Abstract: Objectives: To examine trends in hospitalization and inpatient deaths of neonates, and infectious diseases (IDs) between 2005-2014; and severe acute malnutrition (SAM) between 2010 and 2014 in Yemen.

Method: It was a retrospective descriptive study. Data were extracted from the clinical records of the patients admitted from 2005 to 2014 for neonates and cases aged 1-59 months with IDs. For cases with SAM data were available from 2010 to 2014. Data were analyzed using SPSS version 20.

Results: Between 2005 and 2014, 39282 under-5 hospitalized and 33.6% were neonates. Of 26069 aged 1-59 months, 15224(58.4%) hospitalized with IDs. Pneumonia (44.6%), diarrhea (29.9%), and meningitis (10.6%) were the main subgroups. During the study period, there were 4183 under-5 deaths. Neonatal deaths accounting for 3671 (87.8%). Deaths aged 1-59 month were 512(12.2%) and IDs contributing 440(85.9%). Compared to 2005/06, neonatal hospitalization and death declined by 9.2% and 18.1% in 2013/14, and IDs by 56.8% and 79.2%, respectively. Pneumonia reductions were 65.4% and 83.7%, diarrhea 42% and 95.5%, and meningitis 73% and 83%, respectively. Between 2010-2014, SAM cases were 1781 of 13689 total hospitalization [13% (95%CI 12.5-13.6)] and 53 SAM deaths of 224 total deaths [23.7 % (18.6-29.6)]. SAM hospitalization rate increased from 8.5% in 2010, to 18.4% in 2014 and death rate increased from 27% (17.6-39.0) to 57.5% (42.2-71.5), respectively.

Conclusion: Despite significant decline in IDs and vaccine preventable diseases, this study showed 87.8% of under-5 mortality were neonates. The increasing trends in SAM hospitalization and death are alarming. Interventions to improve neonatal survival and to reduce SAM morbidity and mortality are urgently needed.

Abstract:  Background: Breastfeeding problems are common during the early period but can often be prevented or overcome with adequate support. Child-health nurses meet almost all children during their first weeks of life and play an important role in promoting breastfeeding and in strengthening parents’ confidence and their belief in their own ability. It is, therefore, important to gain more knowledge about child-health nurses’ experiences.

Objective: To describe child-health nurses’ experiences of providing breastfeeding support.

Methods: This qualitative study is descriptive with an inductive approach. A purposive sample of eight child-health nurses recruited from district health care centers participated. Data were collected through focus group interviews and analyzed with content analysis.

Results: Child-health nurses consider it to be important to provide early breastfeeding support and that early hospital discharge following birth can complicate breastfeeding. Furthermore, the introduction of infant formula and tiny tastes given to the baby can be a barrier to breastfeeding. Parents’ confidence had an effect on breastfeeding, and breastfeeding is promoted by confident parents. Trends and cultural differences have an influence on parents’ attitudes toward breastfeeding. Child-health nurses stated the importance of having a consensus breastfeeding policy.

Conclusion and Recommendation: A number of factors affect breastfeeding, and breastfeeding support from child-health nurses is important in the early stages after birth. To conclude, the support must be individually tailored with a focus on the parents’ needs. There is a need for greater cooperation between the maternal care and child-health care staff in order to provide adequate and continuous breastfeeding support throughout the care chain.

Keywords: Breastfeeding, child-health nurse, child-health service, focus group interview, qualitative content analysis.