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Olcina Simón MA, Rotella R, Soriano JM, Llopis-Gonzalez A, Peraita-Costa I, Morales-Suarez-Varela M. Breastfeeding-Related Practices in Rural Ethiopia: Colostrum Avoidance. Nutrients 2023; 15:2177. [PMID: 37432341 DOI: 10.3390/nu15092177] [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: 04/18/2023] [Revised: 04/25/2023] [Accepted: 05/01/2023] [Indexed: 07/12/2023] Open
Abstract
The practices of colostrum avoidance and prelacteal feeding, which are common in many developing countries, including Ethiopia, are firmly rooted in ancient traditions. The main objective of this work is to identify the prevalence of colostrum avoidance and study its associated factors among mothers of children aged less than 2 years old in the Oromia region of Ethiopia. A cross-sectional study on the practice of colostrum avoidance/prelacteal feeding was conducted in a rural community with 114 mothers of children under 2 years old. Our results reflected that colostrum avoidance and prelacteal feeding were practiced by 56.1% of mothers. The percentage of women who started breastfeeding in the first hour after birth, as recommended by the WHO, was 2.6%. Of the women who practiced colostrum avoidance, 67.2% gave birth at home, and 65.6% were attended by relatives. The likelihood of avoiding colostrum increases in mothers who have a lower educational level, who did not receive health care at the time of delivery, who think that colostrum is dirty and dangerous and who did not receive information about breastfeeding from healthcare professionals. The knowledge emanating from this work may be useful in designing new breastfeeding education programs and/or interventions in Ethiopia and other developing countries.
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Affiliation(s)
- M Ascensión Olcina Simón
- MOS Solidaria, Avda. Blasco Ibáñez, 5-8º Puerta 16, 46400 Cullera, Spain
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Avda. Vicent Andres Estelles s/n, 46100 Burjassot, Spain
| | - Rosita Rotella
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Avda. Vicent Andres Estelles s/n, 46100 Burjassot, Spain
| | - Jose M Soriano
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, Carrer Catedrático Agustín Escardino 9, 46980 Paterna, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Avda. Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - Agustin Llopis-Gonzalez
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Avda. Vicent Andres Estelles s/n, 46100 Burjassot, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avda. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - Isabel Peraita-Costa
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Avda. Vicent Andres Estelles s/n, 46100 Burjassot, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avda. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
| | - María Morales-Suarez-Varela
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Avda. Vicent Andres Estelles s/n, 46100 Burjassot, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, Avda. Monforte de Lemos 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain
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Modeling spatial determinants of initiation of breastfeeding in Ethiopia: A geographically weighted regression analysis. PLoS One 2022; 17:e0273793. [PMID: 36107834 PMCID: PMC9477376 DOI: 10.1371/journal.pone.0273793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/15/2022] [Indexed: 11/19/2022] Open
Abstract
Background The World Health Organization (WHO) encourages breastfeeding to begin within the first hour after birth in order to save children’s lives. In Ethiopia, different studies are done on the prevalence and determinants of breastfeeding initiation, up to our knowledge, the spatial distribution and the spatial determinants of breast feeding initiation over time are not investigated. Therefore, the objectives of this study were to assess spatial variation and its spatial determinant of delayed initiation of breastfeeding in Ethiopia using Geographically Weighted Regression (GWR). Methods A cross-sectional study was undertaken using the nationally representative 2016 Ethiopian Demographic and Health Survey (EDHS) dataset. Global Moran’s I statistic was used to measure whether delayed breastfeeding initiation was dispersed, clustered, or randomly distributed in study area. Ordinary Least Squares (OLS) regression was used to identify factors explaining the geographic variation in delayed breastfeeding initiation. Besides, spatial variability of relationships between dependent and selected predictors was investigated using geographically weighted regression. Result A total weighted sample of 4169 children of aged 0 to 23 months was included in this study. Delayed initiation of breastfeeding was spatially varies across the country with a global Moran’s I value of 0.158 at (p-value<0.01). The hotspot (high risk) areas were identified in the Amhara, Afar, and Tigray regions. Orthodox religion, poor wealth index, caesarian section, baby postnatal checkup, and small size of a child at birth were spatially significant factors for delayed breastfeeding initiation in Ethiopia. Conclusion In Ethiopia initiation of breastfeeding varies geographically across region. A significant hotspot was identified in the Amhara, Afar, and Tigray regions. The GWR analysis revealed that orthodox religion, poor wealth index, caesarian section, baby postnatal checkup, and small birth weight were spatially significant factors.
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Ahmed MAA, Musa IR, Mahgoub HM, Al-Nafeesah A, Al-Wutayd O, Adam I. Patterns, Outcomes and Predictors of Pediatric Medical Admissions at Gadarif Hospital in Eastern Sudan. Front Pediatr 2022; 10:764028. [PMID: 35155303 PMCID: PMC8829559 DOI: 10.3389/fped.2022.764028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 01/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The reduction of childhood mortality is a reliable indicator of a national health system's progress and improvement. Sudan's population is still suffering from communicable diseases, with a considerably higher mortality rate among children. Efforts are therefore needed to reduce mortality and achieve the Millennium Development Goals and Sustainable Development Goals. This study was conducted to determine the morbidity, mortality and outcomes of children admitted to Gadarif Hospital in eastern Sudan. METHOD A retrospective study was conducted by reviewing the medical files of pediatric patients who were admitted to Gadarif Hospital between March 1, 2019 and March 31, 2020. RESULT A total of 740 medical files were reviewed. Most, 453 (61.2%) of the admissions were males. The median (interquartile range) age was 3.0 (8.0) years and 433 (58.8%) of the admissions were under 5 years of age. The median (interquartile range) of the length of hospital stay was 9.0 (12.0) days. Visceral leishmaniasis, malnutrition, severe malaria, sickle cell disease, acute watery diarrhea, severe anemia (regardless of its cause), septicemia and acute respiratory infection were the most common causes of admission. The mortality rate was 5.7%, and it was significantly higher in females than males [24/287 (8.4%) vs. 18/453 (4.0%), P = 0.01] and in children under 5 years [36/433 (8.3%) vs. 6/307 (2.0%), P < 0.001]. Malnutrition, visceral leishmaniasis, septicemia and meningitis/encephalitis were the main diseases causing death in the study population. The case fatality rate was not significantly different in malnutrition than in visceral leishmaniasis [9/93 (9.7%) vs. 7/178 (3.9%), P = 0.05]. CONCLUSION The main causes of morbidity and mortality for children admitted to Gadarif Pediatric Hospital were communicable diseases. The mortality rate was 5.7%. Females and children under 5 years were the most vulnerable groups for fatality.
