RIFT VALLEY UNIVERSITY ABICHU CAMPUS

DEPARTEMENT OF GMPH

EXCLUSIVE BREAST FEEDING PRACTICE AND ASSOCIATED FACTORS

AMONG MOTHERS OF INFANT AGED 0-5 MONTHS IN PUBLIC HEALTH
CENTERS ADDIS ABABA ETHIOPIA

BY: FIRE ABRHA (BSC)

December -2019

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 RIFT VALLEY UNIVERSITY ABICHU CAMPUS

DEPARTEMENT OF GMPH

EXCLUSIVE BREAST FEEDING PRACTICE AND ASSOCIATED FACTORS

AMONG MOTHERS OF INFANT AGED 0-5 MONTHS IN PUBLIC HEALTH
CENTERS ADDIS ABABA ETHIOPIA

ADVISOR: Dr.ESKINDER WOLKA (PHD)

APROPOSAL SUBMITED TO RIFT VALLEY UNIVERSITY ABICHU CAMPUS IN

PARTIAL FULFILLEMENT OF THE REQUIREMENT FOR THE DEGREE OF
MASTERS OF GENERAL PUBLIC HEALTH

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Rift valley university Abichu campus Master of public health

Research project submission form

Name of investigator Fireabrha

Name of Advisor Dr.Eskinderwolka (phd)

Full title of the research project Exclusive breast feeding practice and associated factors
among mothers of infant aged 0-5months in public
health centers Addis Ababa Ethiopia

Duration of project December 16 to march 15, 2020

Study area Addis Ababa

Budget Total budget 43,630ETB

Address +251912012778
Email Fireabrha2018@gmail.com

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List of figure

Figure1, conceptual frame work----------------------------------------------------------------13

Figure1.1 Schematic presentation of the sampling technique procedure--------------------17

List of table
Table 1: Budget breakdown-----------------------------------------------------------------------22

Table 2 Time table----------------------------------------------------------------------------------23

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ACKNOWLEDGMENT
First I would like to thank God for giving me the chance to prove that he is always with
me and helping me through all the way. Then my greatest gratitude goes to rift valley
university abichu campus for giving me this chance to learn new things and face different
experience. I would also like to express my heartfelt gratitude my advisor Dr. Eskinder
wolka (PhD).My appreciation also goes to Addis Ababa Health Bureau and Health
Centers. Last but not the least I would like to thank my families and friends for being
there with me in every line in my life to support me.

Contents

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List of table....................................................................................................................................iv
ACKNOWLEDGMENT.................................................................................................................v
List abbreviation and acronyms.....................................................................................................ix
Summary.........................................................................................................................................x
1.1Background................................................................................................................................1
1.2. Statement of the problem.........................................................................................................3
1.3. Significance of the study..........................................................................................................5
2. Literature review.........................................................................................................................6
2.1. Prevalence of Exclusive breast feeding practices.................................................................6
2.2. Exclusive breastfeeding.......................................................................................................7
2.3. Factors associated with practice of exclusive breastfeeding.................................................7
2.3.2. Maternal and family related factors..................................................................................8
2.3.3. Obstetric and health facility related factors.....................................................................10
2.3.4. Infant related factors.......................................................................................................11
2.4. Conceptual framework...........................................................................................................13
Figure1Conceptual framework.................................................................................................13
3. OBJECTIVE OF THE STUDY.........................................................................................................14
3.1. General objective...............................................................................................................14
3.2. Specific objective...............................................................................................................14
4. Methods....................................................................................................................................15
4.1Study area and period..........................................................................................................15
4.2. Study design......................................................................................................................15
4.3. Source population..............................................................................................................15
4.4. Study population................................................................................................................15
4.5. Eligibility criteria...............................................................................................................16
4.6. Sample size determination.................................................................................................16
4.7. Sampling technique or procedure.......................................................................................16
Fig.2 Schematic presentation of the sampling technique procedure..............................................17
4.8. Data collection Tools.........................................................................................................18
4.9. Data collection procedures.................................................................................................18
4.10. Data quality management................................................................................................18
4.11. Study variables.................................................................................................................19

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 Dependent variable...............................................................................................................19
Independent variables...........................................................................................................19
4.12. Operational definition......................................................................................................19
4.13. Data analysis procedure...................................................................................................20
4.14. Ethical consideration........................................................................................................20
4.15. Dissemination plan..........................................................................................................21
Work plan and Budget..................................................................................................................21
Plan for data processing and analysis........................................................................................22
Reference......................................................................................................................................24
ANNEXSES.................................................................................................................................27
ASSURANCE OF PRINCIPAL INVESTIGATOR.....................................................................54

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viii
List abbreviation and acronyms
AOR: -adjusted odds ratio

BF: -breast feeding

BFP: -breast feeding practices

BMS: -breast milk substitute

ANC: -antenatal care

CPF: -complementary feeding

EBF: -exclusive breast feeding

EBFP: -exclusive breast feeding practice

EDHS: -Ethiopian demographic health survey

IF: - infant formula

PNC: - postnatal care

SD: -standard deviation

UNICEF: -united nation children’s fund

PAS: -proportional allocation to size

SSA:-sub-Saharan Africa

WCA:-west and central Africa

WHO: - world health organization

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Summary
Background:-In Ethiopia an estimated 70000 infants deaths, per year which is 24% of
total infant death annually are due to suboptimal breastfeeding practices, in which can be
prevented by exclusive breastfeeding and Ethiopia has history of suboptimal breast
practice of which only 52%of children under six months age are exclusively
breastfeed(1).

Objective:-the objective of this study is exclusive breast feeding practice and associated
factors among mothers infant aged 0-5 months in public health centers Addis Ababa
Ethiopia

Method:-facility based cross-sectional study will be done in selected ten health centers in
Addis Ababa during data collection period from April 1 stto june2020. Multistage
sampling technique will be used to select health facilities by taking clients flow chart in
to account. And data will be collected using a sample of 612 voluntary participants which
are selected by systematic random sampling. Data will be collected using structured
questioner. Then data will be entered using EPI data software version 3.1 by the principal
investigator and STATA 14 software program will be used to analyzed the entered data.
Final proposal is submitted to rift valley university abichu campus the study is approved
by department of general public health of rift valley university Ethical review Committee.

Work plan and Budget:-these will be conducted during may1 stto June2020and the total
estimated budget for this study is 42,680 ETB which is self-sponsored.

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1. Introduction

1.1Background
Exclusive breastfeeding defined as the infant receives only breast milk, no other liquids
or solids are given. No even water with the exception of oral rehydration solution, or
drops/syrups of vitamins, mineral or medicine(2).the significance of this study all health
professional to give for them mother to counseling/health education session to minimize
the suboptimal breast feeding practice and strengthen exclusive breast feeding practice
for the first six months of life.

Early supplementation is discouraged for several reasons. First, it exposes infants to

pathogens and thus increases their risk of infection, especially diarrheal disease. Second,
it decrease infants intake of breast milk and therefore suckling, which in turn reduces
breast milk production. Third in low resource settings, supplementary food is often
nutritionally inferior (3, 4).

Poor feeding practices particularly sub optimal breastfeeding and complementary feeding
practices for infants and young children are the major cause of child malnutrition along
with other common illnesses(5).chronic malnutrition due to poor breastfeeding practice
causes diminished cognitive and physical development of children and its limits to attain
their potential to learn earn throughout their lives(6).

It provides all infants nutritional and fluid needs in the first six months and is a perfect
combination of proteins, fats, carbohydrate and fluid (5). Nutrients such as vitamins A
and C, iron, zinc, and vitamin D are more easily absorbed from breast milk than from
milk. And it contains essential fatty acids needed for the infants growing brain, eyes, and
blood vessels and these are not available in other milks(4, 7, 8).

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In spite of what is known about the benefits of exclusive breast feeding for children,
mothers, families and society practice of exclusive breastfeeding is unsatisfactory in
many parts of the world. Only 35% of infants worldwide are exclusively breastfed during

the first four months of life (9). And 38% of children less than 6 months of age are
exclusively breastfed in the developing countries and 31% in SSA (10). while in Ethiopia
52%of children exclusively breastfed for six months (4).

Many factors have found to affect EBF practice such as; societal beliefs favoring mixed
feeding, lack of adequate support in health facilities and in the community, aggressive
promotion of infant formula through media, inadequate maternity leave legislation, lack
of knowledge on the dangers of not EBF among women , their partners, and families (4).

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1.2. Statement of the problem
Globally, sub-optimal feeding of infant and infectious disease contributes a 60% of total
children death, It is estimated that sub-optimal breastfeeding, especially non-exclusive
breastfeeding in the first six months of life, results in 1.4 million deaths and 10% of
disease in under-fives, and also has long term impact, including poor school performance,
reduce productivity, and impaired intellectual and social development .it can also
increase the risk of dying due to diarrhea and pneumonia among 0-5 month old infant by
more than two-fold (7, 11).

Evidence shows that of the sixty (60%) of under-five mortality caused by malnutrition
(direct or indirectly ) more than two-thirds of those are associated with appropriate
breastfeeding practices during infancy. not more than 35% of infants worldwide are
exclusive breastfed during their first four month of life (12, 13).

Suboptimal breastfeeding practice has different determinants and an infant formula

promotion is amongst them. one study reported that the promotion of-in-hospital formula
supplementation was associated with nearly 2-fold greater risk of not fully breastfeeding
days 30-60 and nearly 3-fold risk of breastfeeding cessation by day 60 (14).other study
found children were more likely to be given formula if their mother recalled advertising
messages, or a doctor, or mother or relative recommended it and those using formula
were 6.4 times more likely to stop breastfeeding (15).similarly other study reported
mothers who received formula milk sample had lower breastfeeding rate (16).

In Ethiopia an estimated 70000 infants deaths, per year which is 24% of total infant death
annually are due to suboptimal breastfeeding practices, in which can be prevented by
exclusive breastfeeding and Ethiopia has history of suboptimal breast practice of which
only 52%of children under six months age are exclusively breastfeed (1).

Suboptimal breastfeeding contributes for 45% of neonatal infectious death, 30% of

diarrheal deaths and 18% of acute respiratory deaths among under five children in
developing countries (14). It also accounts for 10% of the disease burden in children less
than five years old (17, 18).

