Breastfeeding practice and rural-urban livelihood in Dodoma, Tanzania, by Kwalu Samwel Dede, Adalbertus Kamanzi and Leo de Haan

Abstract                          

WHO and UNICEF promote exclusive breastfeeding (EBF) for babies up to six months of life because it is key to infants’ health and growth. However, despite mothers worldwide being knowledgeable about the advantages of EBF, only a minority follows up on the advice.

Literature provides many reasons for non-adherence to WHO’s EBF recommendation. However, few studies have focused on mothers’ livelihoods as an explanation, while we argue that this potentially is an important determining factor. With rural livelihoods in sub-Saharan Africa currently rapidly transforming, that knowledge gap becomes even more ardent. This paper explores through qualitative analyses, the relationship between breastfeeding practices and urban and rural livelihoods in Dodoma Region, Tanzania. The aim is to address the knowledge gap and as such to inform both research and health practice.

From the literature review it is established that various aspects of mothers’ livelihoods can impact on their breastfeeding practices. Our qualitative analysis through in-depth interviews and Focus Group Discussions, as well as Focus Group Workshops confirms the impact of a number of these livelihood aspects. Moreover, for some aspects marked differences between rural and urban settings became apparent. Rural casual/unskilled and rural agricultural livelihood activities impact positively on EBF. All other livelihood activities, either rural or urban, have a negative impact on EBF. That is, all have the same bearing: opportunities for mothers to breastfeed reduce and breastfeeding is substituted by other food. Distance between the workplace and home and working conditions at the workplace are the most salient aspects of livelihood activities to explain for this.

Rural livelihoods are now rapidly transforming and especially small-scale business livelihoods are emerging in rural areas. Our qualitative analysis shows that working conditions in these small-scale business livelihoods, rural and urban, are among the most unattractive for EBF. With rural livelihood transformations on the rise, we expect the rural EBF rate to decline soon.

Keywords

Exclusive breastfeeding, livelihoods, Dodoma, Tanzania.

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