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Facilitators
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| Health providers found the interpersonal communication skills sessions embedded in the training very useful |
“I think interpersonal communication was most useful, because it’s one thing to know a topic or know a particular subject and it’s another thing to pass it across to the mothers. I think that was the most important thing for us. For those mothers that don’t want to adopt exclusive breastfeeding, through interpersonal communication we are able to encourage them and convince them to adopt exclusive breastfeeding.” (Female health provider, 7 years at health facility) |
| The counseling materials refreshed and reinforced the knowledge and skills they obtained from the training |
“It was very easy because we have our counseling manual with us. We didn’t have problems at all. If you go through the counseling manual, you don’t even have issues at all in counseling on exclusive breastfeeding.” (Female health provider, 2 years at health facility 2 years) |
| WhatsApp support groups helped health providers encourage and motivate mothers to practice exclusive breastfeeding |
“Most time when a patient says, ‘I don’t want to do exclusive’, you [the health provider], you give up. When a patient says, ‘I need to buy formula’, you [the health provider], you give up. When a patient says, ‘my mother said I should give water and I’m giving water’, you [the health provider], you give up. But now, not anymore! We must keep on following up with them [mothers], refreshing their mind on WhatsApp. We’re always refreshing their mind, sending out materials, you know, encouraging them, announcing when they do well on the platform. Everybody will be happy, congratulating them, ‘you did exclusive!’” (Female health provider, 15 years at health facility) |
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Barriers
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| Increased workload for the health providers |
“It has added to the workload. It’s like somebody was sweeping one room before, and then you told the person to sweep 3 more rooms, without giving the person more hands to do the work.” (Female health provider, 15 years at health facility) |
| More time was required to provide services |
“Time was actually a barrier. We had to make time, and we have so many persons to attend to. It’s just inadequate manpower, that’s all, and we are trying to attend to that. For me, most of the time, I have to try my best to squeeze out some time to talk to [the mothers] and when I have the time it really pays.” (Female health provider, 15 years at health facility) |
| Intrusions in health providers’ personal time by mothers on WhatsApp |
“Mothers will be asking questions at midnight. Most especially the first-time mums. When they don’t know what to do when they encounter difficulties, they will have to call, not minding the time or send message either personal or to the group. Most times when they don’t get answers from the group, they tend to call me personally.” (Female health provider, 2 years at health facility) |
| Some mothers experienced challenges with internet access, which limited their access to WhatsApp videos and messages |
“I think it’s those women that don’t have much data or that don’t subscribe, so they feel like whenever they enter WhatsApp, our messages will wipe all their data. Some of them just exit the group.” (Female health provider, 2 years at health facility)
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