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Suboptimal breast feeding practice in the world and in country are exist, but to improve
exclusive breast feeding, factors influencing its practice to be assessed and identified
although some factors have been identified in the world and in the country, there is no
study conducted that infant formula promotions and how it affect on exclusive breast
feeding practice which could have an implication for better intervention.

The findings of this study to increase infant health and also reduce death, as well as
prevent infection disease including otitis media, RTI and non-infectious disease like child
obesity due to suboptimal breastfeeding practices.

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1.3. Significance of the study
WHO and UNICEF recommended infant should be exclusive breastfed for the first six
months of life to achieve optimal growth, development and health as well as prevent
infection disease including otitis media, RTI and non-infectious disease like child
obesity. Thereafter, to meet their evolving nutritional requirements, infant should receive
nutritionally adequate and safe complementary foods, while continuing to breastfeed for
up to two years or beyond (5).

Health extension workers who are working at community level, nurse and midwifes who
work in maternity centers (antenatal care unit, post natal care unit and delivery room) and
in the community setting as well all other concerned bodies will utilize the result of this
research as reference in their counseling/health education session to minimize the
suboptimal breast feeding practice and strengthen exclusive breast feeding practice for
the first six months of life.

This study will be documented and provide relevant information on the effect of infant
formula promotions on exclusive breast feeding practice, in Addis Ababa the finding of
this study will also provide the city health office, policy makers and non-governmental
organizations (NGOs) to develop relevant intervention strategies this will also help health
care providers to understand gaps associated with breastfeeding awareness and so that
they are more focused to these gaps during the breastfeeding counseling.

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2. Literature review
General overview
2.1. Prevalence of Exclusive breast feeding practices
Despite appropriate feeding practice is the most cost effective intervention to reduce child
morbidity and mortality, only 35%of infant worldwide are exclusively breastfed during
the first four months of life [9], 38% of infant less than 6 months of age are exclusively
breastfed in the developing countries and 31% in sub-Saharan Africa (10).

The rate of exclusive breast feeding is low in Africa, especially in WCA which is only
21% which results chronic malnutrition like stunting for more than 40% of case and
further deteriorates the child potential to learn and grow throughout their lives (5).

Across sectional study in Malaysia among mothers of children between 6-24 months of
age group showed only 44.3% of mothers breastfed their child exclusively until 6 months
(19). and another similarly study in Malaysia to investigate the factors associated with
EBF showed that the prevalence of exclusive breastfeeding among mothers with infant
aged between one and six months was 43.1% (20).

In Ethiopia breast feeding is a common practice, but a large proportion of mother do not
practice optimal breast feeding. According to Ethiopia demographic health survey
(EDHS) 2011 estimated 52% of under 6 month aged infants are exclusively breastfed. It
is estimated that 70% of 0-1month old infants, 55% of 4-5 month old infant and 32% of
4-5 infants were exclusively breastfed. This national survey estimated median duration of
exclusive breast feeding is 4.2 months at national level and 4.6 months in Amhara region
(4).

The 2016 Ethiopian demographic health survey (EDHS) showing 58% of mothers who
had under 6 months infant prevalence of exclusively breastfeeding practice (21).similarly
studies conducted in Mizan Aman town, Offa district southern Ethiopia, Debre tabor
town, Motta town, (east Gojjam zone), Garage zone south Ethiopia, Goba district, south
east Ethiopia, Bedelle town, the prevalence of exclusive breast feeding was 34.7%, 78%,
70.8%, 50.1%, 21.9% and 43.6% respectively.

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2.2. Exclusive breastfeeding
WHO and UNICEF recommended that all mothers should breastfeed their children
exclusively for the first six months and should continue with additional of appropriate
and sufficient weaning food after 6 months of age[(9).despite the recommendation from
WHO and UNICEF, world worldwide the exclusive breast feeding of children under six
months are 35%(3).only 39% of infants in developing world and 35% o of infants in
Africa are exclusive breast feed (5).

2.3. Factors associated with practice of exclusive breastfeeding

2.3.1. Infant formula promotion

Infant formula promotions as a definition is if any mother exposed to advertisement

material including media, printing material which indicates infant formula is good for
infant or if sample is given to mother or other activities to encourage mothers to use the
formula once in a life time. Because of fear of this promotion the WHO developed
international code of marketing of BMS in 1981 which aims was to protect, promote and
support the EBF (22).

About one in every four infants was provide infant formula within the first six months of
life. an earlier cohort study [9].from central Nepal reported lower prevalence of formula
feeding of 1.7,6.3 and 13.4% at 4,12 and 22 weeks respectively compared to our findings
7.5,6.8 and 17% another study from the bhaktapur districts ,near the capital city of Nepal
reported that 31%of infant aged nine months were provided infant formula (23). The
government of Nepal has banned the advertising of infant formula in health facilities,
enforced the mother milk substitutes (control of sale distribution) act,2049(1992) (24).as
a result, the provision of infant formula as gift or free samples is non-existence in public
hospitals in Nepal, similarly childhood illness management protocol for health workers
discourage formula feeding(23). Despite these efforts, the use of infant formula in Nepal
appears to be on the rise: therefore, there is further need to be curtail such practices.

Nepal follows WHO guideline in infant feeding and encourages and promotes exclusive
breastfeeding in the first life. When mother’s milk is no longer sufficient due to maternal
illness and death, the child health guidelines of the mystery of health recommends clean

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and boiled cow’s milk to avoid contamination and also protect from under in early
infancy (23).

In this study, urban mothers were twice as likely as rural mothers to provide formula their
babies. Urban areas have a number of characteristics’ which make infant particularly
vulnerable to formula feeding. The majority departmental stores and retail pharmacies are
located in urban areas of Nepal. They sell infant formula without any restriction, mothers
who experience some difficulties in breastfeeding can easily find infant formula in urban
areas, and use as an alternative to breastfeeding (23).

2.3.2. Maternal and family related factors

Maternal age:-age of mothers affects exclusive breast feeding, of which different studies
reported that mothers with age older than 30 years were exclusively breastfed their infant
compared younger age mothers(25, 26).an in contrary to above studies, other evidence
indicated that younger mothers whose age less than 30 years were breast fed exclusively
their infant(27).

Educational status of mother:-educational status of the mother has been identified as an

important social determinate of health for children. The role of maternal education on
infant feeding behavior is an interesting area to explore. Women education in Nepal has
long been neglected and still remains much lower than men. In recent year there has been
improvement in women’s education status. Therefore the effect maternal education might
also impart effect on health and infant feeding behavior. This study aims to investigate
the association between early initiation of breastfeeding and mothers education status
using data from Nepal demographic and health survey2001, 2006 and 2011

Maternal economic status:-data from several studies suggest that women of lower
socioeconomic status (SES) are less likely to breastfeed their infant, both in the United
States and elsewhere (28).

Employment status of mothers: - in dubti town being a housewife shows positive

associated with exclusive breastfeeding practices compared to employed mothers.

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Similarly findings were obtained goba district (15), ambo district (29). and dabat district
(30). This could be due to the fact that housewives (unemployed mothers) have more
time to be with their infant throughout the whole day and can provide breastfeeding on
demand. On other hand employed mothers may not have frequent contact with their
infant. This hinders proper breastfeeding practices, and exclusive breastfeeding.

Maternal marital status:-the maternal marital status and religion affects the exclusive
breast feeding as following studies indicated, one study revealed that unmarried women
were 2.2 times more likely to practiced breast feeding exclusively than married women
(16).

Contrary, study from southern Ethiopia reported currently unmarried women had 4 times
chance of less breast fed to their infants exclusively than married women (31).

Residence of the mothers:-places that mothers resides had potential effects on the
exclusively breast feeding practices, reports from Timor leste study revealed those
mother who resides in the rural had breast fed their infant exclusively compared to urban
residents(26).

Similarly finding was obtained from studies done in mecha district, North West of
Ethiopia and Debreberhan district of central Ethiopia, showed that rural resident mothers
had higher chance of breast feeding practice compared to urban residents ((32).

Maternal knowledge and exposure to information:-knowledge of the mothers and

exposure to information about breastfeeding were identified as determinant factors of BF.
Sudan study reported those mothers who had knowledge on breastfeeding were more
likely to breast fed their infants exclusively (33).

Similar finding were reported from mecha district, North West Ethiopia, mothers with
more knowledge about BF were breast fed their infants more likely than their counterpart
(3).

Number of children:-number of children that mothers had were associated with the
exclusive breast feeding; study in Timor-Leste reported mothers with more than 4

9
children were less likely to offered breastfeeding exclusively than mothers with less
infants(34).

Contrary to above study, Vietnam study reported mothers with more than three children
were practiced lower breast feeding compared to mothers with less infants (35).

2.3.3. Obstetric and health facility related factors.

Antenatal care:-Obstetric and health facility related factors were showed to be
determinants factors of exclusive breast feeding, results from Nigeria revealed those
mothers who had four or more antenatal visits were 2.7 times more likely to exclusively
breast fed (5).

Similarly finding were obtained from mecha district, north west Ethiopia and
Debremarkos north west Ethiopia, summarized that mothers who had more ANC visit
during pregnancy had higher chance to breast fed exclusively their infants than who had
less or no ANC follow up(3).

Contrary to above studies, study country wide of Ethiopia reported ANC were not
associated with exclusively breast feeding (3).

Postnatal care: -mothers who had received infant feeding counseling during the
postnatal visit were more likely to breastfed their infants exclusively.

This in line with a study from mecha district were mothers who receive PNC counseling
on infant feeding were more likely to practice EBF compared to those who receive no
counseling during postnatal care (13, 16). And also similar to findings at Debremarkos
(11). and Addis Ababa (21).this shows that postnatal period is an appropriate time to
provide important infant feeding messages.

Place of delivery:-where mother give birth their infants become predictor for breast
feeding continuation, results from Germany study revealed mother who delivered home
were less likely to had breast fed exclusively than those delivered health institutions
[36].study from Cameron reported similar finding, mothers who delivered at home had
lower breast feeding than mothers who delivered health care institution [19].

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Similar to above studies, mothers who delivery home were more likely to breast fed than
those delivered health care institution ,means heath care set up delivery were positively
associated exclusive breast feeding practice (32).

