Spatial variation and determinants of delayed breastfeeding initiation in Ethiopia: spatial and multilevel analysis
Ribka Nigatu Haile1, Biruk Beletew Abate2, Tegene Atamenta Kitaw2
1Department of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia. nigaturebecca@gmail.com.
Insights
Delayed breastfeeding initiation affects over a quarter of Ethiopian mothers, particularly young mothers and those with cesarean births. Targeted interventions in hotspot regions are crucial for improving early breastfeeding practices.
Area of Science:
- Public Health
- Maternal and Child Health
- Epidemiology
Background:
- The World Health Organization recommends initiating breastfeeding within the first hour after delivery.
- Globally, nearly 54% of children in low- and middle-income countries do not initiate breastfeeding within this critical timeframe.
- Understanding factors influencing breastfeeding initiation is vital for maternal and child well-being.
Purpose of the Study:
- To determine the prevalence and spatial distribution of delayed breastfeeding initiation in Ethiopia.
- To identify key determinants associated with delayed breastfeeding initiation among Ethiopian mothers.
Main Methods:
- Utilized 2019 Ethiopian Demographic and Health Survey (EDHS) data from 1982 mothers.
- Employed spatial analysis (Global Moran's I, Getis-Ord Gi* Spatial Statistics) and multilevel mixed-effect logistic regression.
- Defined delayed breastfeeding initiation as failure to initiate within one hour after birth.
Main Results:
- The prevalence of delayed breastfeeding initiation was 26.4% in Ethiopia.
- Significant spatial clustering of delayed initiation was observed in the Somali region, with less clustering in Northern Amhara, Addis Ababa, and Dire Dawa.
- Factors associated with delayed initiation included young maternal age (15-24 years), no antenatal care, cesarean section, and home birth.
Conclusions:
- Delayed breastfeeding initiation in Ethiopia exhibits non-random spatial distribution, with identified hotspots in the eastern regions.
- Interventions should prioritize promoting health facility births and increasing antenatal care visits.
- Support for young mothers and those undergoing cesarean sections is essential to improve timely breastfeeding initiation.
Background:
Despite the World Health Organization's firm recommendation to start breastfeeding during the first hour after delivery, nearly 54% of children in low- and middle-income countries are unable to initiate breastfeeding within the recommended time frame. Understanding the initiation of breastfeeding is essential for optimal child health and maternal well-being.
Methods:
This study was conducted using the recent Ethiopian Demographic and Health Survey (EDHS) data (2019) on a weighted sample of 1982 Ethiopian mothers of children aged under 24 months. The data extraction was conducted between August 1 and 30, 2023. Delayed' initiation of breastfeeding is defined as failure to initiate breastfeeding within one hour after birth. STATA version 17 was used for non-spatial analysis. ArcGIS Pro and Sat Scan version 9.6 were used to map the visual presentation of delayed breastfeeding initiation. Global Moran's I was computed to determine whether delayed breastfeeding initiation is randomly distributed, clustered, or dispersed. Getis-Ord Gi* Spatial Statistics was done to identify significant spatial clusters of cold and hot spot areas. Multilevel mixed-effect logistic regression analysis was computed to identify determinants of delayed breastfeeding initiation.
Results:
The prevalence of delayed breastfeeding initiation is 26.4% (95% CI 24.4, 28.3). Significant clustering of delayed initiation of breastfeeding practice was found in the Somali region. Less clustering was identified in Northern Amhara, Addis Ababa and Dire Dawa. Being a young mother (15-24 years) (AOR 1.66; 95% CI 1.06, 2.62), no antenatal care (AOR 1.45; 95% CI 1.04, 2.02), cesarean section (AOR 4.79; 95% CI 3.19, 7.21) and home birth (AOR 1.53; 95% CI 1.14, 2.06) were found to be determinants of delayed initiation of breastfeeding.
Conclusions:
In Ethiopia, delayed breastfeeding initiation is distributed non-randomly. Significant hotspot areas were identified in the eastern part of Ethiopia. Thus, deploying additional resources in high hotspot regions is recommended. Programs should focus on promoting health facility birth and increasing antenatal care visits. Further emphasis should be considered on supporting young mothers and those giving birth via cesarean section to improve timely breastfeeding initiation.
More Related Videos
Related Concept Videos
01:23Anatomy of the Intestines
Small Intestines
The small intestine is an ~7 meter-long tube with an inner diameter of just 2.5 cm. Since most nutrients are absorbed here, the inner lining of the...
00:55Parental Care