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Ulfa Y, Maruyama N, Igarashi Y, Horiuchi S. Early initiation of breastfeeding up to six months among mothers after cesarean section or vaginal birth: A scoping review. Heliyon 2023; 9:e16235. [PMID: 37292274 PMCID: PMC10245156 DOI: 10.1016/j.heliyon.2023.e16235] [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: 11/25/2022] [Revised: 05/01/2023] [Accepted: 05/10/2023] [Indexed: 06/10/2023] Open
Abstract
Background Early initiation of breastfeeding is important for establishing continued breastfeeding. However, previous research report that cesarean section (C-section) may hinder early initiation of breastfeeding. Despite this, there is currently a lack of literature that examines the rates of breastfeeding after both cesarean section and vaginal birth globally. Research aims The objective of this scoping review was to systematically assess the available literature on the rate of early initiation of breastfeeding within the first hour and exclusive breastfeeding up to 6 months after C-section and vaginal birth, as well as any other factors associated with initiation and exclusive breastfeeding. Methods We adhered to the PRISMA extension guidelines for scoping reviews in conducting our review. In August 2022, we carried out an electronic database search on CINALH, PubMed, EMBASE, and Cochrane Library, and also manually searched the reference list. Results A total of 55 articles were included in the scoping review. The majority of these studies found that mothers who delivered vaginally had higher rates of breastfeeding compared to those who underwent a C-section, at various time points such as breastfeeding initiation, hospital discharge, one month, three months, and six months postpartum. Notably, there was a significant difference in the rate of early initiation of breastfeeding between the two groups. However, at 3 and 6 months after delivery the gap of exclusive breastfeeding rate between C-section and vaginal delivery is narrow. Breastfeeding education, health care providers support, and mother and baby bonding are other factors associate with initiation and exclusive breastfeeding. Conclusions The rate of breastfeeding initiation after C-section has remained low to date. This is due in part to insufficient knowledge about and support for breastfeeding from healthcare providers.
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Affiliation(s)
- Yunefit Ulfa
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
- National Research and Innovation Agency, Jakarta, Indonesia
| | - Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Yumiko Igarashi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan
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Ameyaw EK, Adde KS, Paintsil JA, Dickson KS, Oladimeji O, Yaya S. Health facility delivery and early initiation of breastfeeding: Cross-sectional survey of 11 sub-Saharan African countries. Health Sci Rep 2023; 6:e1263. [PMID: 37181665 PMCID: PMC10173260 DOI: 10.1002/hsr2.1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/20/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023] Open
Abstract
Background and Aims Early initiation of breastfeeding (EIB) remains one of the promising interventions for preventing neonatal and child deaths. EIB is positively associated with healthcare delivery or childbirth. Meanwhile, no study in sub-Saharan Africa (SSA) appears to have investigated the relationship between health facility delivery and EIB; thus, we assessed the correlation between health facility delivery and EIB. Methods We used data from the Demographic and Health Survey (DHS) of 64,506 women from 11 SSA countries. The outcome variable was whether the respondent had early breastfeeding or not. Two logistic regression models were used in the inferential analysis. With a 95% confidence interval (CI), the adjusted odds ratios (aORs) for each variable were calculated. The data set was stored, managed, and analyzed using Stata version 13. Results The overall percentage of women who initiated early breastfeeding was 59.22%. Rwanda recorded the highest percentage of early initiation of breastfeeding (86.34%), while Gambia recorded the lowest (39.44%). The adjusted model revealed a significant association between health facility delivery and EIB (aOR = 1.80, CI = 1.73-1.87). Compared with urban women, rural women had higher likelihood of initiating early breastfeeding (aOR = 1.22, CI = 1.16-1.27). Women with a primary education (aOR = 1.26, CI = 1.20-1.32), secondary education (aOR = 1.12, CI = 1.06-1.17), and higher (aOR = 1.13, CI = 1.02-1.25), all had higher odds of initiating early breastfeeding. Women with the richest wealth status had the highest odds of initiating early breastfeeding as compared to the poorest women (aOR = 1.33, CI = 1.23-1.43). Conclusion Based on our findings, we strongly advocate for the integration of EIB policies and initiatives with healthcare delivery advocacy. Integration of these efforts can result in drastic reduction in infant and child mortality. Essentially, Gambia and other countries with a lower proclivity for EIB must reconsider their current breastfeeding interventions and conduct the necessary reviews and modifications that can lead to an increase in EIB.