Mode of delivery:-affects the way mother breast feed their infants as a lot of evidence
was revealed from different studies, in Germany study showed that mothers who
delivered by caesarean section in health facilities were practiced lower breast feeding
than mothers who delivered vaginally(36).

Similarly other finding reported that those mothers who delivered by caesarean section
were less likely to start breast feeding earlier with in the first one hour and continued the
exclusive breast feeding compared to mothers who delivered vaginally(35).

2.3.4. Infant related factors

Infant age: -infant age was a predictor of exclusive breastfeeding practice. Compared
with infants in the age group of 4 to 6 months, the infant aged less than 2 months were
seven times more likely to be exclusive breastfed when compared to those infants in the
age group 4-6 months. This shows that as the age of the infant approached 6 months, the
rate of exclusive breastfeeding decrease significantly. This is study similar to other
studies [8, 15, 18, and 19].

Sex of the infant:-result of some studies reported that the sexes of infants were
associated with EBF. In Denmark study revealed that male infants were 1.7 times more
likely to breast fed exclusively than female infants (37).

Similar finding were observed from Cameron which said that male infants had breast fed
exclusively more likely than female infants (28). Contrary different finding was revealed
from others study which was female infants had breast fed exclusively compared to male
infants (26).

Birth weight of the infants:-birth weight of infants had effects on breast feeding of
which results of some studies revealed, in Germany study reported term birth infants had
breast fed higher than pre-term birth infants (36).

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Similarly to above study other study finding reported infants whose mothers gave birth at
gestational age between 24-27 were 2.9 times more likely to failure to breast fed
exclusively compared to term infants(37).

Time of breast feeding initiation to the infant: - this study revealed that mothers who
initiated breastfeeding early were more likely to practice exclusive breastfeeding
compared to mothers who initiated breastfeeding later. In mecha district mothers who
initiated breastfeeding immediately after birth were more likely to practice exclusive
breastfeeding than those who did not initiate breastfeeding immediately after birth
[13].this may be due to the fact that late initiation of breastfeeding is associated with
decrease newborn-mother bonding and the inadequate maternal breast milk secretion.
This in turn may lead to early introduction of other foods and/or drinks.

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2.4. Conceptual framework

Maternal and family related factors

Obstetric and health facility
 Socio-demographic related factors
characteristics of mother
 Place of delivery
 Parity
 BF
 Maternal illness
information(counseling)
 Maternal income
 Mode of delivery
 Knowledge on BF
 ANC
 Exposure to information about
 Postnatal care
BF
Exclusively
breast feeding
practice

Infant formula promotion Infant related factors

 Advertisement of infant  Age

formula from TV, radio,  Sex
posters.  Colostrum feed
 Free provision of infant  Timely initiation of BF
formula in HF  Pre-lacteal feeding
 Health provider’s status
recommendation

Figure1Conceptual framework
Adapted and modified from muse .o (2017)

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3. OBJECTIVE OF THE STUDY

3.1. General objective

 To assess exclusive breast feeding practice and associated factors among mothers
of infant aged 0-5 months in public health centers of Addis Ababa Ethiopia.

3.2. Specific objective

 To determine the prevalence of exclusive breast feeding practice
 To identify factors associated with exclusive breast feeding

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4. Methods

4.1Study area and period

The study will be conducted in Addis Ababa city administration, the capital and largest
city of Ethiopia. its situated in central Ethiopia at an elevation of about 2440 m (about
8000 f.t) above sea level on a plateau(38)Addis Ababa encompasses 10-sub cities and
121woreda for administration purpose. (39)Each sub-city is expected to serve for a total
population of 300,000 and each Woreda for 30,000 people.(39)According to Addis
Ababa city administration integrated land information center report Addis Ababa covers
an area of 530.14 square kilometers with projected 2019 total population of
3,384,569(38)with annual growth rate of 2.83%..(39)The overall health care activity of
the city is coordinated by Addis Ababa regional health bureau. There are 52 hospitals:
11government, 41 private and 102 health centers. From these 6 of the government
hospitals and all of the health centers are under Addis Ababa regional health bureau. One
public health center is estimated to give service to 40,000 populations. The city has
classified into two Administrative layers such as the Sub-City top layer followed by
Woreda based on current classification. (39)Based on this the selected Health Centers
represent the study population. The data collection period will be from April 1 stto
june2020.

4.2. Study design

This study will be conducted using quantitative, an institutional based cross-sectional
study design.

4.3. Source population

The source of population will be all mothers of infants aged under six months who will
come for immunization, in patients and out patients in public health centers of Addis
Ababa during the study period.

4.4. Study population

The selected mothers of infants aged under six months who will come to have an
appointment, in patients and out patients in the selected health center during study period
and those who will meet the eligibility criteria

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4.5. Eligibility criteria
4.5.1. Inclusion criteria

All mothers who will be visited health facilities with infants aged under six months in
public health center of Addis Ababa will be included in the study

Only those mothers who brought their children to health facilities will be included in the
study

4.5.2. Exclusion criteria

Care giver beside mothers who brings children of facilities excluded from the sample.

Mothers who came from outside Addis Ababa excluded from the study.

Mothers who had sever ill infants.

4.6. Sample size determination

The sample size required for the study will be calculated using formula to estimate a
single population proportions. The sample size will be determined based on Senegal
(Dakar) prevalence of mothers who were observed promotion of breast milk
substitutes which was 41% (34) and level of precision at 95% level of confidence will
be used. Then 10% for non-response will be taken. The final sample will be

Then the highest sample size will be used = 371

Then adding 1.5 design effect 371*1.5=556

Then add 10% non- respondent rate 556 + (556*10%) =612

Total sample size will be = 612

4.7. Sampling technique or procedure

For this study Multi-stage sampling technique will be used. Out of the ten sub-cities
which are found in Addis Ababa city five will be chosen using simple random lottery
methods which gave equal chance for each sub-city, by the same technique two health
centers will be selected from each selected sub-city’s which will result in total ten health

16
 centers. Then the total sample size will be proportionally allocated for the ten Health
Centers, depending on the client flow in each Health facilities.

Based on SRS

Kolfe Sub- Bole Sub-

cite Nif/Silk lafto Yaka Sub- Akakikality
cite
Sub-cite cite Sub-cite
Clint flowchart

H.C. 2 H.C. 4 H.C. 9 H.C. 10

H.C. 1 H.C. 3 H.C. 5 H.C. 6 H.C. 7 H.C. 8

Total 612sample
participants

Fig.2 Schematic presentation of the sampling technique procedure

17
4.8. Data collection Tools
Structured qualitative questionnaires will be develop by reviewing EDHS questioners and
different literatures and adapted to local situation with necessarily modifications.

The questionnaire consists of six sections. The first section is about socio demographic
characteristics of the respondent. Second information and housing condition questions
third section about sanitation and hygiene forth about maternal/infant health and health
service utilization questions the 5th section is about breast feeding related the last section
about infant formula related questions.

4.9. Data collection procedures

Data will be collected from mother with infant aged 0-5 months who came for
immunization, in patients and out patients during the data collection period which is
between may1stto june15, 2020 and fulfill the inclusion criteria in the selected health
center by using structured questioners.

The structured questionnaires will be develop by reviewing different up to date literatures

and adapted to local situation with necessarily modifications. The questionnaires will be
prepared originally in English and then translated in Amharic (local language) version
then translated back to English version by another person of similar ability to check for to
ensure its consistency. The questionnaires will be pre-tasted for 5% of the sample size
other than the selected health centers in order to realize the questioner contains all the
relevant variables. The data will be collected through three BSC data collectors and one
BSC supervisor

4.10. Data quality management

The quality of the data will be assured starting with the questioner by ensuring that it is
standard and meets its objective by doing pretesting before data collecting then by
employing an experience three midwives data collector and two health officers as
supervisors (which doesn’t work in the selected health center). Two day training will be
given to data collectors and their supervisors by principal investigator on how to choose

18
participants, data collection method /process, and clarifying how to interview the
questionnaire and about the objective of the study.

The data collectors should be sure that every participant are voluntary to involve in the
study before proceeding to the interview. The principal investigator closely follows data
collection along with the supervisor on site throughout the data collection period. The
questionnaire will be checked daily for completeness, inconsistency and error will be
corrected at the spot.

4.11. Study variables

Dependent variable
 Exclusive breast feeding practice

Independent variables
 Infant formula promotion
 Maternal related factors
 Obstetric and facility related factors
 Infant related factors

4.12. Operational definition

Exclusive breastfeeding:-infant fed only breast milk (with the exception order medicines
and vitamins by health professionals)

Breast milk substitutes:-defined as Breast milk substitutes formulated industrially,

prepared children less than six months up to one year and older which includes infant
formula, follow-up formula and growing-up

Infant formula: - defined as breast-milk substitutes formulated industrially, prepared

only for infant aged under six months

Infant formula promotion:- defined as if a mother exposed to advertisement material

including media, printing material which indicates material is good for infant or if sample
is given to mother or other activities to encourage mothers to use the formula once in a
life time.

19
Professional promotion:-defined as if mothers receive recommendation from health
profession, to use infant formula for their infant once in a life time of the mother.

Lay man promotion: -defined as if mothers receive recommendation from family or other
individuals to use infant formula for their infants once in a life time.

Literate:-attended formal school

Illiterate: -never attended school

4.13. Data analysis procedure

The data will entered and cleaned using (EPI data) version 3.1 and analyzed by STATA
software version 14 descriptive summary statistics such as frequency, percentage, means
standard deviation and median will be used to summarize different characteristics of the
study participant. Bivariate analysis will performed on the predictor variables and the
simple binary logistic regression will employed to calculate crude odds ratio to identify
variables associated with exclusive breastfeeding practice and to select variables for the
multivariable logistic regression analysis. Multivariate logistic regression will be used to
control confounding variables adjusted (AOR) with odds ratio 95% confidence interval
will estimate to investigate the association between dependent and independent variables.
Variable p-value ≤0.2 in the bivariate analysis will be taken to the multivariable analysis,
with the exception of infant formula promotion which will promote to the final model
regardless of their cut-off value. In multivariate regression model p-value of P<0.05 will
use as a measure of statistical significance.

