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Birhan TY, Alene M, Seretew WS, Taddese AA. Magnitude and determinants of breastfeeding initiation within one hour among reproductive women in Sub-Saharan Africa; evidence from demographic and health survey data: a multilevel study. BMC Public Health 2022; 22:1062. [PMID: 35624450 PMCID: PMC9145512 DOI: 10.1186/s12889-022-13114-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 03/21/2022] [Indexed: 11/16/2022] Open
Abstract
Background Early initiation of breastfeeding is one of the most simple and essential intervention for child development and survival in the world. World Health Organization recommended to begin breast milk with one hour after delivery. The objective of this study was to determine the magnitude of early initiation of breastfeeding in Sub-Saharan Africa using DHS data set. Methods This study was carried out within 32 Sub-Saharan African countries from 2010–2020, a pooled study of early initiation of breastfeeding was performed. For assessing model fitness and contrast, intra-class correlation coefficient, median odds ratio, proportional change in variance, and deviance were used. In order to identify possible covariates associated with early initiation of breastfeeding in the study area, the multilevel multivariable logistic regression model was adapted. Adjusted Odds Ratio was used with 95% confidence interval to declare major breastfeeding factors. Result The pooled prevalence of early initiation of breastfeeding in Sub-Saharan Africa countries was 57% (95% CI; 56%—61%), the highest prevalence rate of early initiation of breastfeeding was found in Malawi while the lowest prevalence was found in Congo Brazzaville (24%). In multilevel multivariable logistic regression model; wealth index (AOR = 1.20; 95% CI 1.16 – 1.26), place of delivery (AOR = 1.97; 95% CI 1.89 – 2.05), skin-to-skin contact (AOR = 1.51; 95% CI 1.47 – 1.57), mode of delivery (AOR = 0.27; 95% CI 0.25 – 0.29), media exposure (AOR = 1.36; 95% CI 1.31 – 1.41) were significantly correlated with early initiation of breastfeeding in Sub-Saharan Africa. Conclusion The magnitude of early initiation of breastfeeding rate was low in Sub-Saharan Africa. Covariates significantly associated with early initiation of breastfeeding was wealth index, place of delivery, mode of delivery, women educational status, and media exposure. Structural improvements are required for women with caesarean births to achieve optimal breastfeeding practice in Sub-Saharan Africa.
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Affiliation(s)
- Tilahun Yemanu Birhan
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
| | - Muluneh Alene
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wullo Sisay Seretew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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2
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Napyo A, Tumwine JK, Mukunya D, Waako P, Tylleskär T, Ndeezi G. Exclusive breastfeeding among HIV exposed infants from birth to 14 weeks of life in Lira, Northern Uganda: a prospective cohort study. Glob Health Action 2021; 13:1833510. [PMID: 33121390 PMCID: PMC7599030 DOI: 10.1080/16549716.2020.1833510] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Breastfeeding is important for growth, development and survival of HIV exposed infants. Exclusive breastfeeding reduces the risk of morbidity, mortality and increases HIV free survival of infants. Evidence on risk factors for inappropriate breastfeeding in Northern Uganda is limited. Objective This study determined the risk factors for non-exclusivity of breastfeeding in the first 14 weeks of life. Methods This prospective cohort study was conducted among 466 mother-infant pairs between August 2018 and February 2020 in Lira district, Northern Uganda. HIV infected pregnant women were enrolled and followed up at delivery, 6- and 14- weeks postpartum. We used a structured questionnaire to obtain data on socio-demographic, reproductive-related, HIV-related characteristics and exclusive breastfeeding. Data were analysed using Stata version 14.0 (StataCorp, College Station, Texas, USA.). We estimated adjusted risk ratios using modified Poisson regression models. Results The proportion of HIV exposed infants that were exclusively breastfed reduced with increasing age. Risk factors for non-exclusive breastfeeding included infants being born to HIV infected women who: were in the highest socioeconomic strata (adjusted risk ratio = 1.5, 95%CI: 1.01– 2.1), whose delivery was supervised by a non-health worker (adjusted risk ratio = 1.6, 95%CI: 1.01– 2.7) and who had not adhered to their ART during pregnancy (adjusted risk ratio = 1.3, 95%CI: 1.01– 1.7). Conclusions HIV infected women: with highest socioeconomic status, whose delivery was not supervised by a health worker and who did not adhere to ART were less likely to practice exclusive breastfeeding. We recommend ART adherence and infant feeding counselling to be emphasised among HIV infected women who are at risk of having a home delivery, those with poor ART adherence and those of higher socioeconomic status. We also recommend integration of these services into other settings like homes, community and work places instead of limiting them to hospital settings. Abbreviations HIV: Human Immunodeficiency Virus; ART: Antiretroviral therapy; HEI: HIV exposed infant; PMTCT: Prevention of mother-to-child transmission of HIV; MTCT: Mother-to-child transmission of HIV; AFASS: Acceptable, Feasible, Affordable, Sustainable and Safe; LRRH: Lira regional referral hospital; CI: confidence interval; ARR: Adjusted risk ratio; SD: Standard deviation; PCA: Principal component analysis
