Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.4
,
No
.3
, Sep
t
em
b
e
r
20
15, pp
. 192
~196
I
S
SN
: 225
2-8
8
0
6
1
92
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Cont
ribution Fact
ors
on Earl
y Initiation
of Breastf
eeding
Dwifitria
Ariya
n
i,
Lina
Handay
ani
Faculty
of Public Health
, Univ
er
sitas Ahmad Dahlan, Yog
y
akar
ta, Indon
esia
Article Info
A
B
STRAC
T
Article histo
r
y:
Received J
u
n
9, 2015
Rev
i
sed
Au
g
20
, 20
15
Accepted Aug 28, 2015
One of the
cau
ses of high Infant Mortality
R
a
te
is the low
coverag
e
o
f
exclusiv
e breas
tfeed
ing. One
of the supporting factors to exclusiv
e
breastfe
e
ding
is im
plem
enta
tion
of E
a
rl
y
In
itiation of Br
eastfeeding (EIB)
.
Mother’s knowledge and unders
tanding abou
t
th
e EIB, as well as the role of
birth attendants
,
especia
lly
mid
w
ives can
be strongly
support
it’s the EIB.
The purpos
e of this
res
earch
was
to
determine the relations
hip between
mother'
s
knowledge, mother
’s attit
udes and
midwife role with the
implementation
of Ear
l
y
Initiatio
n of Br
e
a
s
t
fe
edi
ng (EIB).
Th
e r
e
s
earch was
an obs
erva
tion
a
l an
al
yt
ic
res
e
a
r
ch em
plo
y
ed
c
r
os
s
s
ectiona
l d
e
s
i
gn.
The
subjects were m
a
tern
it
y m
o
thers who i
npatient
a
t
Pulang Pisau Hospital in
Central Kaliman
tan Province, In
donesia.
The r
e
sults showed that there wer
e
significant r
e
lati
onships between
m
o
ther
'
s
knowl
e
dge, attitud
e
s and m
i
dwife
role with th
e I
m
plem
entation
of Earl
y Ini
t
i
a
ti
on of Breastfe
e
d
ing (EIB).
Attitude
was
th
e m
o
st
influenc
ed variab
le to the
E
I
B.
Keyword:
Attitu
d
e
EIB
K
now
ledg
e
Ro
le of
Midw
i
v
es
Copyright ©
201
5 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Lina Handayani,
Facu
lty of Public Health
,
Uni
v
ersitas A
h
m
a
d
Da
hlan,
Jl
.
Pr
of
. Dr
S
o
epom
o
Ja
nt
ura
n
Yo
gy
aka
r
t
a
55
1
6
4
,
In
d
one
si
a.
Em
a
il: l
i
n
a
fk
m
@
g
m
ail.co
m
1.
INTRODUCTION
Excl
usi
v
e br
ea
st
feedi
n
g i
s
ve
ry
im
port
a
nt
t
o
prom
ot
e i
n
fan
t
heal
t
h
. Ho
we
ver
,
alm
o
st
al
l
di
st
ri
ct
s i
n
In
d
onesi
a
d
o
n
o
t
reac
h t
h
e
na
t
i
onal
t
a
r
g
et
f
o
r e
x
cl
usi
v
e
bre
a
stfeeding. T
h
e m
a
in pr
ob
lem
o
f
th
e low ex
clu
s
i
v
e
b
r
east
f
eed
i
n
g
i
s
th
e lack
o
f
kn
owledg
e of pregn
a
n
t
wo
m
e
n
,
fam
ilies
an
d co
mm
u
n
ities
ab
ou
t th
e im
p
o
r
tan
c
e
of
breast
f
eedi
n
g. One that s
u
pports
the succe
ss of e
x
clusi
v
e
breastfee
ding
is to
i
m
p
l
e
m
en
t a p
r
og
ram
o
f
Early
In
itiatio
n
of Breastfeed
ing (EIB). EIB is
t
h
e p
r
o
cess
of
l
o
okin
g
fo
r
a b
a
b
y
to
th
e m
o
th
er's n
i
pp
le itself or start
feedi
n
g them
s
e
lves afte
r
birth
by placing
a
m
ong the
abd
o
m
en
or ch
est and
let th
e
sk
in
con
t
act between
b
a
b
y
’s sk
in to
m
o
th
er sk
in [1].