4.14. Ethical consideration

First the final proposal will be submitted to rift valley university abichu campus the study
will be approved by department of general public health of rift valley university Ethical
review Committee (ERC). A letter obtained from rift valley university abichu campus of
general public

Health ERC will submit to the selected health center and Addis Ababa health biro to gate
permission for the study area will obtained from the Health Office of the study area
before starting the study. The information sheet and consent will be provided for
respondents to read for those who can read and the data collector will read the consent

20
 form for those respondents who cannot read. Finally informed verbal consent will be
obtained from study participants. Then who agreed will continue the questioner. The
purpose and the benefit of the study will be discussed with each participant

4.15. Dissemination plan

Findings of the study will be submitted and presented to rift valley university abichu
campus department of general Public Health Also; the result will be disseminated to the
Addis Ababa health bureau and to the FMOH of Ethiopia. Finally, an attempt will be
made to publish the findings to reputable journals.

Work plan and Budget

Table 1: Budget breakdown

Budget category Items Unit cost Multiplying factor Cost

21
1. Personnel Data collector 20 per 20 X585 11,700
questioner

Supervisor 100 per day 2X 100 X 44 days 8,800

Training 100 per day 10x 100 x 2 2,000

2. Pre-test 20 per 32*20 640

questioner
Total Personnel costs 23,140 ETB

3. Transport 30 30 X 44 days 1,320

Total Transport costs 1,320ETB
3. Supplies Pens 5 ETB 10 X5 ETB 50

Questionnaires 20 ETB 653 X 20 13,060

Bags 400 ETB 10 x 400 4,000

proposal 500 ETB 2 x 500 1,000

Banding thesis 20 ETB 4X 20 80

R-writable CD 20 ETB 2 X 15 30

TotalSupplies costs = 18,220

TOTAL 42,680 ETB
Contigency =10% of the total [= 4,268

TOTAL = 46,948

Plan for data processing and analysis

Year 2019 2020

22
n month Dec Jan Feb Mar May Jun July Auge
o e

Weak 2 3 4 1 2 3 4 3 4 1 2 3 4 1 1 2 3 4 1 2 1 2 3 1 2

Titile

1 Submit the first draft proposal

2 Advisors review and give comments

3 revise proposal based on the

comments

4 Submit second draft for advisor

5 Advisors review second draft and

give comments

6 revise 2nd proposal based on the

comments

7 Submit research proposal to their

advisors

8 present and defend the research

proposals

9 Students revise proposal based on the

feedback on defense

1 Students submit to the school the

0 final research proposal

1 Ethical approval of the school Rec.

1

23
1 Training of data collector
2

1 Data collection and entry

3

1 Data analysis and interpretation

4

1 Writing result
5

24
Reference
1. CSA, M O. Ethiopia demographic and Health survey 2011 Addis Ababa and
Calverton ,Maryland,USA:. central statistics agency and ORC Macro 2012.
2. Organization(WHO) WH. indicators of assessing infant and young child feeding
practice. France. 2008.
3. T.G W, A.W K, Edrise. assessment of exclusive breastfeeding peractices and
associated factors in Mecha district, northwest Ethiopia. Science Journal of Public
Health. 2014;2(4).
4. Agency CS. Ethiopia Demographic and Health Survey 2011 Addis
Ababa,Ethiopia: . ICF International. 2012.
5. UNICEF. Tracking progress on child and maternal nutrition:. A Survival and
Development priorityNew York. 2009.
6. LJ H, DM. F. Berastfeeding and later cognitive and academic outcomes.
pediatrics. 1998;101(1).
7. RM K, RE B, HB J, BF S. Nelson Textbook of pediatrics 18th ed.
USA:saunders,an imprint of Elsevier Inc. 2007.
8. program Iwiac. Berastfeeding Promotion and Support Guidelines for Healthy Full
Term Infants. Iowa Department of Public Health 2001.
9. (WHO) WHO. Global strategy for infant and young child feeding. . Geneva.
2003.
10. X Ca, T W, DW B, et.al. Global trends in exclusive berast feeding. International
breastfeeding Journal. 2012;7(1):12.
11. G M, M2 E. exclusive breastfeeding and associated factors among mothers in
Debre Markos,northwest Ethiopia: a cross-sectional study. International breastfeeding
Journal. 2015;10(1).
12. Health FMo. Family Health Department of Ethiopia. National Strategy on infant
and young child feedingAddis Ababa,Ethiopia:. 2004.
13. WHO. Infant and young child feeding Model chapter for textbooks for medical
students and allied health professionals. Geneva. 2009.

25
14. CJ C, KG D, JM P, EA W, LA M-R. in-Hospital formula use increases Earely
Breastfeeding Cessation Among First -time mothers intending to exclusively breastfeed.
journal pediatric 2014;164(6):45.
15. HL S, A I, RR R, AA P, JM O, S N-U. is unimpeded marketing for berast milk
substitutes responsible for the decline in berastfeeding in the philippines social science
and medicine 2011;73.
16. (GAO) USGAo. some strategies used to market infant formula may Discourage
berastfeeding. state contracts should better protect aganist Misuse of WIC name. 2006.
17. Hunegnaw MT, Gezie LD, Teferra AS. Exclusive berastfeeding and associated
factors in Gozamin district, northwest Ethiopia:a community based cross-sectional study.
International breastfeeding Journal. 2017;12(30).
18. G.A B, A T, G.A T. Effects of antenatal care and institutional delivery on
exclusive breastfeeding practice in northwest Ethiopia. International breastfeeding
Journal. 2015;10(30).
19. N H, Z T, R S. socio-demographic factors associated with duration of exclusive
berast feeding practice among mothers in east Malaysia. IOSR Journal of Nursing and
Health Science(IOSR-JNHS). 2014;31(1).
20. KL T. factors associated with exclusive breastfeeding among infants under six
months of age in peninsular,Malaysia. International breastfeeding Journal. 2011;6(1):2.
21. JA L, AP B, AJ B, M DO. Deaths and years of life lost due to suboptimal breast-
feeding among children in the developing world:a global ecological risk assessment.
Public Health Nutrition 2006;9(06).
22. Organization(WHO) WH. International code of markiting of berast-milk
substitutes. Geneva. 1981.
23. A.M P, SL H, I A, S.R U, SH D, M C, et al. High consumption of commercial
food products among children less than 24 months of age and production promotion in
Kathmandu Valley. Nepal Maternal and Child Nutrition 2016;12(2).
24. moha GoNip. Substitute for breast milk (sale distribution and control).
Govermental of Nepal.20(49).

26
25. T.T.I A, W.M M, B.M I. Factors predicting Early Discontinuation of Exclusive
Berastfeeding among women in Kelantan,Malaysia. Health and the Environment Journal.
2013;4(1).
26. IMS K. The effect of Socio Demographic Factors on Exclusive Berastfeeding and
duration of Berastfeeding in Timor Leste. JU Journal of Information Technology. 2014;3.
27. B1 T, H2 A, K3 H. Prevalence and determinant factors of exclusive breastfeeding
practices among mothers in Enderta woreda,Tigray, North Ethiopia: a cross-sectional
study. International breastfeeding Journal. 2015;10(2).
28. F.E.E F, B O, E P, A Y, D A, CD O. Maternal Socio-Demographic Determinants
of Exclusive Berastfeeding practice in Cameroon. American Journal of Food and
Nutrition 2016;4(4).
29. T T. Thesis submitted to Addis Ababa University Colleges of health science
Assesment of Exclusive berastfeeding practice and associated factors among mothers in
Motta town,east Gojjam zone,Amhara regional state,Ethiopia. International
breastfeeding Journal. 2015;12(12).
30. (UNICEF) UNCF. Improving breastfeeding in west and Central Africa. West and
Central Africa. 2010.
31. T T, F M, T C. Prevalence and associated factors of nonexclusive Breastfeeding
of infants during the first six months in rural area of Sorro District,Southern Ethiopia: a
cross-sectional study. International breastfeeding Journal. 2016;11(25).
32. MM A, MD A, ZK k. Factors associated with exclusive breastfeeding practices in
Debr Berhan district centeral Ethiopia: a cross-sectional community based study.
International breastfeeding Journal. 2015;10(23):8.
33. S.M I, M.G T, A E. Factors influencing exclusive breast feeding among mothers
with infants age 0-6 months. International Journal Science Reasarch. 2015;4(8).
34. IM. K. the effects of Socio Demograhic factors on Exclusive Breastfeeding in
Timor Leste. Journal OF Information Technology. 2014;3.
35. Q T-TB, H L, A L, D D, L V. Trends and determinants for early initiation and
exclusive breastfeeding under six months in Vietnam:result from the Multiple Indicator
Cluster Surveys. Glob Health Action. 2016;9.

27
36. M K, B R, U S, H KF. Breastfeeding rate and duration in Germany:a Bavarian
cohort study. British Journal of Nutrition 2008;99.

ANNEXSES
Participant information sheet and informed consent form

My name is ----------------------currently I am a masters degree graduate candidate

students at rift valley university abichu campus department of general public health. This
time I’m doing my thesis on the exclusive breast feeding practice and associated factors
in Addis Ababa Ethiopia.

The study title Exclusive breast feeding practice and associated factors among mothers
of infants aged under 6 months in Addis Ababa Ethiopia.

Purpose of the study The finding of this study is to identify exclusive breast feeding
practices and associated factors in Addis Ababa. Knowing this factors have paramount
important for the city of health office to plan for the intervention programs so as to
reduce infant morbidity and mortality that are associated with non exclusive and sub
optimal breast feeding practices which result from infant formula promotion.

Procedure and duration I will be interviewing you using a questionnaire to provide me

with pertinent data that helpful for the study. There are questions to answer were I will
fill the questionnaire by interviewing you, the interview will take few minutes, so I kindly
request you to give me a time for the interview.

Risk and benefits The risk of being participating in this study is very minimal, except
few minutes of interview. There will not be any direct payment for participating in this
study: the findings obtain from the study are useful planning intervention programs.

Confidentiality The information that you provide us will be kept confidential. The name
and other identifiers of participants will not be used in the study to ensure anonymity of
the study.

28
Rights: Participation in this study is fully voluntary. You have the right to declare not to
participate in this study and you have the right to quit the study any time

Contact address: If there are any questions or unclear idea any time about the
study or the procedures, please contact and speak to Principal investigator.