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Affiliation(s)
| | - Imad R. Musa
- Department of Medicine, Royal Commission Hospital in Al Jubail Industrial City, Al Jubail, Saudi Arabia
| | | | - Abdullah Al-Nafeesah
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Osama Al-Wutayd
- Department of Family and Community Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Saudi Arabia
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Ahinkorah BO, Seidu AA, Budu E, Mohammed A, Adu C, Ameyaw EK, Kissah-Korsah K, Adoboi F, Yaya S. Maternal and child factors associated with early initiation of breastfeeding in Chad: evidence from nationally representative cross-sectional data. Int Health 2021; 14:510-518. [PMID: 34614156 PMCID: PMC9450645 DOI: 10.1093/inthealth/ihab060] [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: 04/03/2021] [Revised: 08/17/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022] Open
Abstract
Background Early initiation of breastfeeding (EIB) is an inexpensive practice but has a substantial potential to reduce neonatal morbidity. Therefore, this study investigated the maternal and child-related factors associated with EIB and makes recommendations that could help improve the practice in Chad. Methods We used data from the children's recode file of the 2014–2015 Chad Demographic and Health Survey. A total of 3991 women ages 15–49 y who had last-born children in the 2 y preceding the survey were included in our study. The outcome variable for the study was EIB. Both descriptive (frequencies and percentages) and inferential (binary logistic regression) analyses were carried out. All results of the binary logistic analyses are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results We found the prevalence of EIB in Chad to be 23.8%. In terms of maternal factors, the likelihood of EIB was high among non-working women (aOR 1.37 [95% CI 1.18 to 1.59]), the richest wealth quintile women (aOR 1.37 [95% CI 1.04 to 1.79]) and non-media-exposed women (aOR 1.58 [95% CI 1.24 to 2.02]) compared with working women, the poorest wealth quintile women and media-exposed women, respectively. EIB was lower among children whose mothers had one to three antenatal care visits (ANC; aOR 0.73 [95% CI 0.61 to 0.87]) and four or more ANC visits (aOR 0.80 [95% CI 0.66 to 0.97]) compared with those who had no ANC visits. With the child factors, EIB was higher among mothers of children who were smaller than average size at birth compared with those of larger than average birth size (aOR 1.47 [95% CI 1.24 to 1.74]). Mothers of children of fifth-order or more births compared with those of first-order births (aOR 1.51 [95% CI 1.07 to 2.12]) and those who were delivered through vaginal birth compared with those delivered through caesarean section (aOR 4.71 [95% CI 1.36 to 16.24]) were more likely to practice EIB. Conclusions Maternal and child-related factors play roles in EIB in Chad. Hence, it is important to consider these factors in maternal and neonatal health interventions. Such initiatives, including training of outreach health workers, health education, counselling sessions and awareness-raising activities on breastfeeding geared towards EIB should be undertaken. These should take into consideration the employment status, wealth quintile, exposure to mass media, size of the baby at birth, ANC visits, parity and delivery method.
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Affiliation(s)
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Aliu Mohammed
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Australia
| | - Kwaku Kissah-Korsah
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Faustina Adoboi
- Cape Coast Nursing and Midwifery Training College, Cape Coast, Ghana
| | - Sanni Yaya
- University of Parakou, Faculty of Medicine, Parakou, Benin
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Raihana S, Alam A, Chad N, Huda TM, Dibley MJ. Delayed Initiation of Breastfeeding and Role of Mode and Place of Childbirth: Evidence from Health Surveys in 58 Low- and Middle- Income Countries (2012-2017). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115976. [PMID: 34199564 PMCID: PMC8199672 DOI: 10.3390/ijerph18115976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 11/24/2022]
Abstract
Background: Timely initiation of breastfeeding is the first step towards achieving recommended breastfeeding behaviours. Delayed breastfeeding initiation harms neonatal health and survival, including infection associated neonatal mortality. Eighty percent of neonatal deaths occur in the low-and middle-income countries (LMICs), where delayed breastfeeding initiation is the highest. Place and mode of childbirth are important factors determining the time of initiation of breastfeeding. In this study, we report the prevalence of delayed breastfeeding initiation from 58 LMICs and investigate the relationship between place and mode of childbirth and delayed breastfeeding initiation in each country. Methods: We analysed data from the most recent Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) collected between 2012 and 2017 and reported by 2019. The study sample comprised all women who had a live birth in the 24 months preceding the survey. ‘Delayed’ initiation of breastfeeding was defined using WHO recommendations as starting breastfeeding after one hour of birth. We coded the stratifying variable for the place and mode of childbirth as “vaginal birth at a facility (VBF)”, “caesarean section birth (CSB) “, and “vaginal birth at home (VBH)”. We used respondent-level sampling weights to account for individual surveys and de-normalised the standard survey weights to ensure the appropriate contribution of data from each country. We report the prevalence and population attributable fractions with robust standard errors. The population attributable risk identifies the proportion of delayed initiation that we could avert among VBH and CSB if everyone had the same risk of delaying breastfeeding as in VBF. Results: The overall prevalence of delayed initiation of breastfeeding was 53.8% (95% CI 53.3, 54.3), ranging from 15.0% (95% CI 13.8, 16.2) in Burundi to 83.4% (95% CI 80.6, 86.0) in Guinea. The prevalence of delayed initiation of breastfeeding was consistently high among women who experienced caesarean section births; however, there was no direct association with each country’s national caesarean section rates. The prevalence of delayed initiation among women who experienced VBF was high in Sub-Saharan Africa and South Asia, even though the CSB rates were low. In some countries, women who give birth vaginally in health facilities were more likely to delay breastfeeding initiation than women who did not. In many places, women who give birth by caesarean section were less likely to delay breastfeeding initiation. Population attributable risk percent for VBH ranged from −28.5% in Ukraine to 22.9% in Moldova, and for CSB, from 10.3% in Guinea to 54.8% in Burundi. On average, across all 58 countries, 24.4% of delayed initiation could be prevented if all women had the same risk of delaying breastfeeding initiation as in VBF. Discussion: In general, women who give birth in a health facility were less likely to experience delayed initiation of breastfeeding. Programs could avert much of the delayed breastfeeding initiation in LMICs if the prevalence of delayed initiation amongst women who experience CSB were the same as amongst women who experience VBF. Crucial reforms of health facilities are required to ensure early breastfeeding practices and to create pro-breastfeeding supportive environments as recommended in intervention packages like the Baby-friendly hospital initiative and Early essential newborn care. The findings from this study will guide program managers to identify countries at varying levels of preparedness to establish and maintain a breastfeeding-friendly environment at health facilities. Thus, governments should prioritise intervention strategies to improve coverage and settings surrounding early initiation of breastfeeding while considering the complex role of place and mode of childbirth.
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Affiliation(s)
- Shahreen Raihana
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
- Correspondence: or ; Tel.: +61-406-890-170
| | - Ashraful Alam
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
| | - Nina Chad
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
| | - Tanvir M. Huda
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka 1212, Bangladesh
| | - Michael J. Dibley
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW 2006, Australia; (A.A.); (N.C.); (T.M.H.); (M.J.D.)
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Hagos A, Tsadik M, Belachew AB, Tesfahunegn A. Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study of Ethiopia. PLoS One 2021; 16:e0241428. [PMID: 33914746 PMCID: PMC8084135 DOI: 10.1371/journal.pone.0241428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Optimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 children and 20,000 women lost due to in appropriate breastfeeding each year. In Ethiopia, 50,000 children lost related to malnutrition with 18% were due to poor breastfeeding habit. Little is known on the determinants of breastfeeding with hierarchical level. Therefore, this study aimed to identify factors influencing optimal breastfeeding among children under six month in Ethiopia using a multilevel analysis. METHODS The data of this study were obtained from Ethiopian Demographic and health survey conducted from January to June 2016. A total 1,087 children aged 0-5 months were selected using two stage stratified sampling technique. Multilevel logistic regression analysis was done to identify significant explanatory variables. Akaike information criteria were used to select the best model fit. Fixed effect was done to estimate the association between the outcome and explanatory variable and also random effect to measure the variation explained by the higher level. RESULT Among the total of 1,087 children, 45.4% were optimally breastfeed. Children from the richest wealth index (AOR = 2.87; 95% CI: 1.53-5.43) was positively associated with optimal breastfeeding but, children aged 4-5 months (AOR = 0.19; 95%CI: 0.12-0.27), children born through cesarean section (AOR = 0.18; 955 CI: 0.07-0.51) and residing in Afar region (AOR = 0.13; 95%CI: 0.02-0.92) were found inversely associated with optimal breastfeeding. The random-effects showed that the variation between communities was statistically significant. CONCLUSION Individual and community level factors play a significant role in shaping optimal breastfeeding. Future strategies and health interventions should be strengthen to target individual and community level factors that enhance optimal breastfeeding.
