Facilitators and Barriers to Exclusive Breastfeeding Among Women Working in the Informal Sector: A Qualitative Exploration in Moshi, Tanzania

Stephanie Martin, Beatrice John, Esther Chung, Samantha Grounds, Margaret Bentley, Msuya Sia, Melina Mgongo
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Paid work is a barrier to exclusive breastfeeding (EBF) worldwide. In Tanzania, most women work in the informal sector and cannot access paid maternity leave or other employment benefits, exacerbating these challenges. The objectives of this research were to examine barriers and facilitators to EBF among women working in the informal sector, and identify the strategies women use to meet infant care and feeding and informal work responsibilities.


We conducted semi-structured interviews with 20 mothers of children 1–5 months of age who work in the informal sector in Moshi Urban District, Tanzania. Recorded interviews were transcribed and translated into English. We used Atlas.ti to code transcripts, retrieve text segments, and conduct thematic analysis.


Participants’ mean age was 31 years (range 18–43) and their children's mean age was 2.9 months. Mothers worked as vendors (i.e., food, clothes, or goods) or provided services (e.g., tailor) resulting in varied levels of flexibility and time away from home. Women had very different experiences with work, which was influenced by their job type. However, there was considerable variation between women with the same type of job. Although some women brought their baby to their worksites, most participants thought it was challenging as workplaces are unsafe, it is difficult to simultaneously meet customers’ and infants’ demands, and women are not comfortable breastfeeding in public. Some women left their worksites during the day to go home and breastfeed, but this was not an option for many women who reported long distances to their child, missing customers, and travel costs. Participants’ responses about expressing breastmilk were mixed with many voicing concerns about safety, milk quality, amount, preparation, and feeding.


While informal work may be perceived to facilitate EBF compared to formal work, our findings indicate that in this context it was highly variable and dependent on women's individual circumstances. Targeted strategies and tailored counseling are needed to support women who work in the informal sector to overcome these barriers as well as policy level changes that provide paid parental leave to informal workers.