Infants are one of the most vulnerable groups in disasters/emergencies. So their nutrition should be a major concern area during a disaster. When concentrating on infant and young child feeding on emergencies (IYCF-E) there are several manuals released by infant and young child feeding core group (IFE Core group) on infant feeding in emergencies which is an expert advocacy and resource group on infant and young child feeding (IYCF). It discusses the optimum feeding practices, risk of suboptimal feeding practices and requirements for minimum response in order to deliver a better standard of care to infant and young children during a disaster/emergency situation.

In Sri Lanka Public Health Midwives (PHMM) are the grass root level workers who are involved in infant and young child nutrition. Therefore, assessing knowledge, attitudes and preparedness among PHMM on IYCF-E is of utmost importance to protect infant and young child nutrition during an emergency/disaster situation. This study was conducted to assess knowledge, attitudes and preparedness to protect infant and young child feeding in emergencies among public health midwives in Ampara district.

A descriptive cross sectional study conducted from August 2017 to November 2017. All the PHMM who were attached to Medical officer of health (MOH) offices in Ampara and Kalmunai Regional Director of Health Service (RDHS) areas were included while those who were on maternity leave and PHM who were having experiences in the field less than six months excluded. Pre tested self-administrated questionnaire employed to collect the data with prior informed written consent. The total population was included without any calculation (260) among which only 93% (243) participated in the study. Data analysis was done using SPSS 21 statistical software.

Median age of the sample population was 42 (Inter quartile range 32-46years). Among

PHMM 45,7% were Buddhist. Majority (76.1%) of them educated up to G.C.E

A/Level.58.4% of the participants had field experience as a PHM for more than 10 years.

 Overall knowledge on IYCF in a disaster seemed to be satisfactory among 74.1% of the study population with a ≥ 75% percentage score, while 25.9% were with poor knowledge. Though the majority of the participants were trained on IYCF only 1.6% knew about IYCF in a disaster response which is part of the IYCF programme. There was a statistically significant correlation between overall knowledge and age (p<0.05), overall knowledge and education qualifications (p<0.05), overall knowledge and being train on IYCF (p<0.05) and overall knowledge and service experience in the field (p<0.05) while there was a statistically significant positive correlation between the day of duty reporting after a disaster and PHM residence in the working field (p<0.01). 

Among all participants, 99.2% PHMM were with overall positive attitudes, while only 0.08% with overall negative attitudes. Statistically significant association found between overall attitudes and age (p<0.05), previous personal experience on disasters (p<0.05) and past disaster experience at the working field (p<0.05). 

More than half (56.4%) were with poor preparedness on IYCF in an emergency/disaster. Only 26.3% of PHMM had a disaster response plan for their respective PHM area. Preparedness on IYCF was significantly associated with age (p<0.05), previous personal experience on disasters (p<0.05) and past disaster experience at work (P<0.05).  Inadequate training on disaster management was identified as the reason for poor preparedness by most of the PHMM (92.2%).