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Affiliation(s)
- Agnes Napyo
- Department of Public Health, Faculty of Health Sciences, Busitema University , Tororo, Uganda.,Centre for International Health, University of Bergen , Bergen, Norway.,Department of Pediatrics and Child Health, Makerere University , Kampala, Uganda
| | - James K Tumwine
- Department of Pediatrics and Child Health, Makerere University , Kampala, Uganda
| | - David Mukunya
- Centre for International Health, University of Bergen , Bergen, Norway
| | - Paul Waako
- Department of Pharmacology, Faculty of Health Sciences, Busitema University , Tororo, Uganda
| | | | - Grace Ndeezi
- Department of Pediatrics and Child Health, Makerere University , Kampala, Uganda
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Nsubuga-Nyombi T, Karamagi E, Nabitaka L, Namukose S, Calnan J, Nyakwezi S, Bachou H, Oucul L, Amoah AO. Increasing HIV-Free Survival of Infants: Reorganizing Care Using Quality Improvement for the Optimal Health and Nutrition of HIV-Positive Women and Their Exposed Infants in Uganda. J Int Assoc Provid AIDS Care 2020; 18:2325958219857724. [PMID: 31258023 PMCID: PMC6748534 DOI: 10.1177/2325958219857724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Reorganizing service delivery to integrate nutrition and infant and young child feeding
(IYCF) with prevention of mother-to-child transmission (PMTCT) is important for improving
outcomes of HIV-positive mothers and HIV-exposed infants (HEIs). Quality improvement (QI)
strategies were implemented at 22 health facilities. The percentage of HIV-positive
pregnant women and lactating mothers who received IYCF counseling at each visit improved
(45%-100%; mean = 93.1%, standard deviation [SD] = 15.5). Adherence to IYCF practices
improved (70%-96%; mean = 92.4%, SD = 8.5). Mother–baby pairs receiving the standard care
package improved (0%-100%; mean = 98.6%, SD = 22.6). The HEIs alive at 18 months and
infected decreased (mean = 6.2%, SD = 4.8). Statistical significance of change was
estimated using Fisher exact test and magnitude of change over time by calculating the
odds ratio. For all indicators, improvement was rapid and significant (P
< .001), especially in the first 6 months of QI implementation. Using QI to integrate
nutrition and ensure consistent and comprehensive PMTCT service delivery improved IYCF
adherence and decreased transmission.
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Affiliation(s)
- Tamara Nsubuga-Nyombi
- 1 United States Agency for International Development (USAID) Applying Science to Strengthen and Improve Systems (ASSIST) Project, University Research Co, LLC (URC), Kampala, Uganda
| | - Esther Karamagi
- 1 United States Agency for International Development (USAID) Applying Science to Strengthen and Improve Systems (ASSIST) Project, University Research Co, LLC (URC), Kampala, Uganda
| | - Linda Nabitaka
- 2 AIDS Control Program, Ministry of Health, Kampala, Uganda
| | | | - Jacqueline Calnan
- 4 United States Agency for International Development, Kampala, Uganda
| | - Sheila Nyakwezi
- 4 United States Agency for International Development, Kampala, Uganda
| | | | | | - Aurora Ose Amoah
- 7 United States Agency for International Development (USAID) Applying Science to Strengthen and Improve Systems (ASSIST) Project, Kampala, Uganda.,8 Data Analytics Research and Evaluation Group, Kampala, Uganda
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Asim M, Ahmed ZH, Hayward MD, Widen EM. Prelacteal feeding practices in Pakistan: a mixed-methods study. Int Breastfeed J 2020; 15:53. [PMID: 32513203 PMCID: PMC7278149 DOI: 10.1186/s13006-020-00295-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prelacteal feeding, the feeding a newborn substances or liquids before breastfeeding, is a common cultural practice in Pakistan, but is associated with neonatal morbidity and mortality because it delays early initiation of breastfeeding. In this study, we sought to examine the social and cultural factors associated with prelacteal feeding in Pakistan. METHODS This mixed-method study used data from the Pakistan Demographic and Health Survey (PDHS) 2012-13. Findings from the survey were complemented by qualitative interviews with mothers and healthcare providers. In a subset of PDHS dyads (n = 1361) with children (0-23 months), descriptive statistics and bivariate and multivariable logistic regression analysis examined factors associated with prelacteal feeding. The qualitative study included in-depth interviews with six mothers and six health care providers, which were analyzed using NVivo software version 10. RESULTS In PDHS, a majority of children (64.7%) received prelacteal feeding. The most common prelacteal food was milk other than breast milk (24.5%), while over a fifth (21.8%) of mothers reported giving honey and sugar water. Factors associated with prelacteal feeding included: birth at public health facilities (AOR 0.46, 95% CI 0.02, 0.95), maternal primary education (AOR 2.28, 95% CI 1.35, 3.85), and delayed breastfeeding initiation (AOR 0.03, 95% CI 0.01, 0.61). In our qualitative study, the major themes found associated with prelacteal feedings included: easy access to prelacteal substances at health facilities, deliveries in private health facilities, prelacteals as a family tradition for socialization, insufficient breast milk, Sunna of Holy Prophet, and myths about colostrum. CONCLUSIONS These data indicate that prelacteal feeding is a well-established practice and social norm in Pakistan. Policies and interventions aimed at promoting breastfeeding need to take these customs into consideration to achieve the desired behavioral changes.