EIB ro
le in
ach
i
ev
ing
t
h
e ob
j
ectives of the
Millen
n
i
u
m
Dev
e
l
o
p
m
en
t Go
als
(MDGs) wh
ich
i
s
h
e
lp
ing
to
red
u
ce p
o
v
e
rty an
d h
u
n
g
e
r and
also
red
u
c
i
n
g
child
m
o
rtality
with
th
e targ
et o
f
redu
cing
d
eat
h
s
b
y
2/
3 f
r
o
m
199
0
t
o
2
0
1
5
. T
h
e
ot
he
r be
nefi
t
s
of E
I
B
are:
he
l
p
i
ng t
h
e ba
by
get
s
t
h
e m
i
l
k
fi
rst
,
i
m
provi
n
g
m
i
l
k
pr
o
duct
i
o
n,
b
u
i
l
di
ng
a
bo
n
d
of
l
ove
bet
w
een
m
o
t
h
er an
d c
h
i
l
d
[
1
]
.
There a
r
e seve
ral factors that cau
se EIB process is not carried
ou
t, n
a
mely
matern
al facto
r
s and
infa
nt factors. Factors such m
o
thers from
maternal physical fact
ors
w
e
ak
e
n
ed
a
f
te
r
ch
ild
b
i
r
t
h
and
psychological factors of m
o
ther that affe
ct the
oxy
t
o
ci
n h
o
rm
one. P
r
edi
s
po
si
t
i
on f
act
ors o
f
excl
usi
v
e
b
r
east
f
eed
i
n
g failu
re
d
u
e
to the lack
o
f
kno
wled
g
e
and
exp
e
rien
ce
of m
o
th
ers an
d th
e m
o
th
er is no
t facilitated
to
EI
B [2
].
Kn
owledg
e an
d
attitu
d
e
are i
m
p
o
r
tan
t
facto
r
s in
th
e
formatio
n
o
f
so
meo
n
e
's actio
n
s
. Th
e b
e
tter
k
nowledg
e
o
f
th
e m
o
th
er abo
u
t
t
h
e EIB
wi
ll h
e
lp
m
o
th
er
s in
breastfee
ding as
early
as
possible. The role of
heal
t
h
w
o
r
k
e
r
s
as a bi
rt
h at
t
e
nda
nt
was
very
sup
p
o
rt
i
v
e acc
om
pl
i
s
hed t
o
E
I
B
.
D
u
ri
ng t
h
e m
o
t
h
er'
s
pregn
a
ncy
,
mid
w
iv
es pro
v
id
e in
fo
rm
atio
n
abo
u
t
th
e
IMD so
wh
en
do
i
n
g
lab
o
r and
mo
th
er facilitate
d
to
EIB, t
h
e m
o
th
er
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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PH
S I
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:
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6
Co
n
t
ribu
tion
Fa
cto
r
s on
Ea
rl
y In
itia
tio
n
o
f
Brea
stfeed
i
n
g (Dwifitria
Ariyan
i)
19
3
w
ill b
e
m
o
tiv
a
t
ed
to
breastfeed
as early as
p
o
s
sib
l
e to
h
e
r in
fan
t
[3
]. The u
s
e of an
ten
a
tal care (AN
C
) found
to
b
e
correlated
with
tim
el
y i
n
itiatio
n
o
f
breastfeed
ing
[4
]-[6
]
.
2.
R
E
SEARC
H M
ETHOD
Thi
s
wa
s an
o
b
s
ervat
i
o
nal
a
n
a
l
y
t
i
c
research e
m
pl
oy
ed cross
sect
i
onal
de
si
g
n
. T
h
i
s
desi
g
n
st
udi
e
d
t
h
e
correlation between risk factors
and
th
e e
ffe
cts of the a
p
proach, obse
rvati
on
or t
h
e colle
ction of data at
a tim
e
[7]
.