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Affiliation(s)
- Edward K. Ameyaw
- Institute of Policy Studies and School of Graduate StudiesLingnan UniversityTuen MunHong Kong
- L & E Research Consult LtdUpper West RegionGhana
| | - Kenneth S. Adde
- Department of Population and HealthUniversity of Cape CoastCape CoastGhana
| | | | - Kwamena S. Dickson
- Department of Population and HealthUniversity of Cape CoastCape CoastGhana
| | - Olanrewaju Oladimeji
- Department of Public HealthWalter Sisulu UniversityMthathaEastern CapeSouth Africa
| | - Sanni Yaya
- School of International Development and Global StudiesUniversity of OttawaOttawaOntarioCanada
- The George Institute for Global HealthImperial College LondonLondonUK
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Wan S, Jin B, Kpordoxah MR, Issah AN, Yeboah D, Aballo J, Boah M. A descriptive analysis of the coverage of newborn care services among women who delivered in health facilities in 17 sub-Saharan African countries. BMC Pregnancy Childbirth 2023; 23:256. [PMID: 37069513 PMCID: PMC10108479 DOI: 10.1186/s12884-023-05592-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/10/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Sub-Saharan Africa (SSA) has seen an increase in facility-based births over the years. However, the region has the world's highest newborn mortality rate (42% in 2019). Quality care around the time of birth can avert these deaths. This study examined the newborn care interventions given to women who gave birth in health facilities in 17 countries in SSA. METHODS A cross-sectional population-based study was conducted. We used data from the most recent Demographic and Health Surveys (DHS) conducted in 17 sub-Saharan African countries. We analysed a weighted sample of 226,706 women aged 15-49 years who gave birth in the five years preceding the surveys. We described the coverage of nine newborn care services, namely weighing at birth, breastfeeding initiation within 1 h after birth, skin-to-skin contact, temperature measurement, cord examination, counselling on newborn danger signs, counselling on breastfeeding, breastfeeding observation, and child health assessment before discharge. RESULTS Overall, 72.0% (95% CI: 71.1, 72.8) of births occurred in health facilities, ranging from 40.0% (95% CI: 38.0, 42.1) in Nigeria to 96.3% (95% CI: 95.4, 97.1) in South Africa. Weighing at birth was the most common intervention (91.4%), followed by health checks before discharge (81%). The other interventions, including those given immediately at birth (breastfeeding and skin-to-skin contact), had suboptimal coverage. For instance, 66% of newborns were breastfed within 1 h after birth, and 56% had immediate skin-to-skin contact. Service coverage varied considerably by country and healthcare provider type. CONCLUSIONS The majority of the examined services, namely early breastfeeding, skin-to-skin contact, cord examination, temperature measurement, counselling on newborn danger signs, breastfeeding observation, and counselling on breastfeeding, were found to have suboptimal coverage. Even though many pregnant women in SSA give birth in healthcare facilities, some newborns do not always get the care they need to be healthy and live. This is a missed chance to improve newborn health and survival around the time of birth.
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Affiliation(s)
- Siyuan Wan
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Baiming Jin
- Department of Preventive Medicine, Qiqihar Medical University, Qiqihar, Heilongjiang, China
| | - Mary Rachael Kpordoxah
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Abdul-Nasir Issah
- Department of Health Services, Planning, Management, and Economics, School of Public Health, University for Development Studies, Policy, Tamale, Ghana
| | - Daudi Yeboah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana
| | - Jevaise Aballo
- United Nations Children Fund (UNICEF), Ghana Country Office, P.O. Box AN 5051, Accra, Ghana
| | - Michael Boah
- Department of Epidemiology, Biostatistics, and Disease Control, School of Public Health, University for Development Studies, Tamale, Ghana.