Principal investigator: fire abrha, Cell phone number: +2519 12012778

E- Mail:-fireabrha2018@gmaill.com

If you are willing to be in the study, you will be agreeing and let us proceed

Declaration of informed voluntary Consent

I have read/was read to me this consent form or participant information. I have

clearly understood the purpose of the research, the procedure, risks and benefits,
issues of confidentiality, rights of participating and contact address for any
question. I will be given the opportunity to ask questions for things that were not unclear.
I will be informed that I have the right to quit from the study at any time; therefore
I declare my voluntary consent to participate in this study with my signature.

Signature of the participant _____________ date________________________

Signature of the investigator ___________________ signature _____________ date

Questioner, English version.

Rift Valley University Abichu Campus

Department General Public Health

Questioner on the exclusive breast feeding practice and associated factors among mothers
of infants aged under six months in Addis Ababa Ethiopia

Code number-------------------name of the facility-----------------------

29
Section 1 socio demographic characteristics of mothers/fathers

S Variable Response and code Skip

No
101 How old are you? ------------------years
102 What is your ethnicity? Amhara--------------------------1
Tigre------------------------------2
Gurage----------------------------3
Oromo----------------------------4
Others-----------------------------
103 What is your religion? Orthodox-------------------------1
Muslim---------------------------2
Protestant-------------------------3
Catholic---------------------------4
Other specify---------------------
104 Have you ever attended school? Yes--------------------------- (No)10
No---------------------------- 7

105 If yes what is the highest level No education------------------------1

of school you attended? Primary school(1-8)----------------2
Secondary school(9-12)-----------3
Certificate/diploma-----------------4
Degree and above-------------------5
106 Specific your grade? ----------------------------
107 What is your occupation? House wife-----------------------------1
Remark: what’s your main Daily laborer---------------------------2
income generating activity Students---------------------------------3
Governmental organization
employee--------------------------------------------
-----4
Private organization employee--------5

30
 agriculture---------------------------------6
Other, specify------------------------------
108 What is your marital status
Single (never married)-------------------1 (1)201
Married-------------------------------------2
Divorced------------------------------------3 (3)201
Window-------------------------------------4 (4)201
Cohabitation--------------------------------5 (5)201
109 If you are married/living Yes-----------------------------------
together with a man’s as No------------------------------------- (No)11
husband and wife, have your 2
husband’s ever attended school?
110 If yes, what is the highest level No education---------------------------1
of school he attended Primary school(1-8)-------------------2
Secondary school(9-12)---------------3
Certificate/diploma---------------------4
Degree and above-----------------------5
111 Specific your grade? --------------------
112 What is your husband’s/the man House wife-------------------------------1
you are living with as a husband Daily laborer-----------------------------2
and wife occupation? Students-----------------------------------3
Remark: means your main Governmental organization employee--4
income generating activity. Private organization employee---------5
agriculture----------------------------------6
merchant------------------------------------7
Other, specify------------------------------

31
Section 2 Housing condition

201 A television? Yes-------------------------------------1

No--------------------------------------2
202 Radio/tape recorder? Yes--------------------------------------1
No---------------------------------------2
203 Mobile telephone? Yes--------------------------------------1
No---------------------------------------2
204 Non-mobile/fixed telephone? Yes--------------------------------------1
No----------------------------------------2
205 Electricity? Yes---------------------------------------1
No----------------------------------------2
206 Electric stove? Yes---------------------------------------1
No----------------------------------------2
207 A kerosene lamp/Pressure Yes---------------------------------------1
lamp? No----------------------------------------2
208 Refrigerator? Yes---------------------------------------1
No----------------------------------------2
209 A watch/clock Sofia? Yes----------------------------------------1
No-----------------------------------------2
210 Sofia? Yes----------------------------------------1
No-----------------------------------------2
211 Table? Yes----------------------------------------1
No-----------------------------------------2
212 Chair? Yes----------------------------------------1
No-----------------------------------------2
213 Abedwithcotton/sponge/spring Yes--------------------------------------1
matters? No---------------------------------------2
214 Bajaj? Yes----------------------------------------1
No-----------------------------------------2
215 Car? Yes----------------------------------------1

32
 No-----------------------------------------2
216 Who is the owner of the house Private(own)--------------------------1
you live? Governmental---------------------------2
Rent--------------------------------------3
Other, specify------------------------
217 What is the roofing material of Mud------------------------------------1
your house? Wood----------------------------------2
Corrugated iron----------------------3
Cement/concrete--------------------4
Other, specify-----------------------------
218 What is flooring material of Mud--------------------------------------1
your house? Parquet-----------------------------------2
Cement/ Ceramic ----------------------3
Carpet------------------------------------4
Other---------------------------------
219 Does your household own any Yes--------------------------------------1
livestock, herd or any animals? No---------------------------------------2 (No)
If yes, which one do you have? 221
220 If yes, which one do you have? Camel----------------------------------1
Cows/oxen/bulls----------------------2
Goat------------------------------------3
Sheep----------------------------------4
Others(specify)---------------------------
221 Does your household own any Yes------------------------------------1
agricultural land? No-------------------------------------2
222 What is average monthly ----------------------------------------
income of the households?(in
birr)

33
Section 3.maternal /infant health and health service utilization question

30 How many children do you have ----------------------------children

1 currently?
30 Did you receive ANC service Yes------------------------------------1
2 during your last pregnancy? No-------------------------------------2 (No)
306
30 If yes where did you receive ANC Gov.hospital-----------------------1
3 service? Private hospital--------------------2
Health center-----------------------3
Health post-------------------------4
Private clinic-----------------------5
30 How many times did you receive Ones-------------------------------1
4 ANC during last pregnancy? Two times-------------------------2
Three times-----------------------3
Four times and above------------4
30 Did you receive counseling Yes----------------------------------1
5 concern about breast feeding No-----------------------------------2
during your ANC visit?
30 Where did you give birth of this Hospital----------------------------1
6 infant? Private hospital-------------------2
Health center----------------------3
Health post-------------------------4
Private clinics---------------------5
Home-------------------------------6
Other, specify----------------

30 What was the mode of delivery? Normal/vaginal-------------------1

7 c/s-----------------------------------2
30 What is the age of your infant? -------------------------------months
8

34
 30 What is the sex of your infants? Male--------------------------------1
9 Female-----------------------------2
31 Did you receive PNC with in the Yes----------------------------------1
0 first 24hr of delivery? No------------------------------------2 (No)
401
31 If yes? Where did you receive? Gov. hospital----------------------1
1 Private hospital-------------------2
Health center----------------------3
Health post------------------------4
Private clinics--------------------5
Home------------------------------6
Other, specify-------------------------

31 Did you receive counseling Yes--------------------------------1

2 regarding, breast and No---------------------------------2
complementary feeding practice
during PNC service?
Section 4 breast feeding related question

40 Have you ever breast fed your Yes-----------------------------------1

1 currently baby? NO------------------------------------2 (No)
409
40 If yes to ever breast fed, has your Yes------------------------------------1
2 infant fed breast milk in the last No-------------------------------------2
24hr? (No)
409
40 If your infant breast fed in the ---------------------------times
3 last24hr, how many times you’re
infant did breast fed?
40 If your infant fed breast milk in Yes---------------------------------1
4 the last 24hr, does your infant fed No-----------------------------------2 (No)
other food/liquid in addition to

35
 breast milk? 409
40 If yes, what was other food/liquid Plan water---------------------------1
5 that your infant fed in addition to Juice-----------------------------------2
breast milk? Soup-----------------------------------3
Powdered milk other than infant formula
milk-------------------------4
Fresh animal milk-------------------5
Infant formula milk-----------------6
Tea------------------------------------7
Other liquid specify------------------

40 If your infant fed other food -------------------------------

6 /liquid in addition to breast milk,
how many times your infant fed
breast milk?
40 If your infant didn’t fed breast Plan water----------------------------1
7 milk in the last 24hr,what was Juice-----------------------------------2
food/liquid that your infant fed Soup-----------------------------------3
Powdered milk other than infant
formula-------------------------------4
Fresh animal milk-------------------5
Infant formula-----------------------6
Tea------------------------------------7
Other liquid specify---------------
40 If your infant didn’t fed breast Going back to work----------------1
8 milk in the last 24hr, whatwas the I had illness -------------------------2
reason? Infant illness-------------------------3
Decrease breast milk---------------4
I had no time-------------------------5
Because my infant was feeding infant
formula-----------------------6

36
 Because breast milk can be replace by infant
formula-------------------7
Other, specify---------------------
40 Did you put your infant at your Yes------------------------------------1
9 infant at your chest immediately No-------------------------------------2
after you give birth?
Remark: that’s does your skin and
infant skin contact for awhile after
you delivery?
41 How soon after birth did you put Immediately within 1hr of birth---1 (1)5
0 your infant for the first time to 1hr up to 1day-----------------------2 12
breast feed? After 1day up to 3days-------------3
After 3 days--------------------------4
41 If delayed more than 1hr what c/s delivery---------------------------1
1 were the reasons that made you maternal illness----------------------2
delayed in breast feeding infant illness-------------------------3
initiation? delayed milk secretion--------------4
Multiple answers are possible. infant refusal-------------------------5
because I initiated infant
formula------------------------------------------6
is not appropriate time to
initiate-------------------------------------------7
other specify-----------------

41 Did you fed the first Yes------------------------------------1 (yes)

2 milk/colostrum to your baby? No-------------------------------------2 601
41 If you did not feed first milk Infant unable to take as a food----1
3 /colostrum what the reasons? Is not good for infant health-------2
It’s a tradition/culture---------------3

37
 41 If you did not feed the first Plain water---------------------------1
4 milk/colostrums what was your Sugar or glucose water-------------2
infant give after birth? Powdered milk other than infant formula
milk?------------------------3
Animal milk--------------------------4
Sugar-salt-water solution-----------5
Fruit juice----------------------------6
Infant formula-----------------------7
Tea/infusions------------------------8
Honey---------------------------------9
Fresh butter-------------------------10
Porridge----------------------------11
Other specify-----------------------

Section 5.Barries to Exclusive Breastfeeding

50 Did you experience any Yes---------------------------------------------1

1 breastfeeding problems? No----------------------------------------------2

50 If, yes what was the problem Abscess-----------------------------------------1

2 Mastitis------------------------------------------2
sore/cracked nipples---------------------------3
other (mention)---------------------------------4
50 How did you manage the problem express breast milk--------------------------1
3 went to hospital for advice------------------2
rub local herbs on it---------------------------3
others(mention)--------------------------------4
50 Is there any organizational/ social Yes-----------------------------------------------1
4 support for breast feeding No------------------------------------------------2
50 If yes could you mention it ------------------------------------------------
5

38
 50 What do you think are the reasons lack of information---------------------------1
6 for mothers not breastfeeding work demand----------------------------------2
exclusively? insufficient breast milk-----------------------3
traditions and cultural beliefs----------------4
other (mention)---------------------------------5
50 Is there any culture/tradition Yes-----------------------------------------------1
7 prohibits you from exclusive No------------------------------------------------2
breast feeding up to six months
50 If yes could you mention it ------------------------------------------------
8

Section 6.infant formula related question.