C
r
oss
-
sect
i
onal
de
si
g
n
was c
hose
n
t
o
exam
i
n
e
th
e in
d
e
p
e
nd
en
t variab
les
ar
e kn
ow
ledg
e,
mo
t
h
e
r
’
s
attitu
d
e
an
d
ro
le o
f
t
h
e m
i
d
w
i
f
e with
d
e
p
e
nd
en
t v
a
riab
le is th
e i
m
p
l
em
en
tatio
n
o
f
early b
r
eastfeed
ing
in
itiatio
n
at th
e sam
e
ti
me.
The i
n
st
r
u
m
e
nt
used i
n
t
h
i
s
st
udy
was a q
u
est
i
o
nnai
r
e c
ont
ai
ni
ng
qu
es
t
i
ons ab
o
u
t
t
h
e nam
e
, age,
ed
u
cation
,
know
ledg
e, attitu
de and
ro
le
o
f
th
e m
i
d
w
if
e w
i
th
th
e im
p
l
e
m
en
tatio
n
of th
e EIB. Before
b
e
i
ng
u
s
ed
in
research
, th
e qu
estion
n
a
i
r
e is teste
d
for th
e v
a
lidity an
d
reliab
ility first. Th
e resu
lt sh
owed
th
at the
reliab
ility is g
o
o
d
(t
h
e
Cron
b
a
ch
alph
a
v
a
l
u
e
was
0
.
6
02).
3.
R
E
SU
LTS AN
D ANA
LY
SIS
The desc
ri
pt
i
o
n of m
o
t
h
er’s
kn
o
w
l
e
d
g
e ab
o
u
t
EIB
prese
n
t
e
d i
n
Tabl
e 1.
B
a
sed o
n
Tabl
e 1, i
t
can be
seen t
h
at m
o
re
responde
nts
were categorized
as less
kn
owled
g
e
ab
le ab
ou
t
EIB (64
.
4
%
).
Tabl
e
1. M
o
t
h
e
r’s
k
n
o
wl
e
d
ge
ab
out
EIB
Kno
w
ledg
e
Nu
m
b
er
Percen
tage (
%
)
Less
29
64.
4
Good
16
35.
6
Total
45
100
Th
e d
e
scri
p
tion
of m
o
th
er’s
attitu
d
e
to
ward EIB can
b
e
seen
in
Tab
l
e 2. Tab
l
e 2
shows th
at m
o
re
respon
d
e
n
t
s
were categorized as
h
a
v
i
n
g
poo
r attitu
d
e
toward
EIB (53
.
3
%
)
Tab
l
e
2
.
M
o
th
er’s
attitu
d
e
toward EIB
Atti
tude
Nu
m
b
er
Percen
tage (
%
)
Less
24
53.
3
Good
21
46.
7
Total
45
100
Th
e d
e
scrip
tion
of mid
w
ife's ro
le to
ward
s th
e im
p
l
e
m
en
tatio
n
of th
e EIB is p
r
esen
ted in
Tab
l
e 3.
B
a
sed
on
Ta
bl
e 3,
i
t
can
be
s
een t
h
at
m
a
jo
ri
t
y
of t
h
e m
i
dwi
f
e s
u
p
p
o
rt
t
h
e i
m
pl
em
ent
a
t
i
on o
f
t
h
e
EIB
(
8
2
.
2%
).
Tab
l
e
3
.
Midwife's ro
le toward
s t
h
e im
p
l
e
m
e
n
tatio
n
of th
e
EIB
Role of Midw
ives
Nu
m
b
er
Percen
tage (
%
)
Does not suppor
t
8
17.
8
Suppor
t
37
82.
2
Total
45
100
Tabl
e
4
pr
o
v
i
d
es t
h
e
descri
pt
i
o
n
a
b
o
u
t
t
h
e i
m
pl
em
ent
a
ti
on
o
f
E
I
B
.
T
a
bl
e
4 i
n
fo
rm
s t
h
at
m
o
r
e
m
o
thers practice EIB
(57.8%
).
Tabl
e 4. Im
pl
em
ent
a
t
i
on of E
I
B
EIB
Nu
m
b
er
Percen
tage (
%
)
Not im
ple
m
enting
19
42.
2
Im
ple
m
enting
26
57.
8
Total
45
100
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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:
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06
I
J
PH
S Vo
l. 4
,
N
o
. 3
,
Sep
t
emb
e
r
201
5
:
1
92
–
19
6
19
4
Th
e
relatio
n
s
h
i
p
s
b
e
tween
v
a
riab
les tested
by Sp
earm
a
n
correlatio
n test an
d th
e
resu
lt are shwon
i
n
Tab
l
e
5
.
