Acceptability and factors influencing human milk banking among healthcare professionals in eastern Ethiopia: a mixed methods study

Although human breast milk improves child survival, evidence on its acceptability among healthcare professionals in low-income settings such as Ethiopia remains limited. This study assessed the acceptability of human milk banking (HMBs) and identified factors influencing healthcare professionals’ acceptance of HMBs in public hospitals in eastern Ethiopia. A facility-based, multicenter, and mixed-methods study was conducted in four public hospitals from August to September 2024. The quantitative component used simple random sampling to select 361 healthcare professionals, while the qualitative section used purposive sampling to recruit seven participants for in-depth interviews. Quantitative data were analyzed using Binary logistic regression, with adjusted odds ratio (AOR) and 95% confidence interval (CI). Qualitative data were analyzed thematically based on the theoretical framework of acceptability (TFA). The acceptance rate of HMBs was 38.62% (95% CI: 33.47–43.96%). Factors significantly associated with acceptance included adequate knowledge (AOR = 2.25; 95% CI: 1.03–4.93), good attitude (AOR = 3.11; 95% CI: 1.80–5.38), higher educational level (Master’s/MPH) (AOR = 12.84; 95% CI: 4.19–39.29), being a medical doctor (AOR = 2.70; 95% CI: 1.44–5.03), and having children (AOR = 4.38; 95% CI: 2.54–7.53). Qualitative findings indicated that knowledge of breast milk benefits, confidence in safety protocols, and training opportunities facilitated acceptance, while cultural beliefs, awareness gaps, and resource constraints were identfied as barriers. Four in ten healthcare professionals accepted the concept of HMBs. Targeted interventions focusing on education, training, and resource allocation are needed to improve acceptance and support successful implementation, contributing to reduced child morbidity and mortality in low-income settings.