60 Have ever heard/seen any Yes----------------------------------1

1 information talking about infant No------------------------------------2 (No)
form? 606
60 If you heard/seen, what kinds of Infant formula is good for infant
2 information were you did you health--------------------------------1
received? Infant formula is good for infant
Multiple answer are possible growth-------------------------------2
Infant formula make the infant
smart---------------------------------3
Infant formula is good for infant
intelligence-------------------------4
Breast feeding can be replaced by infant
formula feeding ------------5
Infant formula has same nutritional benefits
as breast feeding------------------------------6
I don’t remember------------------7
60 If yes from where you did you From radio--------------------------1
3 received? Internet------------------------------2

39
 From health professional---------3
From my mother-------------------4
From supermarket keepers-------5
From friend/family----------------6
From TV----------------------------7
From gov.hospital-----------------8
From private hospital--------------9
From health center---------------10
Health post------------------------11
From private clinics-------------12
From pharmacies-----------------13
Other ,specify--------------------
60 If you heard/seen how many times ------------------------------times
4 were you heard?
60 If you heard/seen what was the last Before--------------------months
5 time you were exposed?
60 Have you ever received a sample of Yes---------------------------------1
6 infant formula milk from health No----------------------------------2
institution staffs?
60 Have ever fed infant formula to Yes----------------------------------1
7 your current infant? No-----------------------------------2 (No)
611
60 If yes, has your infant fed infant Yes----------------------------------1
8 formula milk in the last 24hr? No-----------------------------------2 (No)
615
60 If you fed your infant formula milk Because breast milk is not enough------------1
9 in the last 24hr, why you gave? I had illness---------------------------------2
Infant illness--------------------------------3
I had no time to breast feed the infant--------4
Because infant formula better than breast
milk-----------------------------------------------5

40
 Infant formula is good for infant growth,
health and intelligence--------------------------6
Because infant formula has same nutritional
benefits as breast feeding ----------------------7
Other, specify-------------------
61 If you’re infant fed infant formula From pharmacy/drug shops--------------1
0 in the last 24hr, from where you From supermarkets------------------------2
get/buy the infant formula milk? From shops---------------------------------3
I got freely/gift from company----------4
From family---------------------------------5
Other, specify--------------------
61 Did you previous infants ever fed Yes----------------------------------------1
1 infant formula milk? No-----------------------------------------2
61 Have you ever exposed any Yes----------------------------------------1
2 information talking about bottle and No------------------------------------------2 (No)
tea? 614
61 If yes, did your infant drinks Yes---------------------------------------1
3 anything from a bottle in the last No-----------------------------------------2
24hr?
61 Would you recommend formula Yes----------------------------------------1
4 feeding to anyone? No-----------------------------------------2
61 If yes to whom would you To my friends----------------------------1
5 recommended? To my family-----------------------------2
To my neighbors-------------------------3
Others, specify----------------------
Annex2: Amharic version

ስለጥናቱ አጠቃላይ መረጃ እና የስምምነት ማስገንዘቢያ ቅጽ

ጤና ይስጥልኝ እንዴት አድረዋል/እንዴትዋሉ/ልሽ

ፍሬ አብርሀ እባላለሁ፡፡ በሪፍቲ ቫሊ ዩኒቨርስቲ አቡቹ ካምፓስ የህብረተሰብ ጤና

አጠባበቅ ትምህርት ክፍል የሁለተኛ ዓመት የማስተርስ ዲግሪ ተመራቂ ተማሪ ነኝ፡፡

41
የጥናቱ ርዕስ፡-የጡትብቻ የማጥባት ትግበራና ተዛማጅ ችግሮች፣አዲስ አበባ
ኢትዮጵያ፣2012

የጥናቱ ዓላማ፡-የጡት ብቻ የማጥባት ትግበራና እናቶች ጡት ብቻ እንዳያጠቡ

የሚየደርጋቸውን ችግሮች ማወቅ

ተሳታፊዎች፡-ከ 6 ወር በታች ልጆች ያላቸውና በቋሚነት የሚኖሩ እማወራዎች

የጎንዮሽ ጉዳት፡-በዘህ ጥናት መሳተፍ ምንም አይነት ጉዳት የለውም፡፡

ጥቅማ ጥቅም፡-በዘህ ጥናት መሳተፍ ምንም ዓይነት ገንዘብ አያስገኝም፡፡ነገር ግን

በዘህ ጥናት መሳተፍ ስለ ጡት ብቻ ማጥባት እውቀት ያገኛሉ ወይም ያለዎትን እውቀት
ያዳብራሉ፡፡

ስለዘህ የተወሰኑ ጥያቄዎችን ልጠይቅዎት እወዳለሁ፡፡የእርስዎ በእውነት ላይ

የተመሰረተ መልስ ለዘህ ጥናት መሳካት አስተዋፅኦ ያደርጋል፡፡እርሶዎ የሚሰጡት
መረጃ ከአጥኚውና ቃለመጠይቅ አድራጊው በስተቀር በማነኛውም መልኩ ለሌላ 3 ኛ ወገን
ተላልፎ አይሰጥም፡፡በሙሉ ፍቃደኝነት እንዲሳተፉ እየጠየቅሁ የለመሳተፍ ወይም
በማንኛውም ጊዜ ራስዎን ከጥናቱ የማግለል ሙሉ መብት አለዎት፡፡ ማንኛውም ጥያቄ
ካለዎት በሚከተለው አድራሻዬ ማግኘት ይችላሉ፡፡

ፍሬ አብርሀ

ስልክ ቁጥር 0912012778

ኢ.ሜይል Fireabrha2018@gmail.com

የስምምነት መግለጫ ፎርም

ሪፍቲ ቫሊ ዩኒቨርስቲ አቡቹ ካምፓስ

የህብረተሰብ ጤና አጠባበቅ ክፍል

ድህረ ምረቃ ፕሮግራም

እኔ ስሜ ከዘህ በታች የተገለፀው፤የዘህ ጥናት ዓላም በደንብ የተብራራልኝ ስሆን

የጥናቱም ዓላማ ተረድቻለሁ፡፡በዚሁ ጥናት ላይ መሳተፍ በሙሉ ፍቃደኝነት ላይ
የተመሰረተ መሆኑን በሚገባ የተረዳሁ ሲሆን በማንኛውም ጊዜ ከጥናቱ የማግለል መብት

42
እንዳለኝ አውቄአለሁ፡፡ስለሆነም የምሰጠው መረጃ እስከተጠበቀ ድረስ በዚህ ጥናት
ለመሳተፍ ተስማምቻለሁ፡፡በዚህ ጥናት ለመሳተፍ ስምምነቴን ስገልፅ ለምጠይቀው ጥያቄ
በእውነት ላይ የተመሰረተ መልስ ለመስጠት የተስማማሁ መሆኔን አረጋግጣለሁ፡፡

የመረጃ ሰጪው ፊርማ-----------------------------ቀን-----------------------------------

አጥኚው ፊርማ---------------------------------------ቀን------------------------------------

ክፍል 1.አሁንየሚጠየቁትስለእራሶናቤተሰቦባህርያትየተመለከተጥያቄነው

ተ. ጥያቄ መልስ/ኮድ እለፍ

ቁ
10 የእርሶ እድሜ ስንት ነው?
1 ------------------አመት

10 ብሔር አማራ---------------------------------------1
2 ትግሬ----------------------------------------2
ጉራጌ-----------------------------------------3
ኦሮሞ---------------------------------------4
ሌላካለ----------------------------
10 ሀይማኖት ኦርቶዶክስ------------------------------------
3 1
ሙስሊም-------------------------------------2
ካቶሊክ----------------------------------------
-3
ፕሮቴስታንት----------------------------------
4
ሌላካለ---------------------
10 ተምረዋል አዎ----------------------------------------1
4 አይ-----------------------------------------2 (አይ)

43
 107

10 መልሶ አዎ ከሆነ አስከ ስንት ያልተማረ------------------------------------1

5 ተምረዋል? የመጀመርያ ደረጃ(1-8)---------------------
2
ሁለተኛ ደረጃ(9-12)------------------------
3
ዲፕሎማ-------------------------------------4
ዲግሪ አና ከዝያ በላይ----------------------
5

10 ክፍል/ደረጃው ይገለፅ ----------------------------

6
10 ስራ የቤት እመቤት-------------------------------1
7 የቀን ሰራተኛ---------------------------------
2
ተማሪ ----------------------------------------3
የመንግስ ሰራተኛ----------------------------
4
የግል ስራ-------------------------------------
5
የግብርና ስራ---------------------------------
6
ሌላካለ------------------------------------
(1)201
ያላገባ----------------------------------------
10 ---1 (3)201
8 የጋብቻ ሁኔታ ያገባ------------------------------------------ (4)201
--2 (5)201
የተፋታ----------------------------------------