Tab
l
e 5 shows t
h
at
all in
d
e
p
e
nd
ent v
a
riab
les
(kno
wled
g
e
, attitud
e
, ro
le
o
f
m
i
d
w
i
v
es) co
rrelate to
depe
n
d
ent
va
ri
abl
e
(E
IB
)
.
Tab
l
e
5
.
Sp
earman
correlation
test’s resu
lt
I
ndependent Var
i
ables
Value
Dependent var
i
able
Attitude
r = 0.657
EIB
p
= 0,
000
Knowledge
r
= 0.
478
p
= 0,
001
Role of
m
i
dwives
r
= 0.
403
p
= 0.
006
Li
near re
gre
ssi
on t
e
st
em
pl
oy
ed t
o
det
e
rm
i
n
e t
h
e
m
o
st v
a
riab
le in
flu
e
n
c
ed
EIB. Th
e resu
lt o
f
th
is
t
e
st
i
s
shwon i
n
Tabl
e 6
.
B
a
sed o
n
Tabl
e 6 i
t
can be seen t
h
at
t
h
e p- val
u
e of al
l
vari
abl
e
s are 0.
00
0. It
m
eans
that all varia
b
les has
a si
gnifi
cant
relations
hip because p value
<
0
.05.
Tab
l
e
6
.
Resu
lts of lin
ear regressio
n
’s test
Variables
The correl
a
tion coef
f
i
cient
p-
value
Attitude
Knowledge
Role of
m
i
dwives
0.
569
0.
403
0.
362
0,
000
0,
000
0,
000
Th
ere
are si
gn
ifican
t
relatio
n
s
h
i
p
s
b
e
t
w
een
m
o
th
er's kn
owledg
e, m
o
th
er’s attitu
d
e
s and
th
e
m
i
dwi
f
e'
s rol
e
i
n
t
h
e i
m
pl
em
ent
a
t
i
on
of t
h
e EIB
.
T
h
e st
re
n
g
t
h
of t
h
e
rel
a
t
i
ons
hi
p ca
n be
seen f
r
om
t
h
e val
u
e
o
f
r
(co
r
relatio
n
co
efficien
t).
Th
e st
reng
th of th
e relatio
n
s
hip
fro
m
th
e larg
est to sm
alles
t
are th
e attitu
de (r
=
0
.
5
69),
k
nowled
g
e
(r =
0
.
40
3) an
d th
e
ro
le of m
i
d
w
ives (r =
0
.
3
62). It m
ean
s th
at attitu
d
e
is the m
o
st
in
flu
e
n
c
ed
v
a
ri
ab
le to
EIB, wi
th
r v
a
l
u
e =
0.569 that indicat
es a
strong correlation.
3.
1.
Discussions
3.
1.
1.
The relati
o
ns
hip betwee
n
mother’s
kn
owledge and EI
B
The res
u
l
t
s
of
Spearm
a
n co
rrel
a
t
i
on t
e
st
obt
ai
ne
d
p-v
a
lu
e of
0
.
00
1. I
t
m
eans that there is a
rel
a
t
i
ons
hi
p
be
t
w
een
kn
o
w
l
e
dge a
n
d t
h
e E
I
B
.
The st
ren
g
t
h of t
h
e rel
a
t
i
ons
hi
p i
ndi
cat
ed by
t
h
e
val
u
e of r
-
value =
0,478.
It m
eans that th
e stre
ngth
of t
h
e c
o
rrelation
is m
o
d
e
rate or su
fficien
t
.
Th
e r
e
su
lt o
f
m
u
l
tiv
ar
iate an
alysis u
s
in
g
lin
ear
r
e
gr
ession
test o
b
t
ain
e
d
p-
v
a
l
u
e o
f
0.000. Th
is sho
w
s
t
h
at
t
h
ere i
s
a s
i
gni
fi
ca
nt
rel
a
t
i
ons
hi
p
bet
w
ee
n
kn
o
w
l
e
d
g
e a
n
d
i
m
pl
em
ent
a
t
i
on
of t
h
e E
I
B
.
