TABLE OF CONTENTS
| Content | Page |
| Title page | i |
| Certification | ii |
| Dedication | iii |
| Acknowledgements | iv |
| Abstract | v |
| Table of Contents                                                                        | vi |
| List of Tables List of Appendices | ix x |
| List of Figures | xi |
CHAPTER ONE: INTRODUCTION
| 1.1 | Background to the study | 1 |
| 1.2 | Statement of the study | 2 |
| 1.3 | Objective of the study | 3 |
| 1.4 | Research Questions | 3 |
| 1.5 |  Hypotheses                                                                   | 4 |
| 1.6 | Scope of the Study | 4 |
| 1.7 | Significance of the Study | 4 |
| 1.8 | Operational Definition of Terms | 4 |
CHAPTER TWO: REVIEW OF LITERATURE
| 2.0 | Introduction | 6 |
| 2.1 | Overview of Breastfeeding | 6 |
| 2.2 | Exclusive Breastfeeding practice in developing world | 9 |
| 2.3 | Global prevalence of exclusive breastfeeding | 10 |
| Content 2.4 | Prevalence of exclusive breastfeeding practice in Africa | Page 11 |
| 2.5 | Prevalence of exclusive breastfeeding practice in Nigeria | 12 |
| 2.6 | Effect of nursing intervention on exclusive breastfeeding practice | 13 |
| 2.7 | Theoretical Framework               | 15 |
| 2.7 | Conceptual Model                                                   | 17 |
CHAPTER THREE: METHODOLOGY
| 3.0 | Introduction | Â Â Â 18 |
| 3.1 | Research Design | 18 |
| 3.2 | Population | 18 |
| 3.3 | Sample size and sampling Technique | 19 |
| 3.4 | Instrumentation | 20 |
| 3.5 | Validity of instrument | 21 |
| 3.6 | Reliability of the Instrument | 21 |
| 3.7 | Method of Data Collection | 22 |
| 3.8 | Method of Data Analysis | 23 |
| 3.9 | Ethical consideration | 23 |
CHAPTER FOUR: DATA ANALYSIS, RESULTS
AND DISCUSSION OF FINDINGS
| 4.0 | Introduction | 24 |
| 4.1 | Data analysis and result presentation                                              | 25 |
| 4.2 | Discussion of findings | 32 |
Content                                                                                                 Page
CHAPTER FIVE: SUMMARY, CONCLUSION AND
RECOMMENDATIONS
| 5.1 | Summary                                                                         | 36 |
| 5.2 | Conclusion | 37 |
| 5.3 | Recommendations | 37 |
| 5.4 | Limitation of the Study | 38 |
| 5.5 | Suggestion for Further Studies                                                | 38 |
| REFERENCE | 39 | |
| APPENDICES | Â 6 |
LIST OF TABLES
| Table | Page | |
| 1 | Showing Frequencies and percentage on demographic data   | 25 |
| 2 3 | Showing Descriptive statistics of Frequency on Obstetric data Showing Participants’ knowledge category | 26 26 |
| 4 5 | Showing Descriptive statistics of pre-test knowledge regarding Showing Participants’ practice category     | 28 28 |
| 6 | Showing Descriptive statistics of post-test practice        | 29 |
| 7 | Showing Descriptive and inferential statistics of post-test knowledge                  | 30 |
| 8 | Descriptive and inferential statistics of post-test practice | 30 |
APPENDICES
| Appendix | Page | |
| Informed Consent Form | 46 | |
| Questionnaire | 47 | |
| Teaching Module                                                          | 51 | |
| Pictures from field work | 55 |
LIST OF FIGURE
| Figure | Â Page | |
| 1 | Theory of planned behavior conceptual framework | 17 |
CHAPTER ONE
INTRODUCTION
- Background to the Study
The importance of the provision of a nursing-based intervention such as breastfeeding-readiness education for mothers during the antenatal visits is crucial to achieving exclusivity among them. Janson (2010) stated that, nurse- based intervention is very important in establishing successful breastfeeding practice. Valine and Apaldia (2014) suggested that the nursing intervention consisting of breastfeeding education is helpful at improving early initiation and thereafter continuation of breastfeeding for the first two months. Despite the nutritional, economic, immunological, and psychological advantages of breast milk, breastfeeding practice appear to remain below recommended level and one thing that plays a role in breastfeeding success may be nursing intervention. According to World Health Organization (WHO) all lactating mothers should exclusively breastfeed their children for the initial six months and go on with breastfeeding up to two years (WHO, 2010). However studies have shown exclusive breastfeeding is practiced below WHO recommendation (Nasserpour, Nouhjak, & Sharifat, 2010). A target of 90% universal coverage for Exclusive breastfeeding (EBF) is recommended by WHO to prevent 13-15% of 9 million deaths of children under-five in low and middle-income countries annually (Jones, 2013). Reports from Agunbiade and Agun, 2012 in Ile-Ife town also showed that only 19% of the breastfeeding mothers practiced exclusively. On the other hand, mother’s breastfeeding practice can be enhanced with continuous interventions such as prenatal breastfeeding education. UNICEF, (2011) describes that breast milk is the standard, healthiest, simplest, and not expensive feeding way that complete all the children’s needs. Knowledge, expertise and advice of nurses are very vital in creating awareness, education and support for mothers and their babies to achieve exclusivity. Nursing intervention strategies is a significant approach to some of the challenges of breastfeeding practice, making mothers informed of the cost effective benefit of exclusive breastfeeding
