Date of Award


Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Rafael Pérez-Escamilla

Second Advisor

Amber Hromi-Fiedler


Childhood malnutrition is a challenge that needs to be understood as a global health threat. Exclusive breastfeeding (EBF) is recognized as the best practice to improve a child’s growth and cognitive development in the first months of life. The World Health Organization recommends EBF until 6 months. Mothers need family support to adhere to EBF practices. This study aimed to understand the interpersonal level relational influences of fathers, grandmothers, and other family members on the mother-child dyad adherence to EBF practices, as well as document community and societal influences on EBF. This study took place in the Central Region of Ghana in three districts: South Assin, Komenda Edna Eguarfo/Abirem (KEEA), and Gomoa East. We used a qualitative design to analyze 30 semi-structured in-depth interviews with mothers (adults and teens), fathers (adults and teens), and other caregivers of a child younger than 1-year-old. Findings showed that family relational influences on a mother’s exclusive breastfeeding were not happening in isolation as the family members' EBF knowledge and behaviors were influenced by health professionals, community and church members, and societal and environmental characteristics. Fathers’ presence had a protective effect on the mother-child dyad. Fathers built their knowledge on healthcare professionals' recommendations. Grandmothers were key to sharing household and child-caring chores, and their beliefs were influenced by cultural and social norms and community members. Fathers’ and grandmothers’ support was essential to mothers’ adherence to practice EBF, thus the inclusion of these family members in prenatal and postnatal care should be encouraged. Campaigns to improve EBF must target mothers, fathers, and grandmothers with information about the benefits of EBF and responsive feeding to mitigate misinformation and improve adherence to best practices.

Open Access

This Article is Open Access

Included in

Public Health Commons