Dataset Information

Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016.

ABSTRACT:

Background

At the national level in Ethiopia, there is limited knowledge of trends and factors associated with early initiation of breastfeeding and exclusive breastfeeding (EBF), particularly during the Millenium Development Goal (MDG) era (2000-2015). The study aimed to examine the trends and determinants of early initiation of breastfeeding and EBF in Ethiopia between 2000 and 2016.

Methods

Using the Ethiopia Demographic and Health Survey (EDHS) data for the years: 2000 (n?=?3680), 2005 (n?=?3528), 2011 (n?=?4037) and 2016 (n?=?3861), trends in early initiation of breastfeeding and EBF were estimated. Multivariate logistic regression models that adjusted for confounders, sampling weight, clustering and stratification were used to examine the association between socioeconomic, demographic, health service and community level factors with early initiation of breastfeeding and EBF from 2000 to 2016.

Results

The prevalence of early initiation of breastfeeding increased from 48.8% in 2000 to 75.7% in 2016 in Ethiopia. Improvement in EBF prevalence was not statistically significant (from 54.5% in 2000 to 59.9% in 2016). Over the study period, informal maternal employment (Adjusted Odds Ratio [aOR] 0.75; 95% Confidence Interval [CI] 0.68, 0.83), frequent antenatal care visits (aOR 0.74; 95% CI 0.65, 0.85), and cesarean birthing (aOR 0.22; 95% CI 0.17, 0.30) were associated with delayed initiation of breastfeeding. Birthing in the health facility (aOR 1.35; 95% CI 1.05, 1.75) and residing in the metropolis region (aOR 1.95; 95% CI 1.65, 2.32) were associated with timely initiation of breastfeeding. In a similar period, informally employed mothers (aOR 1.37; 95% CI 1.15, 1.63) and those with six or more family size (aOR 1.46; 95% CI 1.10, 1.93) were more likely to exclusively breastfeed their babies.

Conclusion

Early initiation of breastfeeding improved in Ethiopia during the MDG era but it is still below the national target; progress in EBF remained slow. To improve breastfeeding outcomes and meet the global breastfeeding targets in Ethiopia, infant feeding efforts should focus on improving key modifiable factors, including place and mode of birthing and socioeconomic status of mothers.

SUBMITTER: Ahmed KY

PROVIDER: S-EPMC6740001 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016.

Ahmed Kedir Y KY Page Andrew A Arora Amit A Ogbo Felix Akpojene FA

International breastfeeding journal 20190911

<h4>Background</h4>At the national level in Ethiopia, there is limited knowledge of trends and factors associated with early initiation of breastfeeding and exclusive breastfeeding (EBF), particularly during the Millenium Development Goal (MDG) era (2000-2015). The study aimed to examine the trends and determinants of early initiation of breastfeeding and EBF in Ethiopia between 2000 and 2016.<h4>Methods</h4>Using the Ethiopia Demographic and Health Survey (EDHS) data for the years: 2000 (<i>n</ ...[more]

PMID: 31528197

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Project description:IntroductionExclusive breastfeeding (EBF) is the safest and healthiest option of feeding among infants in the first 6 months throughout the world. Thus, the promotion of EBF is essential to prevent complex infant health problems even at the adulthood level. But the majority of previous studies focused on individual- level determinants of EBF by using basic regression models in localized areas. This study aimed to identify the determinants of EBF at the individual and community level which would be helpful to design appropriate strategies for improving the practice of EBF.MethodsIt is a secondary data analysis using the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total of 1185 infants under 6 months of age were included in the analysis. A Multilevel logistic regression model was employed to investigate factors significantly associated with EBF among under-six infants in Ethiopia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was used to measure the association of variables whereas Intracluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were used to measure random effects (variation).ResultIn multilevel logistic regression; 4-5 months age infant (AOR = 0.04, 95%CI:0.02-0.07), female infants (AOR = 2.51, 95%CI:1.61-3.91), infant comorbidities (AOR = 0.35, 95%CI: 0.21-0.57), richest household wealth index (AOR = 10.34, 95%CI: 3.14-34.03) and antenatal care (AOR = 2.25, 95%CI:1.32-3.82) were individual- level determinants significantly associated with exclusive breastfeeding. Whereas, contextual region (AOR = 0.30, 95%CI: 0.10-0.87), community- level of postnatal visit (AOR = 2.77, 95%CI: 1.26-6.58) and community -level of maternal employment (AOR = 2.8, 95%CI: 1.21-6.47) were community level determinants significantly associated with EBF. The full model showed that46.8% of the variation of exclusive breastfeeding was explained by the combined factors at the individual and community levels. Similarly, it showed that the variation in exclusive breastfeeding across communities remained statistically significant (ICC = 8.77% and variance = 0.32 with P<0.001).Conclusion and recommendationOur study showed that both individual and community level determinants were significantly associated with EBF practice among under 6 infants. Based on our findings, it is recommended to promote and enhance antenatal and postnatal care services utilization of mothers to improve exclusive breastfeeding practice and more emphasis should be given to infants with comorbid conditions and those who were living in the pastoralist regions.

