“The State of Breastfeeding in Ghana: Practices and Promotion”

(1993) by Adwoa Steel, Mary Ruth Homer, Charlotte Acquah and Comfort Agyekumwaa,

This well presented report (just over 100 pages) was commissioned by USAID to examine the state of art of breastfeeding in Ghana in order to identify those factors which support optimal breastfeeding practices as well as those which obstruct such practices. Drawing on existing studies and research the report is an excellent synthesis of young child health and nutrition in Ghana and as such serves as a valuable reference document.

The authors show that alarming problems exist in Ghana with current breastfeeding practices. Like many African countries the initiation of breastfeeding is near to universal (mean duration 20.4 months), however, at delivery it is rare for a baby to be put to the breast immediately. Colostrum is often discarded and breastfeeding may be delayed for days until a mother is sure that her milk has arrived. Based on an analysis of the 1988 Ghana Demographic Health Survey one striking finding was that only 2 percent of mothers exclusively breastfeed during the first 4 months because of the widespread belief amongst mothers and health workers that babies need to be given water for thirst. In this respect Ghana ranks one of the two lowest of 25 developing countries in which practices in exclusive breastfeeding have been examined. Another alarming finding was that nationally 52 percent of infants 0-3 months were bottlefed, with this figure being 46 percent in rural areas.

The report concludes correctly that serious problems exist in Ghana with current breastfeeding knowledge, attitudes and practices. The authors present a well articulated social mobilisation and IEC strategy which is aimed at training health care providers to better support mothers to breastfeed successfully and motivate them to change inappropriate young child feeding practices. Some of the findings will be immediately incorporated into the USAID funded Ghana Family Planning and Health Project, whilst others will no doubt have wider application in regards to nutrition related policy and programme development.

(This publication is available from: MotherCare, John Snow Inc., 1616 North Fort Myer Drive, Arlington, Virginia, 22209, USA)

Victoria Quinn