The
st
re
ngt
h
of t
h
e
rel
a
t
i
ons
hi
p
t
h
at
i
s
eq
ual
t
o
0.
40
3 a
n
d i
n
cl
ude
d i
n
t
h
e
categ
o
r
y
of
m
o
der
a
te or
su
ffici
ent c
o
rrelation. T
h
is
resul
t
s
s
u
p
p
o
rt
pre
v
i
o
us
rese
arch c
o
nd
uct
e
d by
S
o
l
i
h
a
h
i
n
201
0. Sh
e fou
n
d
th
at m
o
ther
’
s
kn
ow
ledge ab
ou
t
t
h
e
be
ne
fi
t
s
o
f
breast
f
eedi
n
g
i
n
fl
uence
t
h
e de
ci
si
on of
earl
y
breast
f
eedi
n
g
t
o
new
b
or
ns [
8
]
.
The
res
u
lt of c
u
rrent
resea
r
ch indicates t
h
at
m
o
re k
nowledg
eab
le m
o
th
er,
m
o
re practicin
g th
e EIB
an
d
v
i
ce v
e
rsa. Th
e resu
lt is si
milar with
ano
t
h
e
r prev
iou
s
research resu
lted
th
at
th
ere is a sign
ifican
t
association bet
w
een m
o
ther’s
knowle
d
g
e
w
i
t
h
im
pl
em
entat
i
on
of E
I
B
[
9
]
.
M
o
reo
v
er
,
Vasra
(
2
0
1
3
) i
n
he
r
researc
h
al
s
o
c
oncl
ude
d t
h
at
t
h
ere
i
s
a si
gni
fi
cant
rel
a
t
i
o
ns
hi
p
bet
w
ee
n m
o
t
h
er'
s
k
n
o
wl
e
d
g
e
an
d t
h
e
EIB
[
10]
.
3.
1.
2.
The relati
o
ns
hip betwee
n
mo
t
h
er's
at
tit
ude w
i
th EIB
Th
e resu
lt o
f
cu
rren
t research
showed
that
m
o
re
m
o
th
ers h
a
v
e
poo
r attitu
d
e
to
ward
s th
e EIB
(53
.
3
%
). It is in
lin
e with
p
r
ev
iou
s
research
resu
lted
t
h
at the
m
a
j
o
rity o
f
m
o
th
ers h
a
v
e
l
e
ss sup
portiv
e
attitu
d
e
to
th
e im
p
l
e
m
e
n
tatio
n
o
f
EIB
[11
]
. Th
is h
a
pp
ens fo
r
sev
e
ral reason
s: m
o
th
er
feels
u
n
c
om
fo
rtab
le b
ecau
s
e th
e
b
a
b
y
is no
t clean
e
d
;
t
h
e m
o
ther feels exh
a
u
s
ted
b
y
ch
ildb
i
rt
h
an
d still feels bo
th
ered after
ch
ild
b
i
rth
.
Spea
rm
an correlation test obtained p-val
u
e
= 0.00
0, it
mean
s th
at th
ere is a relatio
n
s
h
i
p
b
e
t
w
een
attitu
d
e
s to
th
e i
m
p
l
e
m
en
tat
i
o
n
of th
e EIB. Th
e stren
g
t
h
o
f
t
h
e relatio
nsh
i
p in
d
i
cated
b
y
r-v
alu
e
=
0
.
6
5
7
wh
ich
means strong c
o
rrelation
bet
w
een
varia
b
les.
Li
near re
gre
s
s
i
on t
e
st
obt
ai
n
e
d p-
val
u
e= 0
.
0
0
0
.
It
sho
w
s
t
h
at
t
h
ere i
s
a si
gni
fi
cant
r
e
l
a
t
i
onshi
p
b
e
tw
een
attitud
e
an
d EIB. Th
e streng
th of
th
e relatio
n
s
h
i
p
o
b
t
ained
b
y
r-v
a
lu
e = 0
.
5
6
9
;
it
show
s
a strong
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Co
n
t
ribu
tion
Fa
cto
r
s on
Ea
rl
y In
itia
tio
n
o
f
Brea
stfeed
i
n
g (Dwifitria
Ariyan
i)
19
5
co
rrelatio
n
b
e
tween
v
a
riab
les.