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Affiliation(s)
- Amanuel Hagos
- Tigray Regional Health Bureau, Adi-Daero Health Office, Adi-Daero, Ethiopia
| | - Mache Tsadik
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abate Bekele Belachew
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Afewerki Tesfahunegn
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- * E-mail:
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Variation and determinants of early initiation of breastfeeding in high and low neonatal mortality settings in India. J Biosoc Sci 2021; 54:199-216. [PMID: 33678208 DOI: 10.1017/s0021932021000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Early initiation of breastfeeding (EIBF) is considered one of the most cost-effective interventions for infant survival and well-being. This study aimed to examine the variations in, and determinants of, early initiation of breastfeeding among women in high and low neonatal mortality rate (NMR) settings in India using data from the fourth round of the National Family Health Survey conducted in 2015-16. At 35%, EIBF was found to be disproportionately low in the high NMR group of states compared with 52% in the low NMR group, with the national average being 44%. The chance of EIBF significantly increased if childbirth was vaginal, delivery took place in a health institution, the mother received breastfeeding advice and the birth was a planned one in both high and low NMR settings. In the high NMR group of states, the probability of initiating breastfeeding immediately after birth improved to a great extent if childbirth was assisted by a trained person and if the mother was exposed to any type of mass media. There is an urgent need to increase the access of mothers to breastfeeding advice during pregnancy and to increase their exposure to mass media, particularly in high NMR states. In addition, achieving universal access to institutional deliveries and deliveries assisted by a skilled birth attendant, especially in high NMR settings, and promoting early breastfeeding, especially in the case of Caesarean deliveries, would further improve the level of EIBF in the country as a whole. These interventions can potentially increase the prevalence of early initiation of breastfeeding and help India attain the neonatal mortality rate target of Sustainable Development Goal 3.
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Shiferaw R, Tadesse SE, Mekonnen TC, Zerga AA. Timely Initiation of Breast Feeding and Associated Factors among Caesarian Section Delivered Mothers in Health Facilities of Dessie City Administration, North Eastern Ethiopia. Pediatr Rep 2020; 13:1-8. [PMID: 33374654 PMCID: PMC7838866 DOI: 10.3390/pediatric13010001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/21/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the magnitude and associated factors of timely initiation of breastfeeding among cesarean section delivered mothers. METHODS A health facility-based cross-sectional study was employed among 421 systematically selected mothers from February to June, 2017. Data were collected by a structured questionnaire. Data entry and analysis was done using Epi Data and SPSS version 24. Binary logistic regression was computed to identify factors. Adjusted odds ratio with a 95% confidence interval was used to declare statistical significance. RESULT The magnitude of timely initiation of breast feeding (among mothers who gave birth by cesarean section was 57%. Counseling during antenatal care (AOR = 3.32; 95% CI: 1.80, 6.13), facility where cesarean section (CS) was performed (AOR = 2.55; 95% CI: 1.57, 4.14), and post-CS counseling (AOR = 6.93; 95% CI: 3.99, 12.02) were factors that contributed for the practice of timely initiation among cesarean section delivered mothers. CONCLUSIONS The magnitude of TIBF was good. Counseling during ANC, the facility where CS was performed and post-natal advice were factors associated with TIBF. Implementation of baby-friendly hospital initiatives should be strengthened in order to promote timely initiation of breast feeding.
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Affiliation(s)
- Roza Shiferaw
- Dessie Zonal Health Department, Dessie 6000, Ethiopia;
| | - Sisay Eshete Tadesse
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; (T.C.M.); (A.A.Z.)
| | - Tefera Chane Mekonnen
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; (T.C.M.); (A.A.Z.)
| | - Aregash Abebayehu Zerga
- School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie 1145, Ethiopia; (T.C.M.); (A.A.Z.)
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Habtewold TD, Mohammed SH, Endalamaw A, Mulugeta H, Dessie G, Berhe DF, Birhanu MM, Islam MA, Teferra AA, Asefa NG, Alemu SM. Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia: A review and meta-analysis. Acta Paediatr 2020; 109:2208-2218. [PMID: 32239528 DOI: 10.1111/apa.15278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/18/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Abstract
AIM To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia. METHODS We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2 and I2 statistics. This meta-analytic review was reported in compliance with the PRISMA statement. RESULTS Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P < .001), paternal educational status (P = .001) and household income (P = .002), being married (P = .001) and multiparity (P = .01) were significantly associated with TIBF. There was no significant publication bias. CONCLUSIONS Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing College of Health Science Debre Berhan University Debre Berhan Ethiopia
- Department of Epidemiology University Medical Centre Groningen University of Groningen Groningen The Netherlands
- Department of Quantitative Economics School of Business and Economics Maastricht University Maastricht Netherlands
| | - Shimels Hussien Mohammed
- Department of Community Nutrition School of Nutritional Sciences and Dietetics Tehran University Tehran Iran
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing College of Medicine and Health Sciences Bahir Dar University Bahir Dar Ethiopia
| | - Henok Mulugeta
- Department of Nursing College of Health Science Debre Markos University Debre Markos Ethiopia
| | - Getenet Dessie
- Department of Nursing School of Health Science College of Medicine and Health Science Bahir Dar University Bahir Dar Ethiopia
| | - Derbew Fikadu Berhe
- School of Pharmacy College of Health Science Mekelle University Mekelle Ethiopia
| | - Mulugeta Molla Birhanu
- School of Clinical Sciences Department of Medicine, Epidemiology and Prevention Division Monash University Melbourne Vic. Australia
| | - Md. Atiqul Islam
- Department of Statistics Shahjalal University of Science and Technology Sylhet Bangladesh
| | - Andreas A. Teferra
- Division of Epidemiology College of Public Health The Ohio State University Columbus OH USA
| | - Nigus Gebremedhin Asefa
- Department of Epidemiology University Medical Centre Groningen University of Groningen Groningen The Netherlands
| | - Sisay Mulugeta Alemu
- Global Health Unit University Medical Centre Groningen University of Groningen Groningen The Netherlands
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Determinants of breastfeeding practices in Myanmar: Results from the latest nationally representative survey. PLoS One 2020; 15:e0239515. [PMID: 32970726 PMCID: PMC7514058 DOI: 10.1371/journal.pone.0239515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022] Open
Abstract
Optimal breastfeeding practices can ensure healthy growth and development of infants, which in the long term can impact the country's economic development. Nevertheless, Myanmar has yet to achieve the WHO's target of 70% for early initiation of breastfeeding, and the country's target of 90% for exclusive breastfeeding. The purpose of this study was to assess the associations between early initiation of breastfeeding and exclusive breastfeeding and bio-demographic, socio-economic and behavioral factors in Myanmar. Using the 2015-2016 Myanmar Demographic and Health Survey, the analysis of early initiation of breastfeeding was based on a sample of 1,506 under-2 children and the analysis of exclusive breastfeeding was based on a sample of 376 children aged 0-5 months. Multiple logistic modeling, with heteroskedasticity-adjusted standard errors, was used. The prevalence rates of early initiation of breastfeeding and exclusive breastfeeding in the study were 67.9% and 52.2% respectively. Having a vaginal delivery (AOR = 2.5; 95% CI = 1.7-3.7) and having frequent (≥ 4) antenatal visits (AOR = 2.4; 95% CI = 1.5-3.8) were associated with higher odds of early initiation of breastfeeding. Having a postnatal checkup (AOR = 0.5; 95% CI = 0.3-0.9) and having an infant that was perceived to be small at birth (AOR = 2.5; 95% CI = 1.1-5.7, for infants perceived to be large at birth) were significantly associated with decreased odds of exclusive breastfeeding. In order to promote optimal breastfeeding practices, this study suggested that delivery and quality of health services during pregnancy need to be strengthened in Myanmar.
