Health Service System of Breastfeeding Promotion and Early Childhood Care in Primary Care Unit

Abstract

This study adopted a mixed method approach of convergent design and aimed to examine a health care system of breastfeeding and early childhood care in the primary healthcare unit in a province of health region 5. Data were collected by 12-item questionnaires with 5-point scale to assess 5 elements of healthcare system including 1) service access 2) health service support systems 3) provider competencies 4) continuous service delivery 5) service outcome, as well as the open-ended questions, in-depth interview, and literature review. For the study of breastfeeding, the samples were: 1) primary healthcare worker (n=1), 2) village health volunteers (VHV) who were randomly chosen (n=120) 3) postpartum mothers with newborns up to 6 months (n=43) who were randomly selected approximately 30 % of the population. The samples of early childhood care were: 1) primary healthcare worker (n=1) 2) VHV (n=120) 3) child development center teacher (N=17) 4) child’s parents (N=118). The data were analyzed by using frequency, percentage, mean, standard deviation, triangulation validation for data content and content analysis. The results of the breastfeeding study revealed that the 5 elements of health care system were rated at the high to highest level, except primary healthcare worker which was rated at the moderate to high level. The primary healthcare worker and VHV required the development of childcare knowledge and breastfeeding skills as there was a lack of training for 3 years. The results of 5 elements of healthcare system of early childhood care were rated at the high to highest level. The primary healthcare worker and VHV had continuous childcare education, but still had communication problems. Pandemic of Covid-19 had negative effects on service access and continuous service both in breastfeeding promotion and early childhood care.