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Kusasira L, Mukunya D, Obakiro S, Kenedy K, Rebecca N, Ssenyonga L, Immaculate M, Napyo A. Prevalence and predictors of delayed initiation of breastfeeding among postnatal women at a tertiary hospital in Eastern Uganda: a cross-sectional study. Arch Public Health 2023; 81:56. [PMID: 37060009 PMCID: PMC10102688 DOI: 10.1186/s13690-023-01079-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/30/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The rates for the delayed initiation of breastfeeding in Uganda remain unacceptably high between 30% and 80%. The reasons for this are not well understood. We aimed to determine the prevalence and predictors for the delayed initiation of breastfeeding in Eastern Uganda. METHODS This study employed a cross-sectional study design. A total of 404 mother-infant pairs were enrolled onto the study between July and November, 2020 at Mbale regional referral hospital (MRRH). They were interviewed on socio-demographic related, infant-related, labour and delivery characteristics using a structured questionnaire. We estimated adjusted odds ratios using multivariable logistic regression models. All variables with p < 0.25 at the bivariate level were included in the initial model at the multivariate analysis. All variables with p < 0.1 and those of biological or epidemiologic plausibility (from previous studies) were included in the second model. The variables with odds ratios greater than 1 were considered as risk factors; otherwise they were protective against the delayed initiation of breastfeeding. RESULTS The rate of delayed initiation of breastfeeding was 70% (n = 283/404, 95% CI: 65.3 - 74.4%). The factors that were associated with delayed initiation of breastfeeding were maternal charateristics including: being single (AOR = 0.37; 95%CI: 0.19-0.74), receiving antenatal care for less than 3 times (AOR = 1.85, 95%CI: 1.07-3.19) undergoing a caesarean section (AOR = 2.07; 95%CI: 1.3-3.19) and having a difficult labour (AOR = 2.05; 95%CI: 1.25-3.35). Infant characteristics included: having a health issue at birth (AOR = 9.8; 95%CI: 2.94-32.98). CONCLUSIONS The proportion of infants that do not achieve early initiation of breastfeeding in this setting remains high. Women at high risk of delaying the initiation of breastfeeding include those who: deliver by caesarean section, do not receive antenatal care and have labour difficulties. Infants at risk of not achieving early initiation of breastfeeding include those that have a health issue at birth. We recommend increased support for women who undergo caesarean section in the early initiation of breastfeeding. Breastfeeding support can be initiated in the recovery room after caesarean delivery or in the operating theatre. The importance of antenatal care attendance should be emphasized during health education classes. Infants with any form of health issue at birth should particularly be given attention to ensure breastfeeding is initiated early.
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Affiliation(s)
- Loyce Kusasira
- Department of Nursing, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
| | - David Mukunya
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
- Sanyu Africa Research Institute, P.O BOX 2190, Mbale, Uganda
| | - Samuel Obakiro
- Department of Pharmacology and Therapeutics, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
| | - Kiyimba Kenedy
- Department of Pharmacology and Therapeutics, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
| | - Nekaka Rebecca
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
| | - Lydia Ssenyonga
- Department of Nursing, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
| | - Mbwali Immaculate
- Department of Nursing, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda
| | - Agnes Napyo
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, P.O. BOX 236, Mbale, Tororo, Uganda.
- Department of Public Health, Faculty of Health Sciences, Uganda Martyrs University, P.O. Box 5498, Kampala, Uganda.
