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Mapping exclusive breastfeeding in Africa between 2000 and 2017.

ABSTRACT: Exclusive breastfeeding (EBF)-giving infants only breast-milk (and medications, oral rehydration salts and vitamins as needed) with no additional food or drink for their first six months of life-is one of the most effective strategies for preventing child mortality^1-4. Despite these advantages, only 37% of infants under 6 months of age in Africa were exclusively breastfed in 2017⁵, and the practice of EBF varies by population. Here, we present a fine-scale geospatial analysis of EBF prevalence and trends in 49 African countries from 2000-2017, providing policy-relevant administrative- and national-level estimates. Previous national-level analyses found that most countries will not meet the World Health Organization's Global Nutrition Target of 50% EBF prevalence by 2025⁶. Our analyses show that even fewer will achieve this ambition in all subnational areas. Our estimates provide the ability to visualize subnational EBF variability and identify populations in need of additional breastfeeding support.

SUBMITTER: Bhattacharjee NV

PROVIDER: S-EPMC6749549 | biostudies-literature | 2019 Aug

REPOSITORIES: biostudies-literature

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Mapping exclusive breastfeeding in Africa between 2000 and 2017.

Bhattacharjee Natalia V NV Schaeffer Lauren E LE Marczak Laurie B LB Ross Jennifer M JM Swartz Scott J SJ Albright James J Gardner William M WM Shields Chloe C Sligar Amber A Schipp Megan F MF Pickering Brandon V BV Henry Nathaniel J NJ Johnson Kimberly B KB Louie Celia C Cork Michael A MA Steuben Krista M KM Lazzar-Atwood Alice A Lu Dan D Kinyoki Damaris K DK Osgood-Zimmerman Aaron A Earl Lucas L Mosser Jonathan F JF Deshpande Aniruddha A Burstein Roy R Woyczynski Lauren P LP Wilson Katherine F KF VanderHeide John D JD Wiens Kirsten E KE Reiner Robert C RC Piwoz Ellen G EG Rawat Rahul R Sartorius Benn B Davis Weaver Nicole N Nixon Molly R MR Smith David L DL Kassebaum Nicholas J NJ Gakidou Emmanuela E Lim Stephen S SS Mokdad Ali H AH Murray Christopher J L CJL Dwyer-Lindgren Laura L Hay Simon I SI

Nature medicine 20190722 8

Exclusive breastfeeding (EBF)-giving infants only breast-milk (and medications, oral rehydration salts and vitamins as needed) with no additional food or drink for their first six months of life-is one of the most effective strategies for preventing child mortality<sup>1-4</sup>. Despite these advantages, only 37% of infants under 6 months of age in Africa were exclusively breastfed in 2017<sup>5</sup>, and the practice of EBF varies by population. Here, we present a fine-scale geospatial analys ...[more]

PMID: 31332393

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Project description:BackgroundAt 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.MethodsUsing 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.ResultsThe 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.ConclusionEarly 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.

Dataset Information

Mapping exclusive breastfeeding in Africa between 2000 and 2017.

Publications

Mapping exclusive breastfeeding in Africa between 2000 and 2017.

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