Project description:BackgroundDespite the well-established benefits of early initiation of breastfeeding and exclusive breastfeeding for the first six months to promote optimal neonatal and child health, evidence indicates that in Ethiopia, a significant number of newborns initiate breastfeeding late, do not adhere to exclusive breastfeeding (EBF) for the recommended duration, and instead are fed with bottles.ObjectiveTo determine the proportion of delayed initiation of breast milk, exclusive breastfeeding, and its individual and community-level predictors among mothers in Ethiopia.MethodsA secondary data analysis was done using the 2019 Ethiopian Mini Demographic Health Survey data. We examined a weighted sample of 2,012 children born within the past 24 months and 623 children aged 0-5 months at the time of the survey. The data analysis was done using STATA version 15. To understand the variation in delayed initiation and exclusive breastfeeding, statistical measures such as the Intraclass correlation coefficient, median odds ratio, and proportional change in variance were calculated. We employed a multilevel mixed-effects logistic regression model to identify predictors for each outcome variable. Statistical significance was determined with a p-value < 0.05.ResultsThe proportion of delayed initiation of breast milk and exclusive breastfeeding were 24.56 and 84.5%, respectively. Women aged 34-49 years old (AOR = 0.33: 95% CI; 0.15-0.72), having a television in the house (AOR = 0.74: 95%CI; 0.33-0.97), delivered by cesarean section (AOR = 3.83: 95% CI; 1.57-9.32), and resided in the Afar regional state (AOR = 1.43: 95%CI; 1.03-12.7) were significantly associated with delayed initiation of breast milk. On the other hand, attended primary education (AOR = 0.67: 95%CI; 0.35-0.99), secondary education (AOR = 0.34: 95%CI; 0.19-0.53), women whose household headed by male (AOR = 0.68; 95% CI; 0.34-0.97), and rural residents (AOR = 1.98: 95%CI; 1.09-3.43) were significantly associated with exclusive breastfeeding practice.ConclusionHealth promotion efforts that encourage timely initation of breast milk and promote EBF, focused on young mothers, those who gave birth through cesarean section, and those residing in urban and the Afar regional state. Furthermore, government health policymakers and relevant stakeholders should consider these identified predictors when revising existing strategies or formulating new policies.

Project description:BackgroundExclusive breastfeeding (EBF) has important benefits for both the mother and child. In India, no nationwide studies have examined patterns of EBF in the past decade to inform national and subnational breastfeeding programmes. The present study aimed to investigate the regional prevalence and determinants of EBF in India.MethodsThis study used a total weighted sample of 21,352 from the 2015-2016 India National Family Health Survey. EBF was measured as the proportion of infants 0-5?months of age who received breast milk as the only source of nourishment, based on mother's recall on feeds given to the infant 24?h before the survey. The prevalence of EBF and other breastfeeding patterns were estimated by region, and multivariable logistic regression that adjusted for clustering and sampling weights was used to investigate the association between the study factors (child, maternal, household, health service and community factors) and EBF by regional areas in India.ResultsThis study indicated that wide differences in the prevalence of EBF and other childhood feeding practices exist across regions of India, where Southern India had the highest EBF prevalence (79.2%) and the North-East reported the lowest (68.0%). EBF prevalence decreased with infant age, dropping faster in the South (43.7% at 5?months) compared to the North-East region (54.0% at 5?months). Similarly, substantial variations in key determinants of EBF were evident by region, where higher birth order was the only common factor associated with non-EBF across all regions. Key modifiable determinants of non-EBF included higher maternal education in the South and belonging to rich households in Central India, while those for EBF were higher maternal education in the Central region and frequent antenatal care (? 4) visits in Northern India.ConclusionThis study demonstrates wide variations in regional prevalence and determinants of EBF in India. Improving EBF participation in India would require multifaceted national and subnational efforts that include dedicated funds and the establishment of appropriate policy and interventions that are consistently monitored and evaluated.

Dataset Information

Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016.

Background

Methods

Results

Conclusion

Publications

Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016.

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