The global exclusive breastfeeding rate for children aged less than six months between the years 2000 and 2007 was 38% (UNICEF, 2008). Within the same period, only 23% of infants less than six months were breastfed exclusively in West and Central Africa while Middle East and North Africa recorded a little higher rate of 26% was (UNICEF, 2008), in Eastern and Southern Africa; East Asia and the Pacific; and South Asia respectively prevalence of 39%, 43% and 44% were observed (UNICEF, 2008).In addition, a study in England showed that infants’ exclusive breastfeeding rate was low, and only 25% of babies remain breastfed until 6 to 8 weeks after birth and 16% of mothers continued breastfeeding for three to five months after birth (Cernadas, Noceda, Barrera, Martinez, & Garsd, 2008). In Nigeria, the practice of exclusive breastfeeding is uncommon with only 13% of infant younger than six months are being exclusively breastfed (Nigerian Demographic and Health Survey, 2008), while in Nigeria, between year 2000 and 2012 merely 15.1% of babies less than six months of age were exclusively breastfed (UNICEF, 2012). Nigeria Demographic and Health Survey 2013 later on reported a a little higher prevalence of 17% EBF rate. A study in Plateau state showed that only 6% of mothers practiced exclusive breast feeding (Amosu, 2010). Niguse, Frehiwot , Dinu and Eyerus (2016) stated that mothers knowlwdge and practice regarding exclusive breastfeeding as been low despite their exposure to training programmes on exclusive programs. According to Agunbiade and Oguunleye 2012, knowledge and practice concerning exclusive breastfeeding among mothers has been low despite exposure to training programmes on exclusive breastfeeding. Tyndall, Kamai, and Changchangi (2016) stated that despite the exposure of mothers to exclusive breastfeeding training, knowledge and practice regarding exclusive breastfeeding among mothers as been low. Despite initiation of exclusive breastfeeding programmes, problem associated with poor exclusive practice seems to persist suggesting a fundamental problem. These prompted the researcher to study the effect of nursing based intervention on exclusive breastfeeding practice among pregnant women attending two primary health care centers in Ikenne local government.
1.2 Statement of the Problem
The rate of infant morbidity and mortality as a result of poor exclusive breastfeeding among mothers as been high (Onah , Osuorah , Ebenebe , Ezechukwu , Ekwochi & Ndukwu, 2014). The incidence of of childhood communicable disease and infection in infants has significantly increased as a result of poor exclusive breastfeeding knowledge and practice among mothers (Talayero, Lizan-Garcia, Puime, Muncharaz, Soto, Sanchez-Palomares, Serrano & Rivera, 2006). The incidence of diarrhea and lower respiratory tract infections has been persistently high due to poor knowledge and practice regarding exclusive breastfeeding among mothers (Rivera, 2006). According to UNICEF (2013), exclusive breastfeeding knowledge and practice in Nigeria is significantly low. Knowledge and practice of mothers regarding exclusive breastfeeding as been low (Chola, 2011; Rea, 2009). Problems associated with poor exclusive breastfeeding practice such as infections, diarrhea, upper respiratory tract infections, childhood obesity, low immunity, sudden infant death syndrome and malnutrition has significantly increased due to poor knowledge and practice regarding exclusive breastfeeding among mothers. The researcher through clinical experience as observed high incidence of malnutrition, childhood obesity and infection and diarrhea. These may be attributed to poor knowledge and practice regarding exclusive breastfeeding and it may also be attributed to a gap in the type of training programme offered to mothers on exclusive breastfeeding. Hence the need for a study on the effect of nursing based intervention on exclusive breastfeeding practice among pregnant women attending two primary health care centers in Ikenne local government
Objective of the Study