44
 3
ባላ
የሞተባት----------------------------------4
ያላገባ ግን አብሮ የሚኖር-------------------
5
10 ካገቡ አብረው ነው የሚኖሩ አዎ-----------------------------------
9 ከባለቤቶት ጋር, ባለቤቶትስ አይ------------------------------------- (አይ)
ተምረዋል? 112
11 መልሶ አዎ ከሆነ አስከ ስንት
0 ተምርዋል? ያልተማረ-------------------------------------
1
የመጀመርያ ደረጃ(1-8)---------------------
2
ሁለተኛ ደረጃ(9-12)------------------------
3
ዲፕሎማ--------------------------------------4
ዲግሪ እና ከዝያ በላይ-----------------------
5
11 ክፍል/ደረጃይገለፅ? --------------------
1
11 የባለቤትዋ ስራ? የቀን ሰራተኛ -------------------------------1
2 ተማሪ-----------------------------------------2
የመንግስት ስራ------------------------------
3
የግል ስራ-------------------------------------
4
የግብርና ስራ---------------------------------
5
ሌላካለ-------------------------
ክፍል 2.አጠቃለይየቤቶትሁኔታ

45
201 ቴለቪዥን አለ-------------------------------------------
1
የለም-----------------------------------------
2
202 ሬድዩ አለ--------------------------------------------
-1
የለም-----------------------------------------
-2
203 ሞባኤል አለ--------------------------------------------
1
የለም-----------------------------------------
2
204 የቤትስልክ አለ------------------------------------------1
የለም---------------------------------------2
205 ኤሊትሪክ አለ-------------------------------------------1
የለም------------------------------------------
2
206 የኤሊትሪክምድጃ አለ-------------------------------------------1
የለም-----------------------------------------2
207 ኩራዝ/መብራት አለ------------------------------------------1
የለም----------------------------------------2
208 ፊሪጅ አለ-----------------------------------------1
የለም---------------------------------------2
209 ሰዓት አለ------------------------------------------1
የለም-----------------------------------------2
210 ሶፋ አለ--------------------------------------------
1
የለም------------------------------------------
2
211 ጠረጴዛ አለ---------------------------------------------

46
 -1
የለም------------------------------------------
2
212 ወንበር አለ--------------------------------------------
1
የለም------------------------------------------
2
213 አልጋከፍራሽጋር? አለ--------------------------------------------
1
የለም-----------------------------------------2
214 ባጃጅ አለ-------------------------------------------1
የለም----------------------------------------2
215 መኪና አለ-----------------------------------------1
የለም---------------------------------------2
216 የምትኖርበት ቤት ባለቤትነቱ የማንነው? የግል---------------------------------------1
መንግስት----------------------------------2
ኪራይ--------------------------------------3
ሌላካለ--------------------------------
217 የቤቶት ጣራ ከምን ተሰራ? ጭቃ-----------------------------------------1
እንጨት-------------------------------------2
ቆርቆር--------------------------------------3
ሲሚንቶ-------------------------------------4
ሌላካለ--------------------------------

218 የቤቶት ወለል ከምን ተሰራ? ጭቃ----------------------------------------1

ጣውላ---------------------------------------2
ሲሚንቶ ----------------------------------3
ምንጣፍ-------------------------------------4
ሌላ------------------------------------
219 በቤቶት ውሰጥ ማንኛውም እንስሳ አለ? አለ------------------------------------------1

47
 የለም----------------------------------------2 (አይ)221
220 መልሶ አዎ ከሆነ የትኛው እንስሳ ነው ግመል---------------------------------------1
ያሎት ? ላም/በሬ--------------------------------------2
ፍየል-----------------------------------------3
በግ--------------------------------------------
4
ሌላካለ----------------------------------
221 የቤተሰብ የግብርና ቦታ አለ?
አለ---------------------------------------------
1
የለም------------------------------------------
2
222 አማካኝ የቤተሰብ የወር ገቢ መጠን ---------------------------------------

ክፍል 3.የእናት /ህፃንየጤናአገልግሎትአሰጣጥ

301 የእርግዝና ክትትል አድርገዋል? አዎ--------------------------------------------1

አይ--------------------------------------------- (አይ)306
2
302 መልሶ አዎ ከሆነ የት ነበር የመንግስት ሆስፒታል-----------------------1
አገልግሎቱን ያገኙት? የግል ሆስፒታል------------------------------2
ጤና ጣብያ------------------------------------3
ጤና ኬላ---------------------------------------4
የግል ክሊኒክ----------------------------------5
303 የመጨረሻው አርግዝና ስንት ጊዜ ቅድመ አንድ ጊዜ---------------------------------------
ወሊድ ክትትል አድርገዋል? 1
ሁለት ጊዜ--------------------------------------2
ሶሰት ጊዜ--------------------------------------3
አራት እና ከዚያ በላይ-----------------------4
304 ቅደመ ወሊድ ክትትል ሲያደርጉ ጡት አዎ---------------------------------------------
የማጥባት የምክር አገልግሎት

48
 ተሰጥቶታል? 1
አይ----------------------------------------------
2
305 ልጆትን የት ነበር የወለዱት? የመንግስት ሆስፒታል-----------------------1
የግል ሆስፒታል-------------------------------2
ጤና ጣብያ-------------------------------------3
ጤና ኬላ---------------------------------------4
የግል ክሊኒክ-----------------------------------5
ቤት---------------------------------------------
6
ሌላ----------------

306 አወላለዶት እንዴት ነበር? በማህፀን---------------------------------------1

ኦፕሬሽን---------------------------------------2
307 አሁን ልጆት ስንት ዓመቱነው? -----------------------------------
308 የልጆትፆታ? ወንድ-------------------------------------------
1
ሴት---------------------------------------------
2
309 ድህረ ወሊድ ክትትል በ 24 ስዓት አዎ---------------------------------------------
አግኝትዋል? 1 (አይ)501
አይ--------------------------------------------2
310 መልሶ አዎ ከሆነ አገልገሎቱ የት ነበር የመንግሰት ሆስፒታል------------------------1
ያገኙት? የግል ሆስፒታል-------------------------------2
ጤና ጣብያ-------------------------------------3
ጤና ኬላ---------------------------------------4
የግል ክሊኒክ ---------------------------------5
ቤት---------------------------------------------
6
ሌላ------------------------

49
311 ድህረ ወሊድ ክትትል ላይ ስለጡት አዎ----------------------------------------------
ማጥባት እና ተጨመሪ ምግብ የምክር 1
አገልግሎት አግኝትዋል? አይ----------------------------------------------
2

312 ስለ ጡት ማጥባት ባለቤትሽ ምን በምክር ይደግፈኛል-------------------------------

አስተዋፆ አደረገልሽ 1
በገንዘብ
ይረዳኛል----------------------------------2
ምንም
አይረዳኝም-----------------------------------3
ሌላ ካለ
ይጠቀስ-------------------------------------4
313 አዎ----------------------------------------------
የሀይማኖት አባቶች እስከ 1
ስድስት ወር ስለ ጡት ብቻ አይ--------------------------------------------2
ማጥባት ምክር ሰጥተውሽ ያውቃሉ

ክፍል 4 ስለጡትአጠባብ

40 ልጆትን ያጠቡታል? አዎ-------------------------------------------1

1 አይ--------------------------------------------- (አይ)
2 409
40 መልሶ አዎ ከሆነ በ 24 ሰዓት ልጆት ጡት አዎ------------------------------------------1
2 ጠብትዋል? አይ-------------------------------------------2 (አይ)
409
40 ልጆት ጡት ሚጠባ ከሆነ በ 24 ስዓት ውስጥ --------------------------ጊዜ
3 ምን ያህል ጊዜ ጠብትዋል?
40 ልጆት ጡት የጠባ ከሆነ በ 24 ሰዓት ከጡት አዎ--------------------------------------------
4 በተጨማሪስ ምግብ ወይም ፈሳሽ ተጠቅምዋል? 1 (አይ)
አይ---------------------------------------- 409

50
40 መልሶ አዎ ከሆነ ከጡት በተጨማሪ የሰጡት የባንባውሀ------------------------------------1
5 ምግብ ወይም ፈሳሽ ምን ነበር? ጭማቂ----------------------------------------2
ሾርባ------------------------------------------
3
የዱቄት ወተት------------------------------4
የላም ወተት---------------------------------5
ከስደስት ወር በታች የተዘጋጀ የዱቄት
ወተት------------------------------------------
6
ሻይ---------------------------------------------
7
ሌላ-------------------

40 ልጆት ተጨማሪ ምግብ ወይም ፈሳሽ -------------------------------

6 ከወሰደ/ች ስንት ጊዜ ጡት
ይጠባል/ትጠባለች?
40 ልጆት ያለፈው 24 ሰዓት ምንም ጡት የባንባ ውሀ---------------------------------1
7 ካልጠባ ምን ምግብ/ ፍሳሽ ወሰደ/ች ጭማቂ-------------------------------------2
ሾርባ----------------------------------------3
የዱቄት ወተት ይሻላል ከስድስት ወር በታች
የተዘጋጀ የዱቄት ወተት------------4
የእንስሳ ወተት--------------------------------5
ከስድስት ወር በታች የተዘጋጀ የዱቄት
ወተት----------------------------------------6
ሻይ--------------------------------------------
7
ሌላ---------------
40 ልጆት ያለፈው 24 ስዓት ጡት ከልጠባ/ ች ወደ ስራ ስለተመለስኩ----------------------1
8 ምክንያቶት ምን ነበር? አሞኝ -----------------------------------------
2

51
 ልጄ ታሞ/ታማ-------------------------------3
የጡቴ ወተት ስለቀነሰ-----------------------4
ሰዓት ስለሌለኝ--------------------------------5
ከስደሰት ወር በታች የተዘጋጀ የዱቄት
ወተት------------------------------------------
6
ምክንያቱም የጡት ወተቱን ከስደሰት ወር በታች
የተዘጋጀ ወተት ስለሚተካው-------7
ሌላ---------------------
40 ልጆትን ከወለዱ በጓላ ወድያውኑን ደረቶት አዎ-------------------------------------------1
9 ላይ አስቀምጥዋል? አይ--------------------------------------------
2
41 ልጆትን ከወለዱ በጓላ ለመጀመርያ ጊዜ መቼ ልክ አንደወለድኩ በ 1 ሰዓትውስጥ--1 (1)412
0 አጠቡ? ከ 1 ሰዓትአስከ 1 ቀን-------------------2
ከ 1 ቀን በጓላ አስከ 3 ቀን---------------3
ከ 3 ቀን በጓላ-----------------------------4
41 ከ 1 ስዓት በላይ ሳያጠቡ ከቆዩ ምን ነበር በኦፕሬሽን ስለወለድኩ---------------------1
1 ምክንያቶት ሳያጠቡ የቆዩበት? የእናት ህመም------------------------------2
ከአንድ በላይ መልስ ይቻላል. የልጅ ህመም---------------------------------3
ጡት ወተት አልወጣ ስላለ-----------------4
ልጅ አልጠባ ብሎ----------------------------5
ምክንያቱም ከመጀመርያው ከስድሰት ወርበታች
የተዘጋጀ የዱቄት ወተት
ስለሰጠሁት/ስለሰጠሀት-----------------------6
ለማስጀመር ጥሩ ጊዜ አልነበረም-----------7
ሌላካለ-----------------