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Affiliation(s)
- Muhammad Asim
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Department of Sociology, University of Sargodha, Sargodha, Pakistan
- Population Research Center, University of Texas at Austin, Austin, USA
| | - Zarak Husain Ahmed
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Mark D. Hayward
- Department of Sociology & Population Research Center, University of Texas at Austin, Austin, USA
| | - Elizabeth M. Widen
- Department of Nutritional Sciences & Population Research Center, University of Texas at Austin, Austin, Texas USA
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Tongun JB, Sebit MB, Ndeezi G, Mukunya D, Tylleskar T, Tumwine JK. Prevalence and determinants of pre-lacteal feeding in South Sudan: a community-based survey. Glob Health Action 2019; 11:1523304. [PMID: 30295171 PMCID: PMC6179051 DOI: 10.1080/16549716.2018.1523304] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Pre-lacteal feeding (PLF) is a barrier to optimal breastfeeding and increases the risk of diarrhoea and acute respiratory tract infections in infants.The prevalence and predictors of PLF are not well studied in South Sudan. Understanding the predictors of PLF is crucial in designing interventions to increase exclusive breastfeeding (EBF) rates. Objective: To assess the prevalence and factors associated with PLF in Jubek State, South Sudan. Method: This was a community based cross-sectional study of 810 mothers of children under two years of age in Jubek State, South Sudan. Mothers were interviewed in their homes using a semi-structured questionnaire to collect data on PLF, socio-demographic and birth characteristics. Multivariable analysis was used to identify factors independently associated with PLF. Results: A total of 426/810 (53 %), 95% confidence interval (CI) [48 %, 59 %] mothers had given pre-lacteal feeds to their infants. The commonest pre-lacteal feeds included glucose solution (54%), water (26%), and infant formula (14%). Having received antenatal breastfeeding counselling decreased the odds of PLF [adjusted odds ratio (AOR) 0.60; 95% CI (0.43, 0.82)]; while discarding of colostrum increased the use of pre-lacteal feeds [AOR 1.57; 95% CI (1.17, 2.11)]. Conclusion: The prevalence of PLF in South Sudan is high. Predictors of PLF included lack of breastfeeding counselling and discarding of colostrum. Infant feeding counselling should be given to all pregnant women in the health facilities and communities. The counselling should emphasize the health benefits of colostrum and discourage the practice of discarding it.
