Infant and Young Child Feeding Practices among Mothers in Lahore, Pakistan: A Cross-Sectional Study

Background: Inadequate child feeding practices lead to malnutrition, higher under-five mortality rates and adverse effects on quality of life. This study aimed to assess the breastfeeding and complementary feeding practices of mothers as well as the influence of various sociodemographic factors on them in local families of Lahore. Methods: This is a cross-sectional, descriptive study. It was conducted in CMH (Combined Military Hospital), Lahore in 2018. It comprises a sample of 203 mothers with children of at least two years of age, from various urban areas of Lahore. The subjects were selected on the basis of the inclusion criteria. Mothers with psychiatric illnesses and children with congenital anomalies were excluded from the study. Mothers were approached in the paediatric outpatient departments of four tertiary care hospitals of Lahore. Responses were recorded using a modified version of the Action Contre La Faim (ACF) questionnaire. Independent sample t-test and chi-square test were applied for analysis of the data. Results: Early initiation of breastfeeding within one hour from birth was observed in 83.3% children. Most children were administered colostrum (69.5%). The rate of exclusive breastfeeding for the first six months was 45.3%.  A child was being breastfed 8.21 ± 6.67 (mean ± SD) times a day. Maternal educational status, total number of adults in a household, and access to free healthcare were identified as important factors influencing the practice of breastfeeding. Porridge, khichdi, eggs, fruit and yoghurt were the most frequently used complementary foods. Conclusions: A high rate of an early start of breastfeeding and a low rate of exclusive breastfeeding for at least six months were predominant in our population. Administration of colostrum was observed in approximately two-thirds of the study participants. Education of the mother, type of the family system (nuclear or combined), and access to free healthcare strongly influence the breastfeeding practices.

Psychological Construct As Core Determinant of Effective E-Learning Process

The purpose of the current study is to examine the role of external influences (i.e. E-environment and Technology-Internet-Quality) associated with individual’s psychological influences (i.e. Learning Orientation, Learning Motives, Perceived-Ease-of-Use and Perceived-Usefulness) and customer satisfaction. Basically, study identifies the environmental, technological and psychological perspectives in the development/creation of particular of consumer’s response behaviors through the cognitive process in the context of e-learning. Current study was based on descriptive and causal research design. Data was collected from a sample of 1,338 customer / students of e-learning (from three universities providing E-learning education) through convenient sampling. Hence, responses were analyzed using structural equation modeling through AMOS 22. The results suggest that customers’ e-environmental, technological and psychological influences play a significant role in the development of customer satisfaction as well as subjective well-being.In comprehensive manner, the finding indicates that ‘E-environment (i.e. Self-Paced Learning Environment and Instructor-Led Learning Environment)’ and ‘Technology factors (i.e. Technology Quality and Internet Quality)’ have positive impact on individual’s psychological influences (i.e. Learning Orientation, Learning Motives, Perceived-Ease-of-Use and Perceived-Usefulness) and which ultimately determine customer’s satisfaction and his/her subjective wellbeing. Finally, the overall results of the current study contribute in building a rigor of social cognitive theory and consumer planned behavior theory in the context of e-learning. The study, adds significant value to the literature in three ways: first, it provides comprehensive discussion on e-learning construct and also the role of motivational forces in the formation of customer satisfaction as well as his/her subjective well-being from two perspectives i.e. external influence (e-environment and technology elements) and internal influence (psychological elements). Second, Stimulus-Organism-Response framework is used to conceptualize and propose that an individual’s external influences affect the psychological influences, thus leading to the development of response behavior. Third, conceptual framework is based on the integration of two disciplines in the formation of individual ‘behavior i.e. ‘consumer behavior’ (Stimulus-Organism-Response Model) and Information Technology (Technology Acceptance Model). Basically, this framework is used to test and verification of the individual’s planned behavior theory derived from individual psychology, social psychology and IT. According to consumer’s cognitive process, it is established that customer’s e-environmental, and technological factors have significant impact on psychological characteristics which ultimately effects his/her response behaviors. This study would be helpful in making good relationships with customers/students to improve their learning skills and enhance learning motives. To the knowledge of the researcher, the study of customer satisfaction and subjective well-being simultaneously in individual’s psychology, consumer behavior studies and technology contexts is almost ignored. Neither has it been studied quantitatively. Thus, the current study also intends to fill these gaps and contributes to the existing literature on these issues besides improving the understanding of the academicians, policy makers, universities’ management, psychologists, behaviorists, IT experts and marketers regarding these major issues working behind e-learning implementation.