Study area and period
Based on figures Central Statistical Agency in 2005, this woreda has an estimated total population of 403,956, of whom 199,325 are men and 204,631 are women; 16,014 or 3.96% of its population are urban dwellers, which is less than the Zone average of 8.3%. With an estimated area of 2,368.13 square kilometers.The largest ethnic group reported in Este was the Amhara (99.98%), and Amharic was spoken as a first language by 99.98%. The majority of the inhabitants were Ethiopian Orthodox Christianity, with 96.53% of the population reporting they observed this belief, while 3.45% of the population said they were Muslim
The study was conducted in Este (Mekane-Eyesus) among neonates, from March10/2020 to May 2020.
Study design
Community based cross sectional study was employed.
Sources population
All infants <=28 days of age found in Este (Mekane-Eyesus) administrative kebeles were the source population for this study.
Study population
Neonates who are found in randomly selected 02 urban and 03 rural kebeles in Este (Mekane-Eyesus) and who fulfill the inclusion criteria were the study population.
Sampling Unit
Households which found in the selected 02 urban and 03 rural kebeles were the sampling unit that the samples had been taken.
Sample size determination
In this study, sample size was determined by using single population proportion formula
Specific objective 1 aimed to identify practice of mothers on colostrum feeding of neonates at Este (Mekane-Eyesus), south Gondar Amhara, North Central, Ethiopia, 2020.
n0 = 341.5
n0 = 342
By adding 10% none response rate the total sample size is
=342+34.2
=376
=376
The total sample size will be=376
Where:
n= the desired sample size
P= knowledge of mothers about colostrum feeding, Bench Maji Zone (66.66%)
Zα/2 = standard normal variation value at a confidence interval of 95% (1.96)
d= the margin error between the sample and the population (5%)
Sampling technique and sampling procedure
The study participants were selected by multistage sampling method after determining and proportionately allocated of samples. In Mekane –Eyesus there are 03 urban and 05 rural kebeles. The total samples (n=376) will be proportionally allocated based on total population and the required sample size. From this study area about 7676 neonates found distributed among 08 kebeles in Mekane –Eyesus. Among 08 kebeles, 05 kebeles were selected by lottery method, and then proportionally allocating study participants based on the target population who are living in those 05 kebeles. Each participant also selected from household after determining and proportionately allocated of samples in each selected kebeles. During selection of participants, house to house visit was made and all those neonates in one household would be included in the selection process. To select the study participants from each household Kth interval was used to select households which contain the required samples –value was calculated by using the formula N/n for each selected kebeles i.e. For K1=561/376=1st interval, K2=949/376=3rd, Mekane-Eyesus=1369/376=4th, Dengolt 1170 /376=3rd and ᴢiguara=1208 /376=3rd .So the sample will be taken to each kebele every 1st , 3rd , 4th , 3rd and 3rd interval from K1, K2, Mekane-Eyesus ,Dengolt and ᴢiguara respectively according to index neonates residence.
Data collection tools and procedures
Data was collected using structured interview based questionnaire. The questionnaire contains socio demographic characteristics, magnitude related questions, Level of Knowledge, sources of on colostrum feeding and practice part regarding colostrum feeding. Data also collected by using open ended questions and both open ended and closed ended interview based questionnaires primarily being prepared in English then translated to local language questionnaires with local language (Amharic) for its consistency and understandability to the community in which this research conducted. During time of translation all the concern and the local linguistic had been put into consideration and the local language (Amharic) was translated back to English for the appropriateness and conformability of analysis the finding of the research. Pretest was conducted among 5% of the participants in Woreta town and modification will be considered according to its findings. After modification and amendment of the data collected by face to face interview by two BSc holder nurses and one health extension workers who are not working in the assigned area after they obtain a one day training on the tools and necessary cares needed. The parents/guardians were interviewed in their residence.
Variables of the study
Dependent variables
Independent variables
Socio-demographic characteristics
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Age of the baby and parents
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sex of the baby and parents
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Gender
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Marital status
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level of education
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Employment status
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Religion
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Relationship to the child
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Income status
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place of delivery,
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distance to health facility,
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time of labor and mode of delivery
Knowledge related variables
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Awareness about colostrum feeding
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Sources of information
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Counseling about colostrum feeding
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Time of breast feeding initiation
Practice related variables
Operational definitions
Knowledge: In this study refers to awareness about colostrum feedings of pregnant woman during breast feeding period. It will be evaluated by the mothers answer to the questions
Good knowledge: Those answers greater than or equal to 60% questions out of total knowledge related questions.
Poor knowledge: Those answers less than 60% questions out of total knowledge related questions.
Practice: The overt behavior habit or custom of women
Good practice: Score > 60% on the overall practice questions.
Poor practice: Those who answer <60% of practice related questions
Data processing and analysis
First the data was checked for its completeness, consistency and validity. After checking the collected data, then the data entered to EPI-data version 4.5 and transferred to SPSS version 23 statistical software for analysis. Data will be cleaned, and coded for completeness, consistency and to minimized errors. Both Bi-variable and multivariable logistic regression was used to identify factors and variables with p-value of 0.20 and less would fit to logistic model for multivariable analysis. SPSS version 23 statistical software was used and frequencies and odds ratio was determined. Factors associated with the outcome variable at Bi-variable analysis had been identified and the variables with p-value of 0.20 and less would fit to logistic model for multivariable analysis to determine relative prediction level of independent variables to the outcome variable. P-value less than 0.05 at 95% confidence interval had been considered as statistically significant. Model goodness-of-fit would be checked by Hosmer Lemeshow test. Multicollinearity was checked by durbin-Watson, tolerance and Variance Inflation Factors. Chi square also been calculated to test any association between dependent and independent variables .Lastly the result was presented with the form of texts, figures and tables by using frequency and summary statics such as mean, standard deviation, and percentage to relevant variables.
Data quality control
The quality of data was ensured by doing the questioner pre-tested on 5% of the total sample size at Woreta town that is assumed to have relatively similar characteristics of the targeted population. Based on their feedback the necessary amendment was done and the questioner was assessed for its clarity; completeness and evaluate the validity and content of the questionnaire and modified accordingly .Close supervision also made during the data collection and appropriate feedback was provided. Training was given to the data collectors for one day by the principal investigator and the training was focused on the objective, how to obtain consent, keeping confidentiality of the information they gathered. The collected data been cheeked for its completeness every day before the following day of data collection by supervisors and the principal investigator and corrective measures had been taken according to the finding during supervision.
Data presentations
After the data analyzed the findings of the result was presented by descriptive and analytic forms. Descriptive analyzed statistical results was presented by texts, graphs, diagrams and tables but analytic form of findings was presented by text form of odds ratio.
Ethical consideration
Ethical clearance was obtained from Ethical Review Board of Debre Tabor University college of Medicine and Health Sciences, and department of mc midwifery. Letter of permission was granted to Este (Mekane-Eyesus) and South Gondar Zone. After obtained permission from those organizations, the data collectors were going to house to house and starting data collection. The data also was collected after clearly explained the purpose of the study to the participants and after obtained informed consent was got from each study participant.