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Ahmed KY, Abrha S, Page A, Arora A, Shiferaw S, Tadese F, Seifu CN, Yeneabat T, Alemu E, Gebremichael DY, Seiko A, Ogbo FA. Trends and determinants of underweight and overweight/obesity among urban Ethiopian women from 2000 to 2016. BMC Public Health 2020; 20:1276. [PMID: 32838771 PMCID: PMC7447570 DOI: 10.1186/s12889-020-09345-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 08/04/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nutritional, epidemiological and demographic transitions have been associated with the emergence of the double burden of malnutrition globally. In Ethiopia, there has been no nationally representative investigation of trends and determinants of both underweight and overweight/obesity among urban women. This study examined the trends and determinants of underweight and overweight/obesity in urban Ethiopian women from 2000 to 2016. METHODS Trends in the prevalence of underweight and overweight/obesity were investigated based on a series of the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 2559), 2005 (n = 1112), 2011 (n = 3569), and 2016 (n = 3106). Multivariable multinomial logistic regression was used to investigate the association between socioeconomic, demographic, behavioural, and community-level factors with underweight and overweight/obesity. RESULTS The prevalence of underweight in urban Ethiopian women reduced significantly from 23.2% (95% confidence interval [CI]: 20.3, 26.3%) in 2000 to 14.8% (95% CI: 13.1, 16.7%) in 2016, while overweight/obesity increased significantly from 10.9% (95% CI: 9.1, 13.0%) in 2000 to 21.4% (95% CI: 18.2, 25.1%) in 2016. Urban women from rich households and those who had never married were less likely to be underweight. Urban women who were from wealthy households and those who attained at least secondary education were more likely to be overweight/obese. Women who were informally employed and listened to the radio were less likely to be overweight/obese compared to those who were unemployed and did not listen to the radio, respectively. CONCLUSION The prevalence of overweight/obesity increased from 2000 to 2016, with a concurrent reduction in the prevalence of underweight. Interventions aiming to reduce overweight and obesity should target urban women with higher education, those who resided in wealthier households and those who watched the television.
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Affiliation(s)
- Kedir Y Ahmed
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia. .,College of Medicine and Health Sciences, Samara University, Samara-Logia, Ethiopia.
| | - Solomon Abrha
- School of Public Health, College of Medicine and Health Sciences, Wolayta Sodo University, Wolayta Sodo, Ethiopia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia.,School of Health Sciences, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, Sydney, NSW, Australia
| | - Solomon Shiferaw
- School of Public Health, College of Medicine and Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Fentaw Tadese
- College of Medicine and Health Sciences, School of Public Health, Wollo University, Dessie, Ethiopia
| | - Canaan Negash Seifu
- School of Nursing and Midwifery, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia
| | - Tebikew Yeneabat
- Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, Australia
| | - Emana Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | - Abdulaziz Seiko
- CARE Ethiopia, Partner for The Resilience Project, Afar, Samara-Logia, Ethiopia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Campbelltown, Sydney, NSW, Australia.,General Practice Unit, Prescot Specialist Medical Centre, Makurdi, Benue State, Nigeria
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Trends and factors associated with the utilisation of antenatal care services during the Millennium Development Goals era in Tanzania. Trop Med Health 2020; 48:38. [PMID: 32518496 PMCID: PMC7268642 DOI: 10.1186/s41182-020-00226-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/20/2020] [Indexed: 01/10/2023] Open
Abstract
Background A detailed understanding of trends, as well as what act as enablers and/or barriers to the utilisation of antenatal care (ANC) among Tanzanian women, is essential to policymakers and health practitioners to guide maternal health efforts. We investigated the trends and factors associated with ANC service use during the Millennium Development Goals (MDG) era in Tanzania between 1999 and 2016. Methods The study used the Tanzania Demographic and Health Survey (TDHS) data for the years 1999 (n = 2095), 2004–2005 (n = 5576), 2010 (n = 6903) and 2015–2016 (n = 5392). Multivariate multinomial logistic regression models were used to investigate the association between predisposing, enabling, need and community-level factors and frequency of ANC (1–3 and ≥ 4) visits in Tanzania. Results The proportion of women who made one to three ANC visits improved significantly from 26.4% in 1999 to 47.0% in 2016. The percentage of women who make four or more ANC visits declined from 71.1% in 1999 to 51.0% in 2016. Higher maternal education, belonging to wealthier households, being informally employed and listening to the radio were associated with four or more ANC visits. Women who did not desire pregnancy had a lower likelihood to attend four or more ANC visits. Women who had primary or higher education, those who resided in wealthier households and those who were informally employed were more likely to make between one and three ANC visits. Conclusion The study showed that there was an improvement in the proportion of Tanzanian women who made one to three ANC visits, but it also indicated a concurrent decrease in the prevalence of four or more ANC visits. Improving uptake of ANC among Tanzanian women is achievable if national health policies and programmes also focus on key amenable maternal factors of education, household wealth and employment.
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Sen KK, Mallick TS, Bari W. Gender inequality in early initiation of breastfeeding in Bangladesh: a trend analysis. Int Breastfeed J 2020; 15:18. [PMID: 32178697 PMCID: PMC7075039 DOI: 10.1186/s13006-020-00259-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/27/2020] [Indexed: 11/25/2022] Open
Abstract
Background Early initiation of breastfeeding within 1 hour after birth is essential for newborns, because it reduces risk of neonatal mortality and hypothermia to a great extent and also helps in preventing the long-term chronic diseases and in increasing energy and immunity to newborn. In order to reach the ‘very good state’ of timely or early initiation of breastfeeding recommended by WHO, Bangladesh needs to increase the current rate of 51.24 to 100%. An attempt has been made in this study to examine how the early breastfeeding practice changes among male and female children with time controlling the factors associated with this practice. Methods Data from last four consecutive Bangladesh Demographic and Health Surveys (BDHS) have been used in the study. The participants were included whose child born within the last 5 years preceding the surveys of 2004, 2007 and 2011, and within the last 3 years preceding the survey of 2014 in the study and the respective selected participants were 5145, 4765, 7099 and 4370. To conduct the trend analysis, the descriptive statistics of selected variables along with prevalence of early initiation of breastfeeding have been computed by different years and a multiple logistic regression model has been fitted to the pooled dataset of 2004–2014 considering survey years as time. Results Rate of early initiation of breastfeeding increased as time progressed and it was faster for female child compared to male child. For example, female children were significantly 10 and 6% less likely to be initiated early than their counterparts in 2004 and 2007, respectively; whereas after 2007 both male and female children were equally treated for breastfeeding practice. It was also found that rate of early initiation significantly increased for one unit increased in survey year and this increasing rate was higher for female child compared to male child. For example, for one unit of increased in survey year, the early initiation of breastfeeding increased by 60% for male child and by 67% for female child. Besides, survey time, gender, education of parents, wanted index child, mode of delivery, antenatal care visits, wealth index, exposure to media and division were found to have potential influence on early initiation of breastfeeding. Conclusion Demographic and health surveys conducted in Bangladesh since 2011 have shown no evidence of gender discrimination regarding timely initiation of breastfeeding. In order to achieve the target rate of early initiation of breastfeeding recommended by WHO, it requires to take effective intervention regarding maternal and child health education.
