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Meta-Analysis
. 2017 Oct 24;7(10):e014145.
doi: 10.1136/bmjopen-2016-014145.

Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010-2015)

Abukari Ibrahim Issaka  1 , Kingsley Emwinyore Agho  2 , Andre Mn Renzaho  1
Affiliations
Meta-Analysis

Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010-2015)

Abukari Ibrahim Issaka et al. BMJ Open. .

Abstract

Objectives: To carry out a meta-analysis to assess the prevalence of four key breastfeeding indicators in four subregions of 29 sub-Saharan African countries.

Design, settings and participants: The 29 countries were categorised into four subregions, and using cross-sectional data from the most recent Demographic and Health Surveys (2010-2015) of these countries prevalence of each of four key breastfeeding indicators was estimated for each of the subregions by carrying out a meta-analysis. Due to the presence of significant heterogeneity among the various surveys (I2>50%), a random-effect analytic model was used, and sensitivity analysis was performed to examine the effects of outliers.

Main outcome variables: Early initiation of breast feeding, exclusive breast feeding, predominant breast feeding and bottle feeding.

Results: The overall prevalence of early initiation of breast feeding varied between a lowest of 37.84% (95% CI 24.62 to 51.05) in Central Africa to a highest of 69.31% (95% CI 67.65 to 70.97) in Southern Africa; the overall prevalence of exclusive breast feeding ranged between a lowest of 23.70% (95% CI 5.37 to 42.03) in Central Africa to a highest of 56.57% (95% CI 53.50 to 59.95) in Southern Africa; the overall prevalence of predominant breast feeding ranged between a lowest of 17.63% (95% CI 12.70 to 22.55) in East Africa and a highest of 46.37% (95% CI 37.22 to 55.52) in West Africa; while the prevalence of bottle feeding varied between a lowest of 8.17% (95% CI 5.51 to 10.84) in West Africa and a highest of 30.05% (95% CI 28.42 to 31.69) in Southern Africa.

Conclusions: West Africa and Central Africa recorded lower overall prevalence of early initiation of breast feeding and exclusive breast feeding than the WHO's recommended target of 50% by the year 2025. Intervention for improved breastfeeding practices in sub-Saharan Africa should target West and Central Africa, while intervention to minimise bottle feeding should target Southern Africa.

Keywords: community child health; epidemiology; health policy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flow scheme for country selection based on the exclusion and inclusion criteria. DHS, Demographic and Health Surveys.
Figure 2
Figure 2
Prevalence of early initiation of breast feeding in 28 sub-Saharan African countries (2010–2015). Congo Bra, Congo Brazzaville; Congo DR, Democratic Republic of Congo; DHS, Demographic and Health Surveys.
Figure 3
Figure 3
Prevalence of exclusive breast feeding in 28 sub-Saharan African countries (2010–2015). Congo Bra, Congo Brazzaville; Congo DR, Democratic Republic of Congo; DHS, Demographic and Health Surveys.
Figure 4
Figure 4
Prevalence of predominant breast feeding in 28 sub-Saharan African countries (2010–2015). Congo Bra, Congo Brazzaville; Congo DR, Democratic Republic of Congo; DHS, Demographic and Health Surveys.
Figure 5
Figure 5
Prevalence of bottle feeding in 28 sub-Saharan African countries (2010–2015). Congo Bra, Congo Brazzaville; Congo DR, Democratic Republic of Congo; DHS, Demographic and Health Surveys.
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