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Terefe B, Shitu K. Exploring the determinants of exclusive breastfeeding among infants under six months in the Gambia using gambian demographic and health survey data of 2019-20. BMC Pregnancy Childbirth 2023; 23:220. [PMID: 37005575 PMCID: PMC10067212 DOI: 10.1186/s12884-023-05544-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 03/24/2023] [Indexed: 04/04/2023] Open
Abstract
INTRODUCTION For infants, no one is as nutritious as breastmilk for the rest of their lives. It is a great guarantee for their future health, especially if they can exclusively breastfeed for the next few months, from the moment they are born until the end of the fifth month. Although breastfeeding rates are very low, there is no data record about it in the Gambia. OBJECTIVE This study aimed to assess the status of exclusive breastfeeding and its determinants among infants under six months of age in the Gambia. METHODS It is a secondary data analysis using the 2019-20 Gambia demographic and health survey data. A total of 897 weighted mother-infant paired samples were included in the study. A logistic regression analysis method was employed to declare factors significantly associated with exclusive breastfeeding among infants under six months of age in Gambia. Variables with a p-value of 0.2 were entered into multiple logistic regression analysis, and after controlling other confounding factors, an adjusted odds ratio of 95% CI was applied to identify associated variables. RESULTS Exclusive breastfeeding was found in 53.63% only among infants under six months of age. Being a rural resident (AOR = 2.14, 95% CI: 1.33, 3.41), reading a newspaper (AOR = 5.62, 95% CI: 1.32, 24.09), and being counseled on breastfeeding by a health professional (AOR = 1.36, 95% CI: 1.01, 1.82) are times more likely to practice exclusive breastfeeding, respectively. On the other hand, a child with a fever (AOR = 0.56, 95% CI: 0.37, 0.84), a child whose age is 2-3 months (AOR = 0.41, 95 CI: 0.28, 0.59), and a child whose age is 4-5 months (AOR = 0.11, 95% CI: 0.07, 0.16) is less likely to be fed exclusively than a 0-1-month-old child. CONCLUSION Exclusive breastfeeding remains among the public health challenges in the Gambia. Strengthening health professionals' counseling techniques on breastfeeding and infant illnesses, promoting the pros of breastfeeding, and designing timely policies and interventions are urgently needed in the country.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Po. Box: 196, Gondar, Ethiopia.
| | - Kegnie Shitu
- Department of Health Education and Behavioral Science, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mengistu GT, Mengistu BK. Early initiation of breast feeding and associated factors among mother-baby dyads with immediate skin-to-skin contact: cross-sectional study based on the 2016 Ethiopian Demographic and Health Survey data. BMJ Open 2023; 13:e063258. [PMID: 36990497 PMCID: PMC10069540 DOI: 10.1136/bmjopen-2022-063258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE The study aimed to assess the practice of early initiation of breast feeding (EIBF) and associated factors among mother-baby dyads who practiced immediate skin-to-skin contact in Ethiopia. DESIGN Cross-sectional study. SETTING The study was conducted nationally in nine regional states and two city administrations. PARTICIPANTS In the study, 1420 mother-baby dyads with last-born children (children born in the 2 years preceding the survey, children <24 months old) and children put on the mother's bare skin. The data of the study participants were extracted from the Ethiopian Demographic and Health Survey 2016. OUTCOME MEASURES The outcome measure of the study was the proportion of EIBF among mother-baby dyads and associations. RESULTS EIBF among mothers and newborns with skin-to-skin contact was 88.8% (95% CI 87.2 to 90.4). EIBF among mother-baby dyads with immediate skin-to-skin contact was more likely among mothers from wealthy families (adjusted OR (AOR)=2.37, 95% CI 1.38 to 4.08), attended secondary and above education (AOR=1.67, 95% CI 1.12 to 2.57), living in Oromia (AOR=2.87, 95% CI 1.11 to 7.46), Harari (AOR=11.60, 95% CI 2.48 to 24.34) and Dire Dawa (AOR=2.93, 95% CI 1.04 to 8.23) regions, gave birth by non-caesarean section (AOR=3.34, 95% CI 1.33 to 8.39), gave birth at hospital (AOR=2.02, 95% CI 1.02 to 4.00), and health centre (AOR=2.19, 95% CI 1.21 to 3.98), and gave birth by midwifery assistance (AOR=1.62, 95% CI 1.06 to 2.49). CONCLUSION Nine in ten mother-baby dyads with immediate skin-to-skin contact early initiate breast feeding. The EIBF was affected by educational status, wealth index, region, mode of delivery, place of delivery and delivery assisted by midwifery. Improving healthcare service, institutional delivery and the competency of maternal healthcare providers may aid the EIBF in Ethiopia.