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Affiliation(s)
- Kanchan Kumar Sen
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh.
| | | | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, 1000, Bangladesh
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Silva LAT, Fonseca VM, Oliveira MICD, Silva KSD, Ramos EG, Gama SGND. Professional who attended childbirth and breastfeeding in the first hour of life. Rev Bras Enferm 2020; 73:e20180448. [PMID: 32074234 DOI: 10.1590/0034-7167-2018-0448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 09/29/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the association between the professionals who attended vaginal delivery and breastfeeding in the first hour of life. METHODS This is a cross-sectional study with data from the Nascer no Brasil (Born in Brazil) survey, conducted in the 2011-2012 period. Data from 8,466 puerperae were analyzed using a logistic regression model with a hierarchical approach. RESULTS The proportion of mothers who breastfed at birth was higher in deliveries attended by nurses (70%). A nurse-assisted delivery was 64% more likely to breastfeed in the first hour of life. Other factors associated with the outcome: residing in the North; age less than 35 years; multiparity; prenatal guidance on breastfeeding in the first hour of life; birth at Baby-Friendly Hospital; companion at birth; and female newborn. CONCLUSIONS Obstetrician nurse/nurse-assisted delivery was a significant independent factor associated with breastfeeding in the first hour of life, suggesting the importance of strengthening the role of the obstetrician nurse.
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Ahmed KY, Page A, Arora A, Ogbo FA. Trends and determinants of early initiation of breastfeeding and exclusive breastfeeding in Ethiopia from 2000 to 2016. Int Breastfeed J 2019; 14:40. [PMID: 31528197 PMCID: PMC6740001 DOI: 10.1186/s13006-019-0234-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/03/2019] [Indexed: 12/22/2022] Open
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.
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Affiliation(s)
- Kedir Y Ahmed
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,2College of Medicine and Health Sciences, Samara University, PO Box: 132, Samara, Ethiopia
| | - Andrew Page
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia
| | - Amit Arora
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,3School of Science and Health, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,4Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Sydney, Australia.,5Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Weastmead, NSW Australia
| | - Felix Akpojene Ogbo
- 1Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2571 Australia.,General Practice Unit, Prescot Specialist Medical Centre Makurdi, Welfare Quarters, Makurdi, Benue State 972261 Nigeria
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Habtewold TD, Sharew NT, Alemu SM. Evidence on the effect of gender of newborn, antenatal care and postnatal care on breastfeeding practices in Ethiopia: a meta-analysis andmeta-regression analysis of observational studies. BMJ Open 2019; 9:e023956. [PMID: 31152028 PMCID: PMC6549640 DOI: 10.1136/bmjopen-2018-023956] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The aim of this systematic review and meta-analysis was to investigate the association of gender of newborn, antenatal care (ANC) and postnatal care (PNC) with timely initiation of breast feeding (TIBF) and exclusive breastfeeding (EBF) practices in Ethiopia. DESIGN Systematic review and meta-analysis. DATA SOURCES To retrieve all available literature, PubMed, EMBASE, CINAHL, WHO Global Health Library, Web of Science and SCOPUS databases were systematically searched and complemented by manual searches. The search was done from August 2017 to September 2018. ELIGIBILITY CRITERIA All observational studies including cross-sectional, case-control, cohort studies conducted in Ethiopia from 2000 to 2018 were included. Newcastle-Ottawa Scale was used for quality assessment of included studies. DATA EXTRACTION AND SYNTHESIS Study area, design, population, number of mothers (calculated sample size and participated in the study) and observed frequency data were extracted using Joanna Briggs Institute tool. To obtain the pooled effect size, a meta-analysis using weighted inverse variance random-effects model was performed. Cochran's Q X2 test, τ2 and I2 statistics were used to test heterogeneity, estimate amount of total/residual heterogeneity and measure variability attributed to heterogeneity, respectively. Mixed-effects meta-regression analysis was done to identify possible sources of heterogeneity. Egger's regression test at p value threshold ≤0.01 was used to examine publication bias. Furthermore, the trend of evidence over time was examined by performing a cumulative meta-analysis. RESULTS Of 523 articles retrieved, 17 studies (n=26 146 mothers) on TIBF and 24 studies (n=17 819 mothers) on EBF were included in the final analysis. ANC (OR=2.24, 95% CI 1.65 to 3.04, p<0.001, I2=90.9%), PNC (OR=1.86, 95% CI 1.41 to 2.47, p<0.001, I2=63.4%) and gender of newborn (OR=1.31, 95% CI 1.01 to 1.68, p=0.04, I2=81.7%) significantly associated with EBF. ANC (OR=1.70, 95% CI 1.10 to 2.65, p=0.02, I2=93.1%) was also significantly associated with TIBF but not with gender of newborn (OR=1.02, 95% CI 0.86 to 1.21, p=0.82, I2=66.2%). CONCLUSIONS In line with our hypothesis, gender of newborn, ANC and PNC were significantly associated with EBF. Likewise, ANC was significantly associated with TIBF. Optimal care during pregnancy and after birth is important to ensure adequate breast feeding. This meta-analysis study provided up-to-date evidence on breastfeeding practices and its associated factors, which could be useful for breastfeeding improvement initiative in Ethiopia and cross-country and cross-cultural comparison. TRIAL REGISTRATION NUMBER CRD42017056768.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Sisay Mulugeta Alemu
- Department of Public Health, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Ayalew T, Tewabe T, Ayalew Y. Timely initiation of breastfeeding among first time mothers in Bahir Dar city, North West, Ethiopia, 2016. Pediatr Res 2019; 85:612-616. [PMID: 30661083 DOI: 10.1038/s41390-019-0299-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND Timely initiation of breastfeeding is one important intervention to prevent childhood morbidities and mortalities. Globally, not more than 35 and 39% in developing countries, 52% in Ethiopia and 38% in Amhara region were initiated with breastfeeding early. METHODS A community based cross-sectional study was conducted from 20 March to April, 2016. A total of 423 mothers who have infants less than 6 month old were included in this study. The data were collected using interviewer administered questionnaire. Binary logistic regression analysis were used to identify factors associated with timely initiation of breastfeeding. RESULTS Prevalence of timely initiation of breastfeeding was 65%. Being male [AOR 2.148 (1.232, 3.745)], breastfeeding counseling [AOR 2.163 (1.187, 3.942)], place of delivery [AOR 8.639 (2.089, 5.720)], normal labor [AOR 4.094 (1.414, 8.728], and religious father support [AOR 1.962 (1.113, 3.458)] were determinants for timely initiation of breastfeeding. CONCLUSIONS Timely initiation of breastfeeding in the study area was 65%. Sex of infant, breastfeeding counseling, birth place, mode of delivery, and religious father support were predictors of timely initiation of breastfeeding. Strengthening timely initiation of breastfeeding through provision of antenatal care services, educating mothers and strengthening health professionals knowledge, and skills on breastfeeding counseling were recommended.
