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. 2024 Dec 18;24(1):1577.
doi: 10.1186/s12913-024-12064-y.

Poor access to breastfeeding counseling services and associated factors among lactating mothers who had optimal antenatal care follow-up in Sub-saharan Africa: a multilevel analysis of the recent Demographic and Health Survey

Alebachew Ferede Zegeye  1 , Deresse Abebe Gebrehana  2 , Selamawit Abrha Bezabih  3 , Seble Ayana Mengistu  4 , Kassaw Chekole Adane  5 , Ayenew Molla Lakew  6
Affiliations

Poor access to breastfeeding counseling services and associated factors among lactating mothers who had optimal antenatal care follow-up in Sub-saharan Africa: a multilevel analysis of the recent Demographic and Health Survey

Alebachew Ferede Zegeye et al. BMC Health Serv Res. .

Abstract

Background: Inadequate access to services for breastfeeding counseling results in poor breastfeeding practices and adverse health consequences. Although poor access to breastfeeding counseling services is a major challenge, its magnitude and determinantes are not well studied in developing countries. Therefore, this study assessed the magnitude and determinants of poor access to breastfeeding counseling services among lactating mothers who had optimal antenatal care follow-up in Sub-Saharan Africa.

Methods: Data from the recent Demographic and Health Surveys, involving a total of 289,929 women, were used for analysis. The determinants of poor access to breastfeeding counseling services were examined using a multilevel mixed-effects logistic regression model. Significant factors associated with poor access to breastfeeding counseling services were declared significant at p-values < 0.05. The adjusted odds ratio and confidence interval were used to interpret the results. A model with the lowest deviance and highest log likelihood ratio was selected as the best-fit model.

Results: In Sub-Saharan Africa, nearly one in two women with optimal antenatal care follow-up had poor access to breastfeeding counseling services. Maternal age (AOR = 1.18, 95% CI: 1.02, 1.38), maternal education (AOR = 1.128, 95% CI: 1.22, 1.35), distance to health facility (AOR = 1.17, 95% CI: 1.13, 1.21), media exposure (AOR = 1.12, 95% CI: 1.08, 1.17), wealth index (AOR = 1.05, 95% CI: 1.00, 1.10), place of delivery (AOR = 4.31, 95% CI: 4.11, 4.52), PNC (AOR = 3.92, 95% CI: 3.78, 4.07), mode of delivery (AOR = 1.88, 95% CI: 1.76, 2.02), birth interval (AOR = 1.12, 95% CI: 1.07, 1.17), residence (AOR = 1.14, 95% CI: 1.09, 1.18), community poverty (AOR = 1.09, 95% CI: 1.03, 1.15), community institutional delivery (AOR = 1.06, 95% CI: 1.01, 1.12), country category (AOR = 2.23, 95% CI: 2.10, 2.37), had higher odds of poor access to breastfeeding counseling services.

Conclusions: Poor access to breastfeeding counseling services among lactating mothers was found to be high. Both individual and community-level factors were determinants of poor access to breastfeeding counseling services. The Ministry of Health in Sub-Saharan Africa should give attention to those women who have not had a postnatal check-up and give birth at home while designing policies and strategies.

Keywords: Antenatal care; Associated factors; Breastfeeding; Optimal; Poor access; Sub-saharan Africa.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Since this study is merely a secondary analyze of the DHS data, ethical approval is not needed. We enrolled with the DHS web archive, requested the dataset for our study, and were granted permission to view and download the data files. As per the DHS study, all participant data were anonymized at the time of survey data collection. Anyone may find more information on DHS data and ethical standards by visiting http://www.dhsprogram.com . Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual framework for factors associated with Poor access to breastfeeding counseling services among women who had optimal ANC follow in Sub-Saharan Africa
Fig. 2
Fig. 2
Poor access to breastfeeding counseling service among women who had optimal ANC follow-up in Sub-Saharan Africa, DHS 2015-2022 (n=289,929 )
Fig. 3
Fig. 3
Poor access to breastfeeding counseling service by wealth status among women who had optimal ANC follow-up in Sub-Saharan Africa, DHS 2015–2022 (n = 289,929)
See this image and copyright information in PMC

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