Awareness and perceptions of donor human milk banking, willingness to receive donor human milk, and associated factors among women in Morogoro, Tanzania

Donor human milk banking (DHMB) is a lifesaving intervention for vulnerable infants, yet awareness, perceptions, and willingness among mothers in Tanzania remain poorly understood. This study assessed postpartum women’s awareness, perceptions, willingness, and associated factors regarding DHMB in Morogoro, Tanzania. A hospital-based cross-sectional study was conducted among 388 postpartum women. Eligible women were breastfeeding mothers of reproductive age recruited consecutively at a regional referral hospital; those who were severely ill or declined consent were excluded. Data were collected using structured questionnaires and analysed using descriptive statistics and logistic regression to determine factors associated with willingness to allow infants to receive donor human milk. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were reported. The mean age of participants was 25 ± 3 years. Most respondents resided in urban areas (71.4%) and were married (79.1%); secondary education was the most common level of education attained (40.7%). Awareness of DHMB was low; only 12.1% had heard of DHMB and 3.9% were aware of services in Tanzania. Despite this, 67.0% perceived donor milk as safe and 71.7% considered it healthier than formula, although 75.5% believed it could transmit HIV and 87.1% reported discomfort using another woman’s milk. Overall, 53.9% were willing to allow their infants to receive donor human milk. In multivariable analysis, urban residence was associated with lower willingness (aOR = 0.41, 95% CI 0.18–0.93), while previous breast milk production difficulties increased willingness (aOR = 2.19, 95% CI 1.11–4.29). Positive perception was the strongest predictor (aOR = 19.51, 95% CI 10.07–37.81). Awareness and knowledge were not independently associated with willingness after adjustment. Awareness of DHMB is low in this setting, but willingness is moderate and strongly driven by perceptions and breastfeeding experience. Strengthening education and addressing misconceptions are essential for successful DHMB introduction in Tanzania.