasia belina (mopane worm) and other local allergens in rural Gwanda district of Zimbabwe

BackgroundThe prevalence of allergic diseases is increasing in Zimbabwe and the data relate to local as well as exotic allergen sources. As entomophagy, the practice of eating insects, is a recognised source of local allergens, we sought to measure the prevalence of and risk factors for sensitisation to Imbrasia belina (mopane worm), a popular edible insect. This was investigated alongside other locally relevant allergens in a rural community in Gwanda district, south of Zimbabwe.MethodsA cross sectional study was conducted among 496 adults and children aged 10 years and above in Gwanda district, a mopane worm harvesting area in Zimbabwe. Data on individual characteristics and mopane worm exposure factors were collected using questionnaires. Sensitivity to allergens was assessed by performing skin prick tests at a local clinic using 10 different commercial allergen extracts (Stallergenes, France) and in-house extracts of mopane worm (Imbrasia belina) and mopane leaves (Colophospermum mopane). Data were analysed using Stata version 13 software.ResultsThe prevalence of sensitisation to at least one allergen was 31.17% (n = 144). The prevalence of atopy was higher in adults (33.33%) than in children (23.53%) (p = 0.059). The commonest inhalant allergen sources were mopane worm (14.29%), Tyrophagus putrescentiae (14.29%), mopane leaves (13.42%), Alternaria alternata (6.49%) and Dermatophagoides pteronyssinus (6.49%). Polysensitisation was demonstrated in the study population and of the 108 participants (75%) who were sensitised to two or more allergens, 66 (61%) were women. Sensitisation to mopane worm and mopane leaves often clustered with Tyrophagus putrescentiae amongst adults. Adjusted logistic regression analyses between mopane worm sensitisation and self-reported exposure variables showed that sensitisation was more likely amongst mopane worm harvesters (OR = 1.92, 95%CI = 0.77–4.79), those who cooked or roasted mopane worms during harvesting (OR = 2.69, 95%CI = 0.78–9.31) and harvesting without personal protective equipment (PPE) (OR = 2.12, 95%CI = 0.83–5.44) compared to non-harvesters.ConclusionAtopic sensitization was common in this mopane worm harvesting community in Gwanda district of Zimbabwe. There was frequent co-sensitisation of mopane worm and mopane leaves with Tyrophagus putrescentiae in children and adults. It is important to determine the clinical relevance of our findings, particularly relating to mopane worm sensitisation.

Barriers and facilitators to exclusive breastfeeding practices in a disadvantaged community in southern Zimbabwe: A maternal perspective

Background: Despite the well-documented significance of EBF in developing countries, many poor communities still present with the highest percentage of disease burden resulting from suboptimal breastfeeding.
 Objectives: To identify the maternal perception on barriers and facilitators to EBF in Gwanda District, Zimbabwe.
 Methods: Five focused group discussions were conducted using 40 purposively-selected mothers while eight in-depth key informant interviews were also conducted. The qualitative data collected were analyzed using thematic network analysis. The themes were used in interpreting the perceived barriers and facilitators of EBF.
 Results: The study identified individual, socio-cultural, health service-related and environmental factors as the basic themes influencing maternal infant feeding choice. These were grouped into two organizing themes, namely, barriers and facilitators of EBF which were summarized into one global theme: EBF intention. Facilitating factors were maternal autonomy, self-efficacy, knowledge of EBF definition, maternal diet, support and sourcing information from healthcare workers. Poor infant feeding practices, affordability of alternative infant feeding options, ritualistic/symbolic infant preparations, family conflicts, increased workload and hot climate were barriers to EBF.
 Conclusion: To increase in uptake of EBF in the study area required comprehensive multiple stakeholder interventions incorporating the mothers, influential family members, religion and traditional advisors, and healthcare workers.

A feasibility study to assess Imbrasia belina (mopane worm) sensitisation and related respiratory health outcomes in a rural community in Gwanda district, Zimbabwe

BackgroundAllergic diseases are considered to be some of the fastest growing chronic conditions in Africa. Of concern is the paucity of knowledge about the local environment and its role in allergic disease development. In response to this, we explored whether Imbrasia belina, a popular indigenous edible insect commonly known as mopane worm, is a potential allergen of clinical and public health significance in Zimbabwe. This study was intended to assess the plausibility and feasibility of this hypothesis with a view to evaluate the insect’s health impact in a larger study.MethodsThe study participants included male and female villagers aged 10 years and above in Gwanda district, Zimbabwe. Eligible participants who completed the household questionnaire were referred to the local clinic for skin prick tests and to measure lung function and allergic airway inflammation. Allergen sensitisation patterns were evaluated using 10 different inhalant allergen extracts including an in-house preparation of mopane worm. Lung function was measured with a Koko Legend spirometer, and fractional exhaled nitric oxide levels (FeNO) (NIOX VERO) were measured in participants with at least one abnormal spirometric parameter. Data was analysed using Stata version 13 software.ResultsOf the 46 eligible participants that completed the household questionnaire, 17 went to the clinic giving a response rate of 37%. The majority who completed the questionnaire were adults (91%) and the children (9%) were all female. The prevalence of sensitisation to Imbrasia belina was 50%, and the prevalence ranged from 22 to 72% for the other allergens including cockroach, mosquito and house dust mites. The data collection tools were safe and well tolerated by participants with no adverse events reported. Self-reported respiratory symptoms, abnormal lung function and elevated FeNO were recorded amongst participants sensitised to mopane worm.ConclusionPre-defined feasibility criteria were met with the exception of a lower than expected response rate for clinic data collection in this pilot study. For the main study, modifying the sampling strategy and applying more consistent community engagement will improve the response rates.