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Affiliation(s)
- Tilksew Ayalew
- Lecturer, Department of nursing, Bahir Dar University, College of Medicine and Health science, Bahir Dar, Ethiopia
| | - Tilahun Tewabe
- Lecturer, college of medicine and health sciences, Bahir Dar University, College of Medicine and Health science, Bahir Dar, Ethiopia.
| | - Yohannis Ayalew
- Lecturer, Department of public health, Addis Ababa University College of Health Sciences School of Allied Health Sciences, Addis Ababa, Ethiopia
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John JR, Mistry SK, Kebede G, Manohar N, Arora A. Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data. BMC Pregnancy Childbirth 2019; 19:69. [PMID: 30760226 PMCID: PMC6373137 DOI: 10.1186/s12884-019-2211-0] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 02/01/2019] [Indexed: 11/23/2022] Open
Abstract
Background Timely breastfeeding initiation is a simple but important measure that has protective effects on infants and mothers. This study aims to determine the predictors of early breastfeeding initiation among mothers residing in Ethiopia. Methods This study employed the 2016 Ethiopian Demographic and Health Survey data. A total of 5546 children born during the last 24 months at the time of survey were included for analysis from nine regional states and two city administration areas. Socio-demographic and socio-economic factors including individual, household and community-level factors were examined of their significance against the outcome variable of early initiation of breastfeeding using a mixed-effect logistic regression model. Results The proportion of infants who had timely initiation of breastfeeding was 74.3% (n = 3064). In the multivariate logistic regression analysis, mothers who delivered with assistance of one or more health professionals had 68% (AOR 1.68; 95% CI: 1.23, 2.29) higher odds of initiating timely breastfeeding. In addition, mothers delivering by a caesarean section had 86% reduced odds of early breastfeeding initiation (AOR 0.14; 95% CI: 0.09, 0.22) when compared to mothers who had vaginal delivery. In terms of socio-demographic factors, the odds of early breastfeeding initiation were more than two and half times higher particularly for mothers residing particularly in Oromiya (AOR 2.58; 95% CI: 1.84, 3.63) and Southern Nations Nationalities and Peoples (SNNP) (AOR 2.75; 95% CI: 1.86, 4.05). In addition, timely breastfeeding initiation was also significantly associated with wealth index with wealthier mothers having 43% higher odds compared to mothers of poorest households (AOR 1.43; 95% CI: 1.07, 1.92). Other factors such as age, gender and birth order of the infant also had significant associations with early breastfeeding initiation. Conclusion Early breastfeeding initiation in Ethiopia is inextricably associated with various socio-demographic, biomedical, and socio-economic factors. The study findings can potentially inform mothers and the wider community on the benefits of timely breastfeeding initiation and policymakers and community leaders to target health promotional interventions and resources where needed.
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Affiliation(s)
- James Rufus John
- School of Nursing and Midwifery, Western Sydney University, Campbelltown, NSW, Australia.,Capital Markets Cooperative Research Centre, Sydney, Australia
| | - Sabuj Kanti Mistry
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - Getahun Kebede
- University of Tasmania, Faculty of Health, School of Health Sciences, Launceston, Tasmania, Australia.,University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia
| | - Narendar Manohar
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia. .,Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia. .,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, Australia. .,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, Australia.
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Habtewold TD, Mohammed SH, Endalamaw A, Akibu M, Sharew NT, Alemu YM, Beyene MG, Sisay TA, Birhanu MM, Islam MA, Tegegne BS. Breast and complementary feeding in Ethiopia: new national evidence from systematic review and meta-analyses of studies in the past 10 years. Eur J Nutr 2018; 58:2565-2595. [PMID: 30229308 DOI: 10.1007/s00394-018-1817-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 08/07/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE The aim of this systematic review and meta-analysis was to provide a national estimate of breast and complementary feeding practices and its predictors in Ethiopia. METHODS PubMed, SCOPUS, EMBASE, CINHAL, Web of Science and WHO Global Health Library electronic databases were searched for all available literature published until April 2018. Observational studies including cross-sectional, case-control and cohort studies were included. Newcastle-Ottawa Scale was used to assess the quality of studies. Heterogeneity of studies was quantified using Cochran's Q χ2 statistic and Higgins's method (I2). A meta-analysis using a weighted inverse variance method was performed. Subgroup analysis was carried out based on region and study area. RESULTS In total, 70 studies that involved > 55,000 women from nine regions and two chartered cities in Ethiopia were included. The pooled national prevalence for timely initiation of breastfeeding (TIBF), exclusive breastfeeding (EBF) and timely initiation of complementary feeding was 66.5%, 60.1% and 62.5%, respectively. Guidance and counselling on breastfeeding, vaginal delivery and health institution delivery significantly increased the odds of TIBF and EBF. In addition, TIBF significantly associated with high EBF practice. Maternal occupational status significantly associated with low EBF practice, but not TIBF. CONCLUSIONS Based on the WHO standard, the current breast and complementary feeding practice in Ethiopia is good and improving. Integrated intervention is still required for further improvement and minimizing the effect of occupational status.
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Affiliation(s)
- Tesfa Dejenie Habtewold
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia. .,Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
| | - Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Islamic Republic of Iran
| | - Aklilu Endalamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Akibu
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigussie Tadesse Sharew
- Department of Nursing, College of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Yihun Mulugeta Alemu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | | | - Tesfamichael Awoke Sisay
- Department of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mulugeta Molla Birhanu
- Department of Adult Health Nursing, School of Nursing, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Md Atiqul Islam
- Department of Statistics, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Balewgizie Sileshi Tegegne
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
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Hassan AA, Taha Z, Ahmed MAA, Ali AAA, Adam I. Assessment of initiation of breastfeeding practice in Kassala, Eastern Sudan: a community-based study. Int Breastfeed J 2018; 13:34. [PMID: 30065774 PMCID: PMC6060461 DOI: 10.1186/s13006-018-0177-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 07/18/2018] [Indexed: 02/08/2023] Open
Abstract
Background The World Health Organization (WHO) encourages early initiation of breastfeeding within the first hour after birth with the objective of saving children’s lives. There are few published research papers about factors associated with the initiation of breastfeeding in Sudan. The aim of this study was to investigate the prevalence of and factors associated with the timely initiation of breastfeeding among mothers with children two years and under in Kassala, Eastern Sudan. Methods A community-based cross-sectional study was conducted from December 2016 to March 2017. Mothers were interviewed using a structured questionnaire. Results A total of 250 mother-child pairs participated in the study. The mean (standard deviation) of maternal age and children’s age was 27.1 (5.68) years and 11.9 (6.9) months, respectively. Of the 250 mothers, 218 (87.2%) initiated breastfeeding within the first hour. In multivariable logistic regression analysis, factors associated with the delay of breastfeeding initiation were having a male baby (Adjusted Odds Ratio [AOR] 3.90, 95% Confidence Interval [CI]1.33, 11.47), and mothers with medical disorders (AOR 5.07, 95% CI 1.22, 21.16). Conclusion There was a high prevalence of early initiation of breastfeeding. An association with delayed initiation of breastfeeding was found amongst mothers who had medical disorders and those who had a male infant. Wherever possible, early initiation of breastfeeding should be promoted for all infants, regardless of gender.