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Affiliation(s)
- Girma Teferi Mengistu
- College of Medicine and Health Science, Department of Nursing, Wolkite University, Welkite, Ethiopia
| | - Bizunesh Kefale Mengistu
- Department of Statistics, Ambo University College of Natural and Computational Sciences, Ambo, Ethiopia
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Aboagye RG, Ahinkorah BO, Seidu AA, Anin SK, Frimpong JB, Hagan JE. Mother and newborn skin-to-skin contact and timely initiation of breastfeeding in sub-Saharan Africa. PLoS One 2023; 18:e0280053. [PMID: 36626377 PMCID: PMC9831337 DOI: 10.1371/journal.pone.0280053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Mother and newborn skin-to-skin contact (SSC) plays a key role in breastfeeding practices of mothers. In this study, we examined the association between mother and newborn SSC and timely initiation of breastfeeding in sub-Saharan Africa (SSA). METHODS This cross-sectional study utilized nationally representative data from the Demographic and Health Surveys of 17 countries in SSA from 2015 to 2020. Multilevel binary logistic regression analysis was performed to examine the association between mother and newborn SSC and timely initiation of breastfeeding. The results are presented using adjusted odds ratios (aOR), with 95% confidence interval (CI). RESULTS The pooled prevalences of mother and newborn SSC and timely initiation of breastfeeding were 45.68% (95% CI = 34.12-57.23) and 62.89% (95% CI = 55.67-70.11), respectively. Mothers who practiced newborn SSC were more likely to practice timely initiation of breastfeeding compared to those who did not practice SSC [aOR = 1.68, 95% CI = 1.58, 1.78] and this persisted after controlling for all the covariates [aOR = 1.38, 95% CI = 1.29, 1.47]. At the country level, mother and newborn SSC increased the odds of timely initiation of breastfeeding in Angola [aOR = 1.99, 95% CI = 1.44, 2.76], Cameroon [aOR = 1.43, 95% CI = 1.02, 1.99], Ethiopia [aOR = 1.62, 95% CI = 1.16, 2.28], Guinea [aOR = 1.69, 95% CI = 1.10, 2.60], Liberia [aOR = 2.03, 95% CI = 1.33, 3.12], Malawi [aOR = 1.47, 95% CI = 1.02, 2.12], Mali [aOR = 1.42, 95% CI = 1.10, 1.84], Sierra Leone [aOR = 1.87, 95% CI = 1.23, 2.83], South Africa [aOR = 2.59, 95% CI = 1.41, 4.76], Tanzania [aOR = 1.60, 95% CI = 1.27, 2.01], Uganda [aOR = 1.43, 95% CI = 1.02, 1.99], Zambia [aOR = 1.86, 95% CI = 1.50, 2.30], and Zimbabwe [aOR = 1.65, 95% CI = 1.24, 2.21]. CONCLUSION The prevalence of SCC was relatively low but timely initiation of breastfeeding was high. Mother and newborn SSC is a strong predictor of timely initiation of breastfeeding in SSA. To enhance timely initiation of breastfeeding after birth, this study recommends that more child and maternal healthcare interventions focused on improving mother and newborn SSC should be implemented.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana
| | - Abdul-Aziz Seidu
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
- Centre For Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - Stephen Kofi Anin
- School of Public Health, Bielefeld University, Bielefeld, Germany
- Department of Industrial and Health Sciences, Faculty of Applied Sciences, Takoradi Technical University, Takoradi, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Department of Kinesiology, New Mexico State University, Las Cruces, NM, United States of America
- * E-mail:
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
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Sako S, Gilano G, Tekabe B, Abebe S. Determinants of early initiation of breast feeding among mothers of children aged less than 24 months in Ethiopia: A community-based cross-sectional study. BMJ Open 2022; 12:e062905. [PMID: 36302572 PMCID: PMC9621175 DOI: 10.1136/bmjopen-2022-062905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE This study aims to assess the prevalence of early initiation of breast feeding (EIBF) and associated factors among mothers having children less than 2 years of age in Ethiopia. DESIGN Community-based cross-sectional study. SETTING In this analysis, data from 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) was used. The survey included all the nine regional states and two city administrations of Ethiopia. PARTICIPANTS We extracted data of 2054 mothers who had