Mu
ltiv
aria
te test sh
o
w
ed
that atti
tu
d
e
is th
e m
o
st in
flu
e
n
tial v
a
riab
le
o
n
th
e
im
pl
em
ent
a
t
i
o
n
of
t
h
e E
I
B
c
o
m
p
ared t
o
ot
he
r
vari
abl
e
s
.
Resu
lts of th
is
research
are
no
t si
m
i
l
a
r wi
t
h
pre
v
i
o
us
resea
r
ch c
o
nd
uct
e
d
by
Issy
a
put
ri
whi
c
h st
at
ed
that there is no relationship
between attitude
and m
o
th
ers
who di
d EIB
[12]. These
differences m
a
y because
in
Issyapu
t
ri’s
research
no
t al
l
m
o
th
ers h
a
v
e
a
g
ood
a
ttitu
de to
ward
s EIB
will do
EIB.
It is influ
e
n
ced
b
y
th
e
lack
o
f
sup
port fro
m
h
ealth
work
ers and
m
o
tiv
atio
n
its
elf. Othe
r re
search als
o
stated that there is no
relatio
n
s
h
i
p
b
e
tween
attitud
e
an
d
th
e
im
p
l
emen
tatio
n
o
f
EI
B [1
3
]
. Howev
e
r, th
e current resu
lt is i
n
lin
e
with
th
e
th
eo
ry b
y
No
t
o
atm
o
d
j
o. Attitu
d
e
is p
r
ed
ispo
sitio
n
fact
o
r
(d
eterm
i
n
a
n
t
factor) associated
with
t
h
e p
e
rson
's
beha
vi
o
r
[7]
.
Attitu
d
e
is a
pred
ispo
sitio
n or a learn
e
d
ten
d
en
cy
b
y
i
n
d
i
v
i
d
u
a
ls t
o
respon
d po
sitiv
ely or n
e
g
a
tiv
ely
with
m
o
d
e
rate in
ten
s
ity o
r
adeq
u
a
te to
t
h
e ob
j
ect, sit
u
atio
n, con
cep
t,
o
r
o
t
h
e
rs. Attitu
d
e
will arise b
ecau
s
e of
th
e con
s
i
d
erati
o
n
s
d
e
riv
e
d fro
m
in
fo
rm
atio
n
o
r
kno
wled
ge g
a
i
n
ed. Th
is is con
s
isten
t
with
the th
eo
ry states
that pe
ople
wil
l
consider the
gains
a
n
d losses
of
beha
vior that accorda
n
ce
with the
analys
is oft
h
em
[11].
3.
1.
3.
The relati
o
ns
hip betwee
n
the Role
of Mi
dwives with E
I
B
Th
e cu
rren
t resu
lt fo
und
th
at
m
o
st
mid
w
iv
es supp
or
t th
e imp
l
em
en
tatio
n
of th
e EIB
(8
2.2%).
Th
is is
sup
p
o
rt
pre
v
i
o
us re
searc
h
co
ncl
u
de t
h
at
ba
bi
es b
o
r
n
i
n
h
o
s
pi
t
a
l
s
su
pp
ort
e
d by
heal
t
h
w
o
r
k
er
s w
o
ul
d
b
e
m
o
re
lik
ely to
EIB co
m
p
ared
with
b
a
b
i
es bo
rn
wi
th
ou
t su
ppo
rted
b
y
h
ealth work
ers
[14
]
.
The Spea
rm
an correlation test obt
ai
n
e
d
p-
v
a
lu
e = 0.006
, wh
ich
m
ean
s
th
at th
ere is a
relatio
n
s
h
i
p
b
e
tween
th
e mid
w
ife's ro
le
with
th
e i
m
p
l
e
m
en
tatio
n
o
f
th
e EIB
.
T
h
e st
re
n
g
t
h
of t
h
e
rel
a
t
i
ons
hi
p i
n
di
cat
ed by
r-v
a
lu
e = 0.403
; it is in
clud
ed
in th
e category of m
o
d
e
rate
o
r
sufficien
t correlatio
n.
Mu
ltiv
ariate an
alysis em
p
l
o
y
in
g
lin
ear
reg
r
essi
on
test
o
b
t
ain
e
d
p-v
a
l
u
e =
0
.