Religion and Gender Policy Implementation in Zimbabwe

African women’s histories show that economic marginalisation of women is rampant. This article evaluates how the implementation of African Traditional Religions, Christianity and the new National Gender Policy (2013–2017) impact on women’s access to land ownership in the Gwanda district of Zimbabwe. The land reform programme, initiated by the Zimbabwean government, endeavoured to alleviate the limited access to land by women through a quota system. The new National Gender Policy (2013–2017) asserts that women should constitute 20% of all recipients of A2 farming land. Women now have the right to apply for A1 and A2 agricultural land, and it gives women authority to control land as a means of production. This marks a departure from the traditional custom where women would acquire land only through their husbands, fathers or any male relative. In this study, a mixed-method approach and case study design were applied to explore if this could eradicate gender inequality caused by religions on women’s access to land ownership? The instruments were questionnaires, interviews, focus group discussions and document analysis. Purposive sampling was used to select a sample of 80 participants. The findings are that the patriarchal system and cultural practices of African Traditional Religions and Christianity hinder women from accessing land. Some women have a fear of the unknown. The study recommends that women should be conscientised against the marginalising effects of religious, cultural and patriarchal practices, and informed on the contents of the current National Gender Policy (2013–2017). There should also be more female representation on the Land Allocation Committee.

An evaluation of the perinatal mortality surveillance system in Gwanda District, Matabeleland South Province, Zimbabwe

Background. A preliminary review of perinatal mortality surveillance data (January - August 2017) suggested an under-reporting of perinatal deaths in Gwanda District, Matabeleland South. Objective. To evaluate the effectiveness of the perinatal mortality surveillance system in Gwanda District, Matabeleland South, Zimbabwe. Methods. This descriptive cross-sectional study interviewed 50 healthcare workers employed in the district using pretested intervieweradministered questionnaires. The sample was drawn from 16 randomly selected healthcare facilities. Records for perinatal mortality cases were reviewed and data were analysed. Results. Only 32% of healthcare workers knew the case definition of perinatal death. Approximately two-thirds of participants (68%) knew who should complete notification forms and ~half (52%) of the respondents cited fear of blame as the reason for a low perinatal death report rate in the district. Although 50% of participants reporting having participated in perinatal death reviews and 78% reporting using the data for planning community health programmes, there was no recorded evidence in support. Perinatal mortality case notification forms were not in stock at 13 of the 16 sampled healthcare facilities. Conclusion. Poor knowledge of the perinatal mortality surveillance system was found among participants. The low reporting rate suggests that the system does not function effectively in the district. Healthcare workers feared blame, which suggests management intervention is required to create a trusted reporting environment.

Factoring water harvesting into climate change adaptation: Endogenous responses by smallholder farmers in Gwanda district, Zimbabwe

Climate change in the form of temperature increases and rainfall variability has intensified in the last three decades. Recent studies in Southern Africa (of which Zimbabwe is part) have indicated ...

Determinants of exclusive breastfeeding among mothers of infants aged 6 to 12\u2009months in Gwanda District, Zimbabwe

BackgroundIn 2016, 98% of children in Zimbabwe received breastmilk, however only 40% of babies under six months were exclusively breastfed 24 h prior to data collection. A 2014 survey revealed that Matabeleland South Province had the country’s highest starvation rates and food insecurities were rife. This study aimed at investigating maternal, infant, household, environmental and cultural factors influencing exclusive breastfeeding (EBF) practice in Gwanda District.MethodsA cross-sectional study was conducted from January to March 2018. Interviews used pretested structured questionnaires for 225 mothers of infants aged between six and twelve months at immunization outreach points and health facilities. Descriptive statistics, bivariate and multivariate analysis estimated the association between the dependent and independent variables. Exclusive breastfeeding was defined as feeding an infant on breast milk only from birth up to the age of six months.ResultsThe majority of mothers (n = 193; 89%) had knowledge about EBF and 189 (84%) expressed a positive attitude towards the practice, however, only 81 (36%) practiced exclusive breastfeeding. The most common complementary food/fluid given to the infants was plain water (n = 85; 59%). Predictors for EBF were: maternal Human Immuno-deficiency Virus positive status (Odds Ratio [OR] 0.30; 95% Confidence Interval [CI] 0.17, 0.56) and being economically independent (OR 0.41; 95% CI 0.21, 0.79). Barriers to practicing EBF were: being a young mother under 25 years of age (OR 3.05; 95% CI 1.67, 5.57), having one or two children (OR 2.49; 95% CI 1.29, 4.79), living in less than two rooms (OR 3.86; 95% CI 1.88, 7.93) and having a baby of low birthweight (OR 1.05; 95% CI 0.40, 2.71). After multivariate analysis, only the mother’s economic independence was associated with practicing EBF (Adjusted OR [AOR] 0.83; 95% CI 0.30, 0.92). Key informants identified traditional family practices as the major barrier to EBF.ConclusionThe exclusive breastfeeding rates were low despite the mothers’ high knowledge levels and positive attitudes towards the practice. In addressing the multiple factors influencing the cost effective practice, there is need to channel supportive measures through a system-wide approach. This can be achieved by realigning breastfeeding policy directives as well as community attitudes and values towards the exclusive breastfeeding.