Evidence map›Paper›PMID 39833924›Full record

ArticleInternational breastfeeding journal2025

Barriers and drivers to exclusive breastfeeding in Kyrgyzstan: a qualitative study with mothers and health workers.

Cath Jackson, Marina Duishenkulova, Nurila Altymysheva, Jyldyz Artykbaeva, Raisa Asylbasheva, Eleonora Jumalieva, Anastasia Koylyu, Sian Lickess, Tursun Mamyrbaeva, Veerle Snijders and 2 more

Abstract read
In one paragraph

Article in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Cath Jackson *Behavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark. cath@validresearch.co.uk.
Marina Duishenkulova *Republican Centre of Health Promotion and Mass Communication, Bishkek, Kyrgyzstan.
Nurila AltymyshevaRepublican Centre of Health Promotion and Mass Communication, Bishkek, Kyrgyzstan.
Jyldyz ArtykbaevaMinistry of Health of Kyrgyzstan, Bishkek, Kyrgyzstan.
Raisa AsylbashevaMinistry of Health of Kyrgyzstan, Bishkek, Kyrgyzstan.
Eleonora JumalievaMinistry of Health of Kyrgyzstan, Bishkek, Kyrgyzstan.
Anastasia KoylyuBehavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark.
Sian LickessBehavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark.
Tursun MamyrbaevaKyrgyz State Medical Academy by I.K Akhunbaev, Bishkek, Kyrgyzstan.
Veerle SnijdersBehavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark.
Julianne WilliamsSpecial Initiative on Noncommunicable diseases and Innovation, WHO Regional Office for Europe, Copenhagen, Denmark.
Tiina LikkiBehavioural and Cultural Insights Unit, WHO Regional Office for Europe, Copenhagen, Denmark.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundThe WHO/UNICEF global nutrition target for exclusive breastfeeding for six months is at least 70% of infants by 2030. However, global prevalence rates are 48% with variations between countries and within regions. Kyrgyzstan has consistently high early breastfeeding initiation rates, yet exclusive breastfeeding for six months is 46%. This qualitative study addressed two research questions: (1) What are the barriers and drivers for mothers to exclusive breastfeeding in the first six months? (2) What are the barriers and drivers for health workers in primary care facilities to supporting exclusive breastfeeding in the first six months?

methodsThe study took place from April to June 2023 in five sites (mix of urban and rural). Ten focus group discussions with 40 primary care health workers and 20 in-depth interviews with mothers of a child currently aged 6-12 months who initiated breastfeeding with this child were conducted. Mothers were purposively selected to represent four groups of infant feeding practices in the first six months: (1) exclusive breastfeeding, (2) breastfeeding alongside other fluids/solids, (3) breastfeeding alongside infant formula, (4) breastfeeding followed by switching to formula only. The Capability-Opportunity-Motivation-Behaviour (COM-B) model was the underpinning theoretical framework. Data were analysed using the Framework approach.

resultsThe study uncovered important misperceptions amongst mothers who were not exclusively breastfeeding (groups 2-4). These existed alongside a perceived inability to resolve physical challenges of breastfeeding and social pressure to supplement breastmilk with fluids/solids or formula. Half of all mothers felt uncomfortable breastfeeding in public. Health workers were recommending and supporting women with exclusive breastfeeding during multiple antenatal and postnatal interactions during the initial six months. They were knowledgeable and motivated to do this. Moreover, they felt well supported with training, resources, and legislation with just a few mentioning workplace time or space challenges. Very few doctors appeared to currently be meeting with formula industry representatives.

conclusionsThis theory-informed qualitative study focusing on mother and health worker perspectives provided important insights into the individual and contextual barriers and drivers to exclusive breastfeeding for the first six months in Kyrgyzstan. These insights have informed recommendations for tailored interventions for both groups.

Indexed as

Breast FeedingHealth PersonnelMothersAdultFemaleFocus GroupsHealth Knowledge, Attitudes, PracticeHumansInfantInfant, NewbornKyrgyzstanMaleQualitative ResearchYoung AdultBehavioural insightsBreastfeedingInfant feedingKyrgyz RepublicKyrgyzstanQualitative

Identifiers

PMID39833924
PMCPMC11748667

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.