00
0. Th
is sh
ows a
si
gni
fi
ca
nt
rel
a
t
i
ons
hi
p bet
w
e
e
n t
h
e rol
e
o
f
m
i
dwi
f
e t
o
t
h
e
im
pl
em
ent
a
t
i
on of t
h
e E
I
B
.
The st
re
ngt
h o
f
t
h
e
rel
a
t
i
ons
hi
p
o
b
t
ai
ned
by
r
-
val
u
e =
0.
3
6
2
w
h
i
c
h i
n
di
cat
es a
very
wea
k
c
o
r
r
e
l
a
t
i
on.
The
results are consiste
nt wi
th pre
v
ious
res
earch
that states that there is a relations
hip
betwee
n the
rol
e
of
heal
t
h
wo
r
k
ers
wi
t
h
by
EIB
[
1
5]
.
Ot
he
r resea
r
c
h
also s
u
gge
sted that th
e rol
e
of health workers
t
o
wa
rds t
h
e E
I
B
has si
gni
fi
ca
nt
rel
a
t
i
ons
hi
p
[16]
. T
h
e cu
rr
en
t find
ing
is also
in
lin
e with
p
r
ev
iou
s
stud
y in
N
e
p
a
l [17
]
. Sup
port p
r
o
v
i
d
e
d h
ealth
p
e
rsonnel w
ill g
e
n
e
rat
e
co
nfid
en
ce in th
e
m
o
th
er's d
ecisio
n
to
breastfeed
her
i
n
fa
nt
[1
8]
.
Si
m
ilar with
c
u
rren
t find
ing
,
th
ree stud
ies in
Asia [19
]-[21
] h
a
v
e
also
rep
o
rted
th
at th
e sk
illed
b
i
rth
atten
d
a
n
t
s su
pp
ort po
stp
a
rtum
m
o
th
ers fo
r
ti
m
e
ly in
it
iatio
n of brea
stfee
d
ing.
Health worke
r
s are expe
cted to
tak
e
th
e tim
e
to
m
o
tiv
ate an
d
to h
e
l
p
m
o
th
er’s m
a
tern
ity so
th
at it can
carry
o
u
t
t
h
e EIB an
d exclu
s
iv
e
breast
f
eedi
n
g
.
An
ot
he
r p
r
ev
i
ous
re
searc
h
found
that good
clinical
s
u
p
por
t to
w
a
r
d
s E
I
B c
a
n
e
n
co
ur
ag
e
increasing
EIB
by m
o
ther
[22].
3.
1.
4.
Attitude
was
the m
o
st i
n
flue
ntial
vari
able on the
im
plem
entation of
EI
B
Li
ni
er reg
r
essi
on t
e
st
resul
t
e
d t
h
at
t
h
e t
h
ree
vari
abl
e
s has
a si
gni
fi
cant
re
l
a
t
i
onshi
p wi
t
h
t
h
e p-val
u
e
0
.
0
0
0
.
Th
e stren
g
t
h
of th
e
relatio
n
s
h
i
p
from th
e larg
est to
sm
alles
t
is t
h
e attitu
d
e
of t
h
e m
o
th
er (r = 0
.
5
6
9
)
,
m
o
t
h
er’s k
n
o
w
l
e
dge
(r =
0.
40
3) a
nd t
h
e r
o
l
e
of m
i
dwi
f
e (
r
= 0.
36
2)
. It
ca
n be see
n
t
h
at
t
h
e m
o
st
i
n
fl
uence
d
v
a
riab
le on
t
h
e i
m
p
l
e
m
en
tatio
n
o
f
EIB is th
e
attitu
d
e
wh
ich
sh
ows a stron
g
correlation
.
Tab
l
e 2
sho
w
s
th
at o
n
l
y 4
6
.7
%
m
o
th
ers h
a
v
e
p
o
s
itiv
e attitu
d
e
t
o
ward
EIB. Mo
t
h
ers
wh
o are less
supportive
attitude
to EIB
oc
curs b
ecause
t
h
e
physical condition
of the
m
o
ther who
was s
till tired
from
the
b
i
rth
pro
cess.