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Affiliation(s)
- Ahmed A Hassan
- 1Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Zainab Taha
- 2College of Natural and Health Sciences, Zayed University, Dubai, United Arab Emirates
| | | | | | - Ishag Adam
- 1Faculty of Medicine, University of Khartoum, Khartoum, Sudan
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Ndirangu MN, Gatimu SM, Mwinyi HM, Kibiwott DC. Trends and factors associated with early initiation of breastfeeding in Namibia: analysis of the Demographic and Health Surveys 2000-2013. BMC Pregnancy Childbirth 2018; 18:171. [PMID: 29769063 PMCID: PMC5956738 DOI: 10.1186/s12884-018-1811-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 04/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013. METHODS An analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006-2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used to analyse respondents' demographic, socioeconomic and obstetric characteristics. Factors associated with EIBF were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis. RESULTS EIBF significantly decreased from 82.5% (confidence interval [CI]: 79.5-85.0) in 2000 to 74.9% (72.5-77.2) in 2013. Factors associated with EIBF in 2000 were urban residence (adjusted odds ratio 0.58, 95% CI: 0.36-0.93), poorer household wealth index (1.82, 1.05-3.17), lack of antenatal care (0.14, 0.03-0.81), small birth size (0.38, 0.24-0.63) and large birth size (0.51, 0.37-0.79). In 2013, factors associated with EIBF were maternal age of 15-19 years (2.28, 1.22-4.24), vaginal delivery (2.74, 1.90-3.93), married mothers (1.57, 1.16-2.14), delivery assistance from health professionals (3.67, 1.23-10.9) and birth order of fourth or above (1.52, 1.03-2.26). CONCLUSIONS Namibia has experienced a declining trend in EIBF rates from 2000 to 2013. Factors associated with EIBF differed between 2000 and 2013. The present findings highlight the importance of continued commitment to addressing neonatal health challenges and strengthening implementation of interventions to increase EIBF in Namibia.
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Affiliation(s)
- M N Ndirangu
- Division of Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden.
| | - S M Gatimu
- School of Nursing and Midwifery, Aga Khan University, P.O. Box 30270 - 00100, Nairobi, Kenya
| | - H M Mwinyi
- Kenya Red Cross Society, P.O. Box 40712 - 00100, Nairobi, Kenya
| | - D C Kibiwott
- School of Medicine and Health Sciences, Kabarak University, P.O. Private Bag 20157, Kabarak, Kenya
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Ekubay M, Berhe A, Yisma E. Initiation of breastfeeding within one hour of birth among mothers with infants younger than or equal to 6 months of age attending public health institutions in Addis Ababa, Ethiopia. Int Breastfeed J 2018; 13:4. [PMID: 29410699 PMCID: PMC5782370 DOI: 10.1186/s13006-018-0146-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Accepted: 01/08/2018] [Indexed: 12/01/2022] Open
Abstract
Background Breast milk is comprised of the essential nutrients that an infant needs in the first six months of life. Timely initiation of breastfeeding guarantees that infants receive the colostrum, ‘the first breastmilk’, which contains antibodies that protect the newborn against diseases. Breastfeeding within the first hour of life prevents newborn death due to sepsis, pneumonia, diarrhea and hypothermia. Although breastfeeding is a common practice in sub-Saharan Africa, evidence show that early initiation of breastfeeding is low. Methods We conducted a cross-sectional study of 583 mothers with infants younger than or equal to 6 months of age attending Maternal and Child Health (MCH) clinics of public health institutions in Addis Ababa, Ethiopia from April to May 2012. A simple random sampling design was used to select the institutions included in this study. Data from mothers of infants were collected using interviewer-administered questionnaire. We analyzed the data to examine factors associated with initiation of breastfeeding within one hour of birth using logistic regression models. Results Of 564 (96.7%, 564/583) mothers who breastfed their infants, 58.3% (329/564) initiated breastfeeding within one hour of birth. In the adjusted analysis, mothers who had three or more infants had about twice higher odds of timely initiation of breastfeeding within one hour of birth (Adjusted Odds Ratio [aOR] 2.10; 95% Confidence Interval [CI]1.04, 4.30) compared with mothers who had one infant. Furthermore, women who started antenatal care at their fourth month of pregnancy or later had a 49.0% higher odds of initiation of breastfeeding within one hour of birth (aOR 1.49; 95% CI 1.01, 2.19) compared to mothers who started antenatal care before their fourth month of pregnancy. Conclusions Initiation of breastfeeding within one hour of birth was low. Initiation of breastfeeding within one hour of birth was highest among multiparous women, mothers aged 30–34 years, and women who began antenatal care at their fourth month of pregnancy or later. Public health officials and health care providers should consider interventions to promote and support early initiation of breastfeeding.
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Affiliation(s)
- Meseret Ekubay
- 1Department of Nursing, College of Health Sciences, Institute of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Aster Berhe
- Midwifery Advisor, UNFPA Ethiopia Country Office, Addis Ababa, Ethiopia
| | - Engida Yisma
- 3School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.,4Robinson Research Institute, School of Medicine, The University of Adelaide, Adelaide, Australia
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Alzaheb RA. A Review of the Factors Associated With the Timely Initiation of Breastfeeding and Exclusive Breastfeeding in the Middle East. CLINICAL MEDICINE INSIGHTS-PEDIATRICS 2017; 11:1179556517748912. [PMID: 29317851 PMCID: PMC5753894 DOI: 10.1177/1179556517748912] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 11/26/2017] [Indexed: 12/02/2022]
Abstract
Background: Breastfeeding supplies all the nutrients that infants need for their healthy development. Breastfeeding practice is multifactorial, and numerous variables influence mothers’ decisions and ability to breastfeed. This review identifies the factors potentially affecting the timely initiation of breastfeeding within an hour after birth and exclusive breastfeeding in the first 6 months in Middle Eastern countries. Methods: The Medline, ScienceDirect, and Web of Science databases were keyword-searched for primary studies meeting the following inclusion criteria: (1) publication in the English language between January 2001 and May 2017, (2) original research articles reporting primary data on the factors influencing the timely initiation of breastfeeding and/or exclusive breastfeeding, (3) the use of World Health Organization definitions, and (4) Middle Eastern research contexts. A random effect model was used to establish the average prevalence of the timely initiation of breastfeeding and exclusive breastfeeding in the Middle East. Results: The review identified 19 studies conducted in Saudi Arabia (7), Iran (3), Egypt (2), Turkey (2), Kuwait (1), the United Arab Emirates (1), Qatar (1), Lebanon (1), and Syria (1). The meta-analysis established that 34.3% (confidence interval [CI]: 20.2%-51.9%) of Middle Eastern newborns received breastfeeding initiated within an hour of birth, and only 20.5% (CI: 14.5%-28.2%) were fed only breast milk for the first 6 months. The 8 studies exploring breastfeeding initiation most commonly associated it with the following: delivery mode, maternal employment, rooming-in, and prelacteal feeding. The 17 studies investigating exclusive breastfeeding most frequently linked it to the following: maternal age, maternal education, maternal employment, and delivery mode. Conclusions: Middle Eastern health care organizations should fully understand all the determinants of breastfeeding identified by this review to provide suitable practical guidance and advice to help new mothers to overcome barriers where possible and to contribute to improving infant and maternal health in the region.