41 ልጆትን የመጀመርያ የጡት ወተት (አንገር) አዎ-----------------------------------------1 (አዎ)501

2 ጠብትዋል/ ጠብታለች? አይ------------------------------------------2

52
41 የመጀመርያ የጡት ወተት (አንገር) ካልጠባ/ ህፃኑ/ህፃንዋልከአነደምግብአይወስድልኝም/
3 ካልጠባች ምክንያቱ ምንድ ነው? አትወስድልኝም -----------------------------1
ለህፃንጤናጥሩነው-------------------------2
ባህላዊልማድ-------------------------------3

41 የመጀመርያ የጡት ወተት(አንገር) ካልጠባ/ የባን ባውሀ--------------------------------1

4 ካልጠባች ልክ እንደተወለደ/ተወለደች ምን ሱካርና ውሀ--------------------------------2
ነበር የሰጠሽ? የዱቄት ወተት ይሻላል ከስድስት ወር በታች
የተዘጋጀ የዱቄት ወተት?----------3
የእንስሳ ወተት------------------------------4
ሱካር-ጨው-ውሀ --------------------------5
ፍራፍሬ ጭማቄ----------------------------6
ከስድስት ወር በታች የተዘጋጀ የዱቄት
ወተት------------------------------------------
7
ሻይ--------------------------------------------
8
ማር-------------------------------------------9
ለጋቅቤ--------------------------------------10
ገንፎ----------------------------------------
11
ሌላካለ----------------------

ክፍል 5. ጡት ብቻ ለማጥባት መሰናክል የሚሆኑ ችግሮች

50 የጡት ችግር ወይም ህመም ገጥሞሽ ያውቃል? አዎ

1 የለም
50 አዎ ከሆነ መልስሽ፤ከተጠቀሱት የትኛው 1.የመቁሰል
2 ሊሆን ይችላል 2. እብጠት

53
 3.የመሰንጠቅ/መድረቅ
4.ሌላ ካለ ይጠቀስ
50 ችግር ሲገጥምሽ እንዴት ታደርጊያለሽ? ወተቱን አፈሰዋለሁ------------------------1
3 ወደ ጤና ተቋም እሄዳለሁ---------------2
በባህል መድሀኒት አሽዋለሁ-------------3
ሌላ ካለ ይጠቀስ---------------------------4
50 በመስርያ ቤት/በማህበረሰባቹህ የጡት አዎ----------------------------------------1
4 ማጥባትን ይደግፋሉ/ያበረታታሉ አይ-----------------------------------------2
50 አዎ ካልሽ ልትጠቅሽልኝ ትችይ ---------------------------------
5
50 እናቶች ጡት ብቻ የማያጠቡበት ምክንያት መረጃ ስለሌላቸው------------------------1
6 ምን ይመስልሻል? ስራ ስለሚበዘባቸው-----------------------2
ጡት ወተት በቂ ስላልሆነ----------------3
ባህል ና ተለምዶስለሆነ------------------4
ሌላ ካለ ይጠቀስ---------------------------5
50 በአከባቢያችሁ ጡት ብቻ እስከ ስድሰት ወር አለ------------------------------------------1
7 እንድታጠቢ የሚያደርግ ባህል ወይም ተለምዶ አይ------------------------------------------2
አለ
50 አለ ካለሽ ልትጠቅሽልኝ ትችያለሽ --------------------------------------------
8

ክፍል 6.ከስድስትወርበታችየተዘጋጀየዱቄትወተት

601 ስለከስድስት ወር በታች የተዘጋጀ አዎ-------------------------------------------1

የዱቄት ወተት መረጃ ሰምቶው/አይተው አይ--------------------------------------------2 (አይ)606
ያውቃሉ?
602 ከሰሙ ምን አይነት መረጃ ነበር ከስድስት ወር በታች የተዘጋጀ የዱቄት ወተት ለህፃን
የሰሙት/ያዩት ኬት ነበር ያኙት? ጤና ጥሩ ነው---------------1
ከስድስት ወር በታች የተዘጋጀ የዱቄት ወተት ለህፃን
ከሁለት በላይ መመለስ ይቻላል እድገት ጥሩ ነው-------------2
ከስድስት ወር በታች የተዘጋጀ የዱቄት ወተት

54
 የሚጠቀም ህፃን ብልጥ ሰለ
ሚሆን--------------------------------------------
-------3
ከስድስት ወር በታች የተዘጋጀ የዱቄት ወተት ለህፃን
አእምሮ ጥሩ ነው------------4
የናት ጡት በከስድስት ወርበታች የተዘጋጀ የድቄት
ወተት ስለሚተካ--------------------5
ምክንያቱም ከስድስት ወር በታች የተዘጋጀ የድቄት
ወተት ከናት ጡት ተመሳሳይ ጥቅም
ስላለው---------------------------------6
አላስታውሰውም-------------------------------7
603 መልሶ አዎ ከሆነ ኬት ነበር ያገኙት? ከሬድዩ------------------------------------------
1
እንተርኔት-------------------------------------2
ከጤና ባለሙያ--------------------------------3
ከእናቴ------------------------------------------
4
ከሱፐር ማርኬት ሸያጭ---------------------5
ከጓደኛ/ቤተሰብ--------------------------------6
ከተለቪዥን-------------------------------------7
ከመንግስት ሆስፒታል------------------------8
ከግልሆ ስፒታል-------------------------------9
ከጤና ጣብያ--------------------------------10
ጤና ኬላ--------------------------------------11
ከግል ክሊኒክ -------------------------------12
ከመድሀኒ ትቤት-----------------------------13
ሌላካለ---------------------

604 ለምን ያህል ጊዜ ሰሙ/አዩ? ------------------------------ጊዜ

605 ለመጨረሻ ጊዜ የሰሙት/ያዩት መቼ ነበር? ከ--------------------ወር

55
606 ከስድሰት ወር በታች የተዘጋጀ የዱቄት አዎ-----------------------------------------1
ወተት የምርት ናሙና ከጤና ተቋሙ አይ------------------------------------------2
አጊንትዋል?
607 ለአሁኑ ልጆት ከስድሰት ወርበታ አዎ-----------------------------------------1
ችየተዘጋጀ የዱቄት ወተት አይ------------------------------------------2 (አይ)511
ይሰጡታል/ይሰጣታል?
608 መልሶ አዎ ከሆነ ከስድሰት ወር በታች አዎ-----------------------------------------1
የተዘጋጀ የዱቄት ወተት ላለፈ 24 ሰዓት አይ------------------------------------------2 (አይ)515
አስጠቅምዋል?
609 ከስድሰት ወር በታች የተዘጋጀ የዱቄት ምክንያቱም የናት ጡት ወተት በቂ አይደለም
ወተት ላለፈ 24 ሰዓት ከተሰጠ ለምን ----------------------------------1
ሰጡ? ታምሜ ነበር-------------------------------2
ህፃን ታማ/ታሞ-------------------------------3
በቂ ጊዜ አልነበረኝም ጡት ለማጥባት------4
ምክንያቱም ከስድስት ወር በታች የተዘጋጀ የድቄት
ወተት ከናት ጡት ስለሚበልጥ---5
ከስድስት ወር በታች የተዘጋጀ የድቄት ወተት
ለህፃናት እድገት ጤና እና አእምሮ ጥሩ ነው
--------------------------------------6
ምክንያቱም ከስድስት ወር በታች የተዘጋጀ የድቄት
ወተት ከናት ጡት ተመሳሳይ ጥቅም
ስላለው---------------------------------7
ሌላካለ-------------------
610 ከስድሰት ወርበታች የተዘጋጀ የዱቄት ከፋርማሲ-------------------------------------1
ወተት ላለፈ 24 ሰዓት ለህፃን ከሰጡ ከሱፐርማርኬት-----------------------------2
ኬት ነበር የገዙት? ከሱቅ------------------------------------------3
በነፃ--------------------------------------------
4
ከቤተሰቦቼ-------------------------------------5
ሌላ--------------------

56
 611 ከስድሰት ወር በታች የተዘጋጀ የዱቄት አዎ-----------------------------------------1
ወተት ከዘህ በፊት ለወለዱት ልጆች አይ------------------------------------------2
ሰጥተው ያወቃሉ?
612 ማንኛውም መረጃ ስለጡጦ የጡት ጫፍ አዎ------------------------------------------1
ሰምተው ያውቃሉ? አይ-------------------------------------------2 (አይ)614
613 መልሶ አዎ ከሆነ ማንኛዉም የሚጠጣ ላለፈ አዎ-------------------------------------------1
24 ሰዓት ህፃኑ/ህፃንዋ በጥጦ አይ--------------------------------------------2
ወስደዋል?
614 ከስድሰት ወር በታች የተዘጋጀ የዱቄት አዎ--------------------------------------------1
ወተት እንዲጠቀሙ መክረሻል? አይ--------------------------------------------2
615 መልሶ አዎ ከሆነ ለማን መክርሽ? ለጓዶኞቼ-------------------------------------1
ለቤተሰቦቼ------------------------------------2
ለጎረቤቶቼ------------------------------------3
ሌላ----------------------

ASSURANCE OF PRINCIPAL INVESTIGATOR

The undersigned agrees to accept responsibility for the scientific ethical and technical
conduct of the research project and for provision of required progress reports as per terms
and conditions of the Research Publications Office in effect at the time of grant is forwarded
as the result of this application.

57
Name of the student FIRE ABRHA Date: _________________Signature _________________

Approval of the Advisors

Name of the advisors: Dr.ESKINDER WOLKA(PHD) Date: --------------------

Signature---------------

58