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Affiliation(s)
- Justin Bruno Tongun
- a Centre for International Health , University of Bergen , Bergen , Norway.,b Department of Paediatrics and Child Health , College of Medicine, University of Juba , Juba , South Sudan
| | - Mohamedi Boy Sebit
- c Department of Internal Medicine , College of Medicine, University of Juba , Juba , South Sudan
| | - Grace Ndeezi
- d Department of Paediatrics and Child Health, School of Medicine , College of Health Sciences, Makerere University , Kampala , Uganda
| | - David Mukunya
- a Centre for International Health , University of Bergen , Bergen , Norway
| | - Thorkild Tylleskar
- a Centre for International Health , University of Bergen , Bergen , Norway
| | - James K Tumwine
- d Department of Paediatrics and Child Health, School of Medicine , College of Health Sciences, Makerere University , Kampala , Uganda
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Temesgen H, Negesse A, Woyraw W, Getaneh T, Yigizaw M. Prelacteal feeding and associated factors in Ethiopia: systematic review and meta-analysis. Int Breastfeed J 2018; 13:49. [PMID: 30505338 PMCID: PMC6260692 DOI: 10.1186/s13006-018-0193-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022] Open
Abstract
Background Prelacteal feeding can be defined as giving any solid or liquid foods other than breast milk during the first three days after birth. It affects timely initiation of breastfeeding and exclusive breastfeeding practices. Even though the issue was investigated in Ethiopia, fragmented and inconsistent findings were reported. Therefore, the main objective of this meta-analysis was to estimate the pooled prevalence of prelacteal feeding and associated factors in Ethiopia. Methods The preferred reporting items for systematic reviews and meta-analyses guideline was followed. Articles were systematically searched through different searching mechanisms. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument adapted for cross-sectional study design was used for quality assessment of each individual study. The total of 28 studies were included and analyzed. The random effect model was used to estimate the pooled prevalence; subgroup analysis and meta-regression were performed to identify the probable source of heterogeneity. Both Egger’s, and Begg’s test were used to check publication bias. The effects between associated factor variables, and prelacteal feeding practices were tested. Results A total of 492 studies were retrieved and 28 studies were included in the meta-analysis. The pooled prevalence of prelacteal feeding practice in Ethiopia was 25.29% (95% Confidence Interval [CI] 17.43, 33.15) with severe heterogeneity (I2 = 99.7, p < 0.001) and no publication bias. Antenatal care (Odds Ratio [OR] 0.25, 95% CI 0.09, 0.69), counselling on infant feeding (OR 0.37, 95% CI 0.22, 0.63), timely initiation of breastfeeding (OR 0.28, 95% CI 0.21, 0.38) and an urban residence (OR 0.47, 95% CI 0.26, 0.86) had lower odds, while home birth had higher odds (OR 3.93, 95% CI 2.17, 7.10) of prelacteal feeding in Ethiopia. Conclusions In Ethiopia, one in four children were given prelacteal foods. Mothers who gave birth at home are more prone to give prelacteal foods. Whereas, antenatal care, timely initiation of breastfeeding, counseling on infant feeding and an urban residence decreases prelacteal feeding practices in Ethiopia. Therefore, the government and health institutions should focus to increase maternal health service utilization and promote infant and young child feeding practices according to the guideline.
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Affiliation(s)
- Habtamu Temesgen
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Ayenew Negesse
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Wubetu Woyraw
- 1Department of Human Nutrition and Food Sciences, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Temesgen Getaneh
- 2Department of Midwifery, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Molla Yigizaw
- 3Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Takele WW, Tariku A, Wagnew F, Ekubagewargies DT, Getinet W, Derseh L, Anlay DZ. Magnitude of prelacteal feeding practice and its association with place of birth in Ethiopia: a systematic review and meta-analysis, 2017. Arch Public Health 2018; 76:63. [PMID: 30377528 PMCID: PMC6196449 DOI: 10.1186/s13690-018-0308-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 08/20/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Prelacteal feeding is one of the commonest inappropriate child feeding practice which exposes to malnutrition, infection, and neonatal mortality. However, there is no systematic review and meta-analysis that estimates the pooled prevalence of prelacteal feeding and its association with place of birth in Ethiopia. Therefore, this study aimed at investigating the magnitude of prelacteal feeding practice and its association with home delivery in the country. METHODS Primary studies were accessed through, HINARI and PubMed databases. Additionally, electronics search engines such as Google Scholar, and Google were used. The Joana Briggs Institute quality appraisal checklist was used to appraise the quality of studies. Data were extracted using Microsoft Excel spreadsheet. Heterogeneity between the studies was examined using the I2 heterogeneity test. The DerSimonian and Liard random-effect model was used. The random effects were pooled after conducting subgroup and sensitivity analyses. Publication bias was also checked. RESULTS A total of 780 primary studies were accessed. However, about 24 studies were included in the qualitative description and quantitative analysis of the prevalence of prelacteal feeding. To examine the association between home delivery and prelacteal feeding practice, only six studies were included. The prevalence of prelacteal feeding ranged from 6.1-75.8%. The pooled prevalence of prelacteal feeding among Ethiopian children was 26.95% (95% CI: 17.76%, 36.14%). The highest prevalence was observed in the Afar region. The pooled odds of prelacteal feeding among women who gave birth at home was increased by 5.16 (95% CI: 3.7, 7.2) folds as compared to those who gave birth at Health institutions. CONCLUSION Prelacteal feeding practice in Ethiopia was found to be high. Home delivery was strongly associated with prelacteal feeding practice. Therefore, promoting institutional delivery and strengthening of the existing child nutrition strategies are recommended.
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Affiliation(s)
- Wubet Worku Takele
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Wagnew
- Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Daniale Tekelia Ekubagewargies
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wondale Getinet
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Lema Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Degefaye Zelalem Anlay
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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