Table 3 Programmatic implications of the study findings
Areas of interest | Constraints/ barriers | Facilitators | Opportunities for intervention |
|---|---|---|---|
Perceptions of breastfeeding | -Working mothers introduced formula in preparation for joining work | - All mothers prized breast milk over formula -Care givers were supportive of breastfeeding -All female RMG workers received a maternity benefit package and leave | -At the factory level policies supportive of breastfeeding should be enforced - Counseling and a supportive environment (breast pump, space, breaks) should be provided by the factories as a part of their maternity package |
Perceptions of expressed breast milk | - Concerns of longevity and safety of the expressed milk -Not a social norm | - Mothers prized breast milk -Mothers and caregivers understood the disadvantages of formula | - It is important to ensure the safety of the expressed breast milk - Mothers can be trained and counseled to express and use breast milk -Caregivers should be trained about the use of expressed milk |
Sources of information | -Mothers are receiving negative information about expressed breast milk from their social network and/or media | - A few doctors are promoting expressed breast milk | -There is a need for developing behavior change communication (BCC) strategies to increase the cultural acceptability of expressed breast milk at work and in the community -Key people in social network such as mothers, mothers-in-law, husbands should be targeted for counseling -BCCs should address beliefs about expressed breast milk |
Work environment | - Heavy workload and limited break time - No privacy for breastfeeding - Inadequate crèche facilities -Unsupportive supervisory chain | -Factory policy for providing breastfeeding breaks -Most factories had a day care facility -Management is concerned about high employee dropout rates | -Create space in the existing crèche for breast milk expression -Create a program for breast milk expression with the time constraints in mind -Train existing crèche workers to counsel and train mothers -Motivate the factory management to invest in the program - Constantly motivate the supervisors to ensure that mothers can utilize breaks |