Knowledge and barriers to optimal infant and young child feeding practices among syrian refugees from the Bekaa region : a pilot study

Abstract

This report describes the practicum internship which was conducted at the organization of Action Against Hunger coordination office in Beirut Ashrafieh district. Action Against Hunger is an international nongovernmental organization that has an overall mission to save lives of communities and individuals by eradicating hunger through prevention, detection and treatment of undernutrition, especially during and after emergency situations and disaster. In Lebanon, the organization exists since 2006 and works in several sectors including nutrition and health, water sanitation and hygiene, protection as well as food security and livelihood. The practicum started on December 2018 and finished around the third week of May 2019. Throughout the internship the student worked on a qualitative research study that aimed to explore the views understanding as well as the barriers to optimal infant and young child feeding (IYCF) practices among Syrian refugees caregivers in the Bekaa region in Lebanon. As several assessments reveal that IYCF practices are suboptimal among Syrian refugees residing in Lebanon, the student focused the practicum on exploring the knowledge and the barriers primary health workers as well the Syrian refugee caregivers face when they want to respectively promote or adopt optimal feeding practices. The study followed the qualitative methodology by developing Focus Group Discussions and interviews topic guides and analyzing them using a thematic framework. Due to circumstances, an ethical approval was not applied for. Yet the student made sure to follow ethical procedure throughout the study process by taking informed consent from the participants, providing a favorable risk benefit ratio, and empowering herself through psychosocial first aid training to mitigate any sort of emotional breakdown of the participants. Findings of the study revealed significant gaps in knowledge among primary health workers as well as Syrian refugees caregivers on optimal infant and young child feeding practices. This was evident through the many misconceptions these two populations have on breastfeeding, and the feeding practices that were recommended for the child according to the international guidelines. Although primary health workers appeared to be among the supporters of breastfeeding for the mothers and always encouraged them through providing the mothers safe space for breastfeeding, there appear to be some major barriers for the proper promotion of these practices including : lack of knowledge on several practices, lack of understanding of acute malnutrition and how optimal IYCF practices can contribute to its prevention, lack of means to strengthening the support of optimal infant and young child feeding practices including time and place dedicated to talking about these topic among pregnant and lactating women, in addition to the negative attitude taken by primary health workers toward Syrian refugee caregivers and the feeling of hopelessness. Several recommendations followed targeting various stakeholders involved in IYCF mainly the caregivers, governments academic institutions and organization.