Use of Drama for Improving Breastfeeding Initiation, Exclusive Breastfeeding and Breastfeeding Self-efficacy among Rural Pregnant Women from Selected Communities in Two Local Government Areas (LGAs) in Ibadan, Nigeria

Background: Breastfeeding self-efficacy (BFSE) is a key variable that enhances exclusive breastfeeding (EBF) and promotes positive health outcomes for infants and their mothers. To increase BFSE and EBF of mothers, numerous interventions targeting prenatal and postnatal periods have been developed. However, there is paucity of studies utilizing drama interventions for improving BFSE and EBF. Objectives: This study assessed the effect of drama usage on breastfeeding self-efficacy, initiation, and exclusive breastfeeding of pregnant women in rural communities in Lagelu and Egbeda Local Government Areas (LGAs). Methodology: A quasi-experimental designed was carried out with pregnant women in their second trimester. Selected communities from Lagelu and Egbeda LGAs were randomized into experimental and control groups. A total of 200 pregnant women (100 experimental and 100 control groups) were enlisted as well as followed-up at one, three, and six months after giving birth. Six-session program comprising four episodes of drama and two sessions on hygiene practices were presented to experimental groups in the communities prior to delivery, while the control group received only hygiene talk. An electronic questionnaire (ODK) was used to obtain information on socio-demographic, BFSE, initiation, and exclusive breastfeeding during prenatal and postnatal periods. BSFE score was categorized as low ([14][1]–[32][2]), average ([33][3]–51), and high (52–70). Descriptive and inferential statistics was used to analyzed data α0.05. Results: The experimental and control mean ages were 28.40 ±6.50 and 27.00±6.20 respectively. Average and high BSE pre-intervention (11.0%; 89.0% and 9.0%; 91.0%) and six months post-intervention (97.3%;100% and 95.2%; 95%) for intervention and control. Age, marital status and occupation were predictors of BFSE (R2 = 22.3; p<0.001) Conclusion: Experimental women had an increase in BFSE, initiation, and EBF practice compared to control women. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The award grant was given to Mrs Ogundairo Yetunde Omotola by Nestle Foundation for the study of problems of Nutrition in the world, Lausanne, Switzerland. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval was obtained from the University College Hospital and University of Ibadan Ethical Review Committee and Oyo State Ethical Review Committee I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All relevant data are within the manuscript and its supporting information files [1]: #ref-14 [2]: #ref-32 [3]: #ref-33