Breastfeeding self-efficacy status and determinant factors among postnatal women in public hospitals of the Gurage Zone, Central Ethiopia: a mixed study design

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BACKGROUND: Breastfeeding self-efficacy is a mother's confidence in her ability to breastfeed, influencing her decision to do so. Across the world, due to low breastfeeding self-efficacy and limited attention to breastfeeding practices expose mothers and infants to adverse health outcomes and poor mother-child bonding and development. Most previous studies focused on breastfeeding knowledge, but there is limited research on breastfeeding self-efficacy and its associated factors. Thus, this study aimed to assess breastfeeding self-efficacy status and determinant factors among postnatal women in Gurage Zone public hospitals, Central Ethiopia. METHODS: A facility-based mixed-method cross-sectional study was conducted among 422 systematically selected women in Gurage Zone public hospitals, Central Ethiopia, from February 15 to March 15, 2025. Data were collected using a pre-tested interviewer-administered questionnaire, entered into Epi-Data 4.1, and analyzed using SPSS 26. Four focus group discussions were conducted with purposive sampling and analyzed thematically. Binary logistic regression identified factors associated with breastfeeding self-efficacy at P < 0.05. RESULTS: In this study, the overall breastfeeding self-efficacy status was 51.3% (95% CI: 47, 56). Women's primary educational attainment (AOR = 1.97; 95%CI:1.01,3.83), secondary and above educational attainment (AOR = 3.30; 95%CI: 1.87,5.85), ANC contacts (AOR = 2.24; 95%CI:1.37,3.63), breastfeeding experience (AOR = 3.59; 95%CI:2.10,6.13), moderate perceived social support (AOR = 2.96; 95%CI:1.47,5.55), and high perceived social support (AOR = 3.23; 95%CI:2.02,6.59) were significantly associated with breastfeeding self-efficacy. CONCLUSION: In this study, 48.7% lacked breastfeeding confidence. Educational status, ANC contact, breastfeeding experience, and perceived social support were associated with breastfeeding self-efficacy. Therefore, strengthening health education and counseling is needed to improve postpartum women's breastfeeding confidence..

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