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. 2017 Dec;20(17):3109-3119.
doi: 10.1017/S1368980017002567. Epub 2017 Oct 5.

The impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African countries with high diarrhoea mortality

Felix A Ogbo  1 , John Eastwood  2 , Andrew Page  1 , Oniovo Efe-Aluta  3 , Chukwudi Anago-Amanze  3 , Eshioramhe A Kadiri  4 , Ifegwu K Ifegwu  5 , Sue Woolfenden  2 , Kingsley E Agho  6
Affiliations

The impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African countries with high diarrhoea mortality

Felix A Ogbo et al. Public Health Nutr. 2017 Dec.

Abstract

Objective: The current study aimed to examine the impact of sociodemographic and health-service factors on breast-feeding in sub-Saharan African (SSA) countries with high diarrhoea mortality.

Design: The study used the most recent and pooled Demographic and Health Survey data sets collected in nine SSA countries with high diarrhoea mortality. Multivariate logistic regression models that adjusted for cluster and sampling weights were used to investigate the association between sociodemographic and health-service factors and breast-feeding in SSA countries.

Setting: Sub-Saharan Africa with high diarrhoea mortality.

Subjects: Children (n 50 975) under 24 months old (Burkina Faso (2010, N 5710); Demographic Republic of Congo (2013, N 6797); Ethiopia (2013, N 4193); Kenya (2014, N 7024); Mali (2013, N 3802); Niger (2013, N 4930); Nigeria (2013, N 11 712); Tanzania (2015, N 3894); and Uganda (2010, N 2913)).

Results: Overall prevalence of exclusive breast-feeding (EBF) and early initiation of breast-feeding (EIBF) was 35 and 44 %, respectively. Uganda, Ethiopia and Tanzania had higher EBF prevalence compared with Nigeria and Niger. Prevalence of EIBF was highest in Mali and lowest in Kenya. Higher educational attainment and frequent health-service visits of mothers (i.e. antenatal care, postnatal care and delivery at a health facility) were associated with EBF and EIBF.

Conclusions: Breast-feeding practices in SSA countries with high diarrhoea mortality varied across geographical regions. To improve breast-feeding behaviours among mothers in SSA countries with high diarrhoea mortality, breast-feeding initiatives and policies should be context-specific, measurable and culturally appropriate, and should focus on all women, particularly mothers from low socio-economic groups with limited health-service access.

Keywords: Breast milk; Breast-feeding; Diarrhoea; Infants; Sub-Saharan Africa.

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Figures

Fig. 1
Fig. 1
Prevalence of breast-feeding practices in sub-Saharan African countries with high diarrhoea mortality: (a) exclusive breast-feeding; (b) predominant breast-feeding; (c) early initiation of breast-feeding; (d) bottle-feeding. Data from the most recent and pooled Demographic and Health Survey data sets for 50 975 children under 24 months of age: Burkina Faso (2010), N 5710; Demographic Republic of Congo (DRC; 2013), N 6797; Ethiopia (2013), N 4193; Kenya (2014), N 7024; Mali (2013), N 3802; Niger (2013), N 4930; Nigeria (2013), N 11 712; Tanzania (2015), N 3894; and Uganda (2010), N 2913. Early initiation of breast-feeding=the proportion of children 0–23 months of age who were put to the breast within one hour of birth; exclusive breast-feeding=the proportion of infants 0–5 months of age who received breast milk as the only source of nourishment, but allows oral rehydration solution, drops, or syrups of vitamins and medicines; predominant breast-feeding=the proportion of infants 0–5 months of age who received breast milk as the main source of nourishment, but allows water, water-based drinks, fruit juice, oral rehydration solution, drops, or syrups of vitamins and medicines; bottle-feeding=the proportion of infants 0–23 months of age who received any liquid (including breast milk) or semi-solid food from a bottle with a nipple/teat
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