Mo
st o
f
th
e m
o
th
ers refu
sed
on
th
e
g
r
ou
nd
s th
at th
e co
nd
itio
ns are stil
l weak
and
also
so
m
e
ti
mes n
o
t
all o
fficers imp
l
em
en
tin
g
th
e EIB to
po
stp
a
rtu
m
m
o
th
ers. Officers
who
do
no
t im
p
l
e
m
e
n
t t
h
e
EIB
d
u
e t
o
t
h
e
l
ack of co
or
di
nat
i
on
bet
w
ee
n t
h
e o
ffi
cers
so t
h
at
t
h
e di
v
i
si
on o
f
t
a
sks
becom
e
s une
v
e
n. T
h
e
ch
ild
b
i
rth
pro
c
ess
m
o
re assisted
b
y
a
m
i
d
w
ife wh
ile th
e obstetrician
rarel
y
was in
th
e h
o
s
p
ital. Th
e
p
r
esen
ce
o
f
an
ob
stetrician
can
also
h
e
l
p
m
o
tiv
ate th
e m
o
th
er in
order to
h
a
v
e
a
po
sitiv
e attitu
d
e
so
as t
o
su
ppo
rt th
e
i
m
p
l
e
m
en
tatio
n
of th
e EIB. Th
e absen
ce
of
h
o
s
p
ital po
lic
ies th
at ob
lig
e
health
wo
rk
ers t
o
im
p
l
e
m
en
t th
e EIB,
so
if th
ere are
h
ealth
work
ers wh
o do
no
t imp
l
em
en
t th
e EIB will no
t b
e
a
p
r
ob
lem
.
Mo
th
ers wh
o
are less sup
portiv
e attitu
d
e
to
EIB m
a
y al
so
b
e
in
flu
e
n
c
ed
by e
m
o
tio
n
a
l facto
r
s.
Stab
l
e
e
m
o
tio
n
a
l state d
e
term
in
es t
h
e po
sitiv
e attitu
d
e
of m
o
th
ers. Em
o
tio
n
a
l
stab
ility can
b
e
ach
iev
e
d
wh
en
a
h
u
s
b
a
nd
o
r
f
a
mil
y
p
r
ov
id
es
ad
equ
a
te suppo
r
t
and
m
o
tiv
atio
n
.
Su
ppo
r
t
giv
e
s an
i
m
p
r
essio
n
th
at sh
e is lo
v
e
d
an
d
cared
for, h
a
s p
r
i
d
e and
v
a
lu
ed
so
t
h
at b
y
it will
affect th
e em
o
tio
n
a
l. Mo
th
er will b
e
m
o
re cal
m
,
com
f
ort
a
bl
e a
n
d c
o
n
f
i
d
e
n
t
t
o
do
EIB
[
23]
.
4.
CO
NCL
USI
O
N AN
D SU
G
G
ESTIO
N
S
B
a
sed
on t
h
e r
e
sul
t
s
an
d
di
sc
ussi
o
n
, i
t
ca
n
b
e
co
ncl
u
ded
t
h
at
m
o
t
h
er’s
k
n
o
wl
e
dge
,
attitude
and the
ro
le
o
f
m
i
d
w
iv
es correlate to
EIB.
Attitu
d
e
i
s
th
e m
o
st in
fl
u
e
n
c
ed
v
a
riab
l
e
to
EIB.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
I
J
PH
S Vo
l. 4
,
N
o
. 3
,
Sep
t
emb
e
r
201
5
:
1
92
–
19
6
19
6
Mid
w
iv
es n
e
ed
to prov
i
d
e i
n
fo
rm
atio
n
rel
a
ted
to
EIB. T
h
ey can educa
t
e
m
o
ther
duri
ng ante
natal
care
ANC.
Hop
e
fu
lly, m
o
th
er
will b
e
b
e
tter un
d
e
rstan
d
i
n
g
abo
u
t
th
e im
p
o
r
tan
ce
o
f
EIB
.
It also
d
i
stribu
ted
a
h
a
ndb
ook
t
o
pr
egn
a
n
t
wo
m
e
n
th
at
con
t
ain
th
e m
a
ter
i
al a
b
ou
t
EI
B
and also
im
p
l
e
m
e
n
tatio
n pr
o
c
edu
r
es
of
EIB.
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