last-born children and those mothers who ever breast fed or still breast feeding their children during the survey from the 2019 EMDHS datasets. MAIN OUTCOME MEASURES We performed a two-stage multilevel mixed-effects logistic regression to identify individual and community-level determinants of EIBF. In the final model, variables with a p-value less than 5% and an adjusted OR with a 95% CI were reported as statistically significant variables with EIBF. RESULT The prevalence of EIBF among mothers having children aged 0-23 months was 73.56% (95% CI: 71.65% to 75.47%). Women who delivered at a health facility (adjusted OR (AOR)=1.98; 95% CI: 1.39 to 2.79) and have children with birth order second-fourth (AOR=1.76; 95% CI: 1.24 to 2.49) were more likely to initiate early breast feeding than their counterparts. On the other hand, women who gave birth by caesarean section (AOR=0.21; 95% CI: 0.13 to 0.33), had multiple births (AOR=0.35; 95% CI: 0.13 to 0.92) and had postnatal check-up (AOR=0.62; 95% CI: 0.44 to 0.91) were less likely to practise EIBF as compared with their counterparts. Region of residence of women was also significantly associated with EIBF. CONCLUSION In this study, the overall prevalence of EIBF was good. Place of delivery, mode of delivery, postnatal check-up, type of birth, birth order and region were factors significantly associated with EIBF. Therefore, government and stakeholders need to show commitment to improve access and utilisation of basic maternal health services to increase the practice of EIBF.
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Affiliation(s)
- Sewunet Sako
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Girma Gilano
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Be'emnet Tekabe
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sintayehu Abebe
- Department of Public Health, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Trends of Inequalities in Early Initiation of Breastfeeding in Ethiopia: Evidence from Ethiopian Demographic and Health Surveys, 2000-2016. BIOMED RESEARCH INTERNATIONAL 2022; 2022:5533668. [PMID: 35265715 PMCID: PMC8898814 DOI: 10.1155/2022/5533668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 12/23/2021] [Accepted: 02/16/2022] [Indexed: 02/07/2023]
Abstract
Background Early initiation of breastfeeding (EIBF) is a costless practice with numerous neonates' survival benefits. Thus, any disparity results in an unacceptably high neonatal death rate but socioeconomic disparities on EIBF have not been well explored in Ethiopia. Therefore, this study is aimed at assessing the socioeconomic inequalities of EIBF in Ethiopia from 2000 to 2016. Methods The Ethiopian demographic and health survey data and the World Health Organization's Health Equity Assessment Toolkit were used to investigate the inequalities in EIBF across the wealth quintile, education, residence, and subnational region. Difference, ratio, slope index inequality (SII), relative index inequality (RII), and population attributable risk (PAR) were used as equity summary measures. Results In Ethiopia, EIBF practice was 47.4% in 2000, 66.2% in 2005, 51.5% in 2011, and 73.3% in 2016. Wealth-related inequality was observed in the 2000, 2005, and 2011 survey years with SII of -7.1%, -8.8%, and 8.7%, respectively, whereas educational-related inequality was observed in 2005 and 2011 with SII of -11.7% and 6.5%, respectively. However, significant change in wealth-, education-, and residence-related inequalities was detected in 2011. Regional inequality on EIBF was observed in all survey years with a difference of 35.7%, 38.0%, 29.1%, and 48.5% in the 2000, 2005, 2011, and 2016 survey years, respectively. But a significant change in regional inequality was noted in 2016 with a PAR of 17.2%. Conclusions In Ethiopia, the wealth-, residence-, and educational-related inequalities of EIBF increased significantly between the years 2000 and 2011. However, regional inequality persistently increased from 2000 to 2016. Overall, one-sixth of the national level EIBF was decreased due to regional disparity in 2016. The northern regions of Ethiopia (Tigray, Afar, and Amhara) poorly performed compared to the peer regions. Therefore, interventions targeting them would significantly improve the national level of EIBF.
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