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Affiliation(s)
- Riyadh A Alzaheb
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk, Saudi Arabia
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Alebel A, Dejenu G, Mullu G, Abebe N, Gualu T, Eshetie S. Timely initiation of breastfeeding and its association with birth place in Ethiopia: a systematic review and meta-analysis. Int Breastfeed J 2017; 12:44. [PMID: 29026432 PMCID: PMC5627416 DOI: 10.1186/s13006-017-0133-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 09/25/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Timely initiation of breastfeeding is defined as putting the newborn to the breast within 1 h of birth. In Ethiopia, different studies have been conducted to assess the prevalence of timely initiation of breastfeeding and associated factors. The findings of these studies were inconsistent and characterized by great variability. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of timely initiation of breastfeeding and its association with birth place in Ethiopia using the available studies. METHODS Databases, including PubMed, Google scholar, Science direct and Cochrane library were systematically searched. All original studies reporting the prevalence of timely initiation of breastfeeding in Ethiopia were considered. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 statistical software was used to analyze the data. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity between the studies. A random effect model was computed to estimate the pooled prevalence of timely initiation of breastfeeding. In addition, the associations between timely initiation of breastfeeding and place of birth were determined. RESULTS Sixteen studies were finally included in the meta-analysis. The findings of this meta-analysis revealed that, the pooled prevalence of timely initiation of breastfeeding in Ethiopia was 61.4% (CI: 51.4, 71.5%). The study also indicated that rural mothers had lower rate of initiating breastfeeding within the first 1 h after delivery as compared to their urban counterparts. Additionally, mothers who gave birth at health institution were almost 2.11 times more likely to initiate breastfeeding within 1 h as compared to mothers who did not give birth at health institution. CONCLUSION In this study, timely initiation of breastfeeding in Ethiopia was significantly low compared to the current global recommendation on breastfeeding. Women from rural area were less likely to initiate breastfeeding within 1 h as compared with women from urban areas. Mothers who give birth at health institution were more likely to initiate breastfeeding timely.
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Affiliation(s)
- Animut Alebel
- College of Health Sciences, Debre Markos University, P.o.box: 269, Debre Markos, Ethiopia
| | - Getiye Dejenu
- College of Health Sciences, Debre Markos University, P.o.box: 269, Debre Markos, Ethiopia
| | - Getachew Mullu
- College of Health Sciences, Debre Markos University, P.o.box: 269, Debre Markos, Ethiopia
| | - Nurilign Abebe
- College of Health Sciences, Debre Markos University, P.o.box: 269, Debre Markos, Ethiopia
| | - Tenaw Gualu
- College of Health Sciences, Debre Markos University, P.o.box: 269, Debre Markos, Ethiopia
| | - Setegn Eshetie
- College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Demographic and mortality analysis of hospitalized children at a referral hospital in Addis Ababa, Ethiopia. BMC Pediatr 2016; 16:168. [PMID: 27765020 PMCID: PMC5073447 DOI: 10.1186/s12887-016-0709-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/13/2016] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Global childhood mortality rates remain high. Millennium Development Goal 4 focused efforts on reducing rates by two-thirds between 1990 and 2015. In Ethiopia, child mortality rates dropped 71 % from 1990 to 2015, however it is estimated that 184,000 Ethiopian children die each year. There is limited information about pediatric hospital admissions in Ethiopia. Our aims were to examine the temporal relationship of mortality to admission, describe the demographics, and identify cause mortality of children admitted to the Zewditu Memorial Hospital (ZMH). METHODS A four-year retrospective review of pediatric admissions was conducted at the pediatric emergency room and pediatric hospital ward at ZMH in Addis Ababa, Ethiopia. Admission entries from 2011-2014 of children age 29 days-14 years were reviewed. Age, gender, admission date, disease classification, discharge status and date were obtained. Patient gender was compared using Chi-square analysis. A descriptive analysis was used for age and cause mortality. RESULTS A total of 6866 patient entries were reviewed. The proportion of admissions younger than age 5 was 0.747 (95 % CI 0.736-0.757). Overall mortality was 0.042 (95 % CI, 0.037-0.047). The proportion of recorded deaths occurring within 2 days of admission was 0.437 (95 % CI 0.380-0.494). The proportion of male admissions was significantly higher than female admissions in all age groups (male 0.575, p < 0.0001, 95 % CI 0.562-0.586). The main causes of mortality were pneumonia (0.253, 95 % CI, 0.203-0.303), severe acute malnutrition (0.222, 95 % CI 0.174-0.27), HIV/AIDS-related complications (0.056, 95 % CI 0.029-0.083), spina bifida (0.049, 95 % CI 0.024-0.074), and hydrocephalus (0.045, 95 % CI 0.021-0.069). CONCLUSIONS Our study revealed a lower mortality rate than previously reported in Ethiopia. Despite this, 44 % of pediatric hospital mortality occurred early during hospitalization, higher than reported at other Ethiopian hospitals. This adds further evidence that systematic efforts should be dedicated to improve pediatric emergency care. Admissions included 58 % male patients, similar to other reports in Ethiopia implying that this may be a nation-wide phenomenon. The observed disparity may be due to societal factors regarding care-seeking behaviors or male predilection for respiratory illness warranting further investigation. Cause mortality patterns were similar to reports in analogous settings.
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Tewabe T. Timely initiation of breastfeeding and associated factors among mothers in Motta town, East Gojjam zone, Amhara regional state, Ethiopia, 2015: a cross-sectional study. BMC Pregnancy Childbirth 2016; 16:314. [PMID: 27756253 PMCID: PMC5069976 DOI: 10.1186/s12884-016-1108-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/11/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Timely initiation of breastfeeding within one hour after birth and exclusive breastfeeding is recommended for the first six months of infant life along with continuation of breastfeeding up to two years. Timely initiation of breastfeeding has the potential to prevent 22 % of neonatal deaths. The objective of this study was to assess timely initiation of breastfeeding and associated factors among mothers who have infants less than six months of age in Motta town, East Gojjam, Amhara Regional State, Ethiopia. METHOD Community based quantitative cross-sectional study was conducted from April 7, 2015 to May 7, 2015. Simple random sampling technique was applied after taking all registered mothers who have infants less than 6 months old from local health extension workers of each kebele. A total of 423 mothers with infant less than six month old were included in this study. The data was collected from all four Kebeles using interviewer administered questionnaire. Descriptive and inferential statistics were used to present the data. Both bivariate and multivariate logistic regression analyses were used to identify factors associated with timely initiation breastfeeding. RESULT Prevalence of timely initiation of breastfeeding was78.8 % [95 % CL: 74.88 %, 82.72 %]. Mothers who gave birth to their infant in a health institution [AOR = 3.486(1.253, 9.700)], birthed vaginally [AOR = 5.722(3.134, 11.246)] and didn't give prelacteal food [AOR = 4.627(2.095, 10.220)] were more likely to initiate breastfeeding early than their counterparts. CONCLUSION Prevalence of timely initiation of breastfeeding in the study area was 78.8 %. Place of delivery, mode of delivery and prelactal feeding were the independent predictors of timely initiation of breastfeeding. Recommendations to increase timely initiation of breastfeeding were: encouraging mothers to deliver their child in a health institution, minimizing caesarean delivery as much as possible and educating mothers and community as a whole to avoid traditional prelactal feeding practice.
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Affiliation(s)
- Tilahun Tewabe
- Bahir Dar University, College of Medicine and Health science, Bahir Dar, Ethiopia.
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