BACKGROUND Human milk is the best nutrition for all infants. When the mother's own milk is not available, the World Health Organization recommends the use of donated human milk and milk banking for neonates born prematurely or with medical problems. Donor human milk is rarely available in low-resource settings where both the rates of preterm birth and neonatal mortality are highest. The potential to reduce neonatal mortality through use of donated human milk is one that is yet to be fully explored in the African setting. For the introduction of any new health intervention to be successful, determining the barriers and facilitators to its acceptability is a vital first step. There are limited studies on this in sub-Saharan Africa. METHODS This qualitative study used focus group discussions and in-depth interviews to explore the potential barriers and facilitators to utilizing donated human milk for neonates in a hospital setting in eastern Uganda from the perspectives of caregivers (parents, grandparents) and healthcare workers. RESULTS Six focus group discussions involving 28 caregivers were conducted in a hospital setting in eastern Uganda. Four in-depth interviews were then also held with healthcare staff. Lack of knowledge of donated human milk emerged with discussants, and the barriers relating to transmission of infection (HIV) and poor hygiene. Common reasons which facilitated its acceptability were; a general knowledge and recognition that human milk is better than formula milk and a strong belief by caregivers in healthcare workers providing knowledgeable and safe care. Healthcare workers were supportive of introducing donor human milk but perceived a need for community and hospital education programs to enable this to be facilitated and scaled up. CONCLUSIONS This study shows that donor human milk can be acceptable to the caregivers of vulnerable babies in hospital settings in Uganda. Lack of awareness of donor human milk, its benefits and the methods of screening, acquisition and storage of donor milk are all barriers that could be addressed through improved education. This study advocates for national policies and programs that build capacity for effective and sustainable donor milk banking.

中文翻译：

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探索在乌干达东部接受供体母乳的障碍和促进因素-定性研究。

背景技术人乳是所有婴儿的最佳营养。如果母亲自己的牛奶不可用，世界卫生组织建议为早产或有健康问题的新生儿使用捐赠的母乳和牛奶储备。在资源匮乏的早产和新生儿死亡率最高的地区，很少有捐赠人母乳。通过使用捐赠的母乳来降低新生儿死亡率的潜力尚未在非洲环境中得到充分探索。为使任何新的健康干预措施获得成功，确定可接受性的障碍和促进者是至关重要的第一步。在撒哈拉以南非洲，对此的研究很少。方法该定性研究使用了焦点小组讨论和深入访谈，以从照顾者（父母，祖父母）和医护人员的角度探讨乌干达东部医院环境中将捐赠的母乳用于新生儿的潜在障碍和促进因素。结果在乌干达东部的一家医院中进行了六次焦点小组讨论，涉及28名护理人员。然后，还与医护人员进行了四次深度访谈。讨论者开始对捐赠的母乳缺乏了解，与感染传播（HIV）和卫生状况差有关的障碍。促进其接受的常见原因是；通常的知识和认识，即人乳比配方乳更好，并且护理人员坚信提供专业知识和安全护理的医护人员。医护人员支持引入捐赠者的母乳，但认为有必要进行社区和医院教育计划，以促进和扩大这种做法。结论这项研究表明，在乌干达的医院里，供体母乳可以被弱势婴儿的照料者接受。缺乏对捐赠人乳的认识，其好处以及捐赠乳的筛选，获取和储存方法都是可以通过改善教育来解决的障碍。这项研究主张建立国家政策和计划，以建立有效和可持续的捐助者牛奶储存能力。医护人员支持引入捐赠者的母乳，但认为有必要进行社区和医院教育计划，以促进和扩大这种做法。结论这项研究表明，在乌干达的医院中，供体母乳可以被弱势婴儿的照顾者接受。对捐赠人乳的认识不足，其好处以及捐赠乳的筛选，获取和储存方法都是可以通过改善教育来解决的障碍。这项研究主张建立国家政策和计划，以建立有效和可持续的捐助者牛奶储存能力。医护人员支持引入捐赠者的母乳，但认为有必要进行社区和医院教育计划，以促进和扩大这种做法。结论这项研究表明，在乌干达的医院中，供体母乳可以被弱势婴儿的照顾者接受。对捐赠人乳的认识不足，其好处以及捐赠乳的筛选，获取和储存方法都是可以通过改善教育来解决的障碍。这项研究主张建立国家政策和计划，以建立有效和可持续的捐助者牛奶储存能力。结论这项研究表明，在乌干达的医院里，供体母乳可以被弱势婴儿的照顾者接受。对捐赠人乳的认识不足，其好处以及捐赠乳的筛选，获取和储存方法都是可以通过改善教育来解决的障碍。这项研究主张建立国家政策和计划，以建立有效和可持续的捐助者牛奶储存能力。结论这项研究表明，在乌干达的医院中，供体母乳可以被弱势婴儿的照顾者接受。对捐赠人乳的认识不足，其好处以及捐赠乳的筛选，获取和储存方法都是可以通过改善教育来解决的障碍。这项研究主张建立国家政策和计划，以建立有效和可持续的捐助者牛奶储存能力。