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Geospatial variation of bottle feeding practice among children aged 0-23 months in East Africa: Geographically

Andualem Addisu Birlie1, Angwach Abrham Asnake2, Bizunesh Fantahun Kase3

  • 1Department of Health Informatics, College of Medicine and Health Science, Samara University, Samara, Ethiopia.

SAGE Open Medicine
|August 7, 2026
PubMed

Insights

Bottle-feeding in East Africa affects 13% of children, with high-risk areas identified in Rwanda, Tanzania, Madagascar, Kenya, and Mozambique. Targeted parental counseling is recommended for these hotspots to reduce risks associated with bottle-feeding practices.

Area of Science:

  • Pediatric Nutrition
  • Spatial Epidemiology
  • Public Health

Background:

  • Bottle-feeding, defined as feeding infants 0-23 months from a bottle with a nipple, is linked to increased risks of excessive weight gain, malnutrition, iron deficiency, and reduced birth spacing.
  • Geographically weighted regression (GWR) analysis has not been previously applied to understand the spatial determinants of bottle-feeding practices.

Purpose of the Study:

  • To investigate the geospatial variation and identify determinants of bottle-feeding practices among children aged 0-23 months in East Africa.
  • To apply GWR analysis to understand the spatial patterns and associated factors of bottle-feeding.

Main Methods:

  • Utilized data from 28,562 children aged 0-23 months in East Africa.
  • Employed spatial analysis techniques including autocorrelation, hotspot analysis, interpolation, and spatial scan analysis using STATA, ArcGIS, and SaTScan.
  • Applied Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) to assess associations between bottle-feeding and explanatory variables.

Main Results:

  • Identified a 13% prevalence of bottle-feeding practice among children aged 0-23 months in East Africa.
  • Detected significant hotspots of bottle-feeding in Rwanda, Central and Eastern Tanzania, Madagascar, Southern Kenya, and Southern/Eastern Mozambique.
  • A primary cluster of bottle-feeding was identified in Madagascar, with statistically significant findings.

Conclusions:

  • Bottle-feeding practices exhibit a clustered spatial distribution in East Africa, with specific high-risk areas identified.
  • Interventions should focus on parental counseling in identified hotspot regions to mitigate the negative health consequences of bottle-feeding.
  • Findings provide crucial insights for policymakers to target public health efforts effectively in high-risk areas.
Abstract

Keywords:
East Africabottle feedingchildrendemographic health surveygeospatial

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