Healthcare professionals’ knowledge, attitudes, and associated factors with donor breast milk banking in eastern Ethiopia: a multi-centre cross-sectional study

Abstract

Donor breast milk banking (DBMB) provides a critical alternative feeding option for vulnerable infants when maternal breast milk is unavailable, particularly in settings with high neonatal morbidity and mortality. Despite its proven benefits for child survival, its successful implementation depends largely on healthcare professionals’ knowledge and attitudes, yet evidence from low-income countries such as Ethiopia remains limited. Hence, this study aimed to assess healthcare professionals’ knowledge and attitudes toward DBMB and identify factors associated with these outcomes in public hospitals in eastern Ethiopia. A facility-based multicentre cross-sectional study was conducted among 347 healthcare professionals across four public hospitals from 15 August to 13 September 2024. Respondents were selected using simple random sampling from healthcare professionals working in maternal and child health units. Data were collected using a structured self-administered questionnaire, entered into EpiData version 3.1, and analyzed using Stata version 17. Binary logistic regression was used to identify factors associated with knowledge and attitude, with p < 0.05 considered statistically significant. Among 347 healthcare professionals, 12.1% (95% CI: 8.86–16.01) had adequate knowledge, while 31.1% (95% CI: 26.29–36.29) had a favorable attitude toward DBMB. Work experience (AOR = 1.09, 95% CI: 1.02–1.17; p = 0.009), being married (AOR = 2.64, 95% CI: 1.05–6.65; p = 0.038) and favorable attitude (AOR = 2.00, 95% CI: 1.00–4.00; p = 0.047) increased odds of adequate knowledge. Higher experience > 10 years (AOR = 2.19, 95% CI: 1.10–4.36; p = 0.026), higher qualifications (AOR = 2.64, 95% CI: 1.40–4.96; p = 0.002), and adequate knowledge (AOR = 2.15, 95% CI: 1.04–4.44; p = 0.038) were positively associated with favorable attitude. Healthcare professionals demonstrated limited knowledge and suboptimal attitudes toward DBMB. Work experience, marital status, education, and knowledge were significant factors associated with outcomes, and improved knowledge may enhance attitudes toward implementation. Strengthening pre-service education, in-service training, and professional awareness programs may improve healthcare professionals’ preparedness for DBMB implementation. Coordinated efforts by health authorities, training institutions, and healthcare facilities are needed to support the integration of DBMB into neonatal and infant nutrition services in Ethiopia.