By Elizabeth Kemigisha, Advocacy Officer, FIDA Uganda

This week, as we celebrate World Breastfeeding Week, I am reflecting on the impact of maternal employment on breastfeeding practices in Uganda.

Breastfeeding is an integral part of the reproductive process and the World Health Organization (WHO) also recognizes that exclusively breastfeeding infants for up to six months, and continued breastfeeding for up to two years or beyond, is a vital practice to promote the survival and wellbeing of children.

Nevertheless, a recent study finds that the prevalence of exclusive breastfeeding of infants that are five months and younger is only 42.8% in Uganda. 

Maternal employment is a major determining factor of whether and how long a mother breastfeeds her baby. In Uganda, mothers in formal employment are entitled to 60 days of maternity leave on full wages with a guarantee of the job they left behind (or its equivalent) waiting for them when they get back to work.  

While this provision enables breastfeeding of newborns, there is also little support available to women to continue breastfeeding after they have returned to work since few employers allow flexible working hours, day-care at work, breaks during a work day or private rooms for breastfeeding and expressing breast milk or facilities to store the expressed milk.

In the absence of these facilities, within a society that deems women breastfeeding in public to be ‘inappropriate’ and ‘unacceptable’, few working mothers who wish do so will succeed in continuing to exclusively breastfeed their babies up to the time that they are six months old.

Notwithstanding the challenges of working women in the formal sector, they have significantly greater success in breastfeeding than women who are employed in the informal sector. Worldwide, close to 60% of working women make their living in the informal economy which is not regulated or protected by the state, with the result that this population of mothers do not benefit from formal employment-related protections that are known to improve infant and young child feeding practices. Women in Uganda in the informal sector do not have the benefit of paid maternity leave and often have no choice but to return to full-time work very shortly after giving birth. Women who work in markets, for example, face challenges in that vending is a physically demanding job requiring vendors be alert and engage the customers for every sale. Working mothers in this sector cannot attend to their infants during peak market hours and do not have many alternatives to provide them with safe care while they are at work.

Women in the horticulture sector face similar challenges. Through the women@work project implemented by FIDA Uganda with support from HIVOS, a survey involving women in flower farms was conducted, on the availability of breastfeeding and child care services at the farms. Stella (not real name) had this to say: ‘‘It is impossible for one to maintain a certain standard of hygiene especially when breastfeeding.

With that 1-hour lunch break, one can’t even afford to bath off the fumes and spill overs of fertilizers from the farm. Rush to queue for food. Most of us decided to just go straight to breastfeeding our children without even cleaning up’’.

In the face of urgent economic and livelihood responsibilities which women such as Stella face, exclusive breastfeeding is not a priority. To expect one to pursue optimal breastfeeding patterns in such circumstances is to forget that the mother is also a worker. It is also asking an individual to fill the gaps for structural issues of lack of social protection, lack of decent work and employment, and inadequate environmental sanitation.

Considering that most families where the mothers are the sole providers live from hand to mouth, women have little choice but to forego exclusive or any breastfeeding in order to protect their livelihood.

Most of Uganda’s social protection laws and policies focus heavily on the formal sector and efforts to extend them to the informal sector need to be more comprehensive and inclusive. NSSF, for example, which is the largest social security scheme in the country, is limited to the formal economy and covers employees who work in firms employing a minimum of five workers.

Also, the recently passed Employment (Amendment) Act, 2021, which is yet to be assented to by the President of the Republic of Uganda, do not holistically address the challenges faced by women in the informal sector.

The Act is commendable for requiring employers to put facilities and policies in place to protect breastfeeding mothers and makes some provision for domestic and casual workers.

However, the Act leaves out other informal sector occupations outside these two categories and does not bring any relief to the large number of women who work in markets and run their own small businesses.

Our lawmakers, government, businesses and civil society need to take collective action to make sure that breastfeeding is a viable option for all working mothers.