Spatial variation and determinants of delayed breastfeeding initiation in Ethiopia: spatial and multilevel analysis of recent evidence from EDHS 2019.

IF 2.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

International Breastfeeding Journal Pub Date : 2024-02-07 DOI:10.1186/s13006-024-00616-1

Ribka Nigatu Haile, Biruk Beletew Abate, Tegene Atamenta Kitaw

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引用次数: 0

Abstract

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.

查看原文本刊更多论文

埃塞俄比亚母乳喂养启动延迟的空间变化和决定因素：对 EDHS 2019 最新证据的空间和多层次分析。

背景：尽管世界卫生组织坚定地建议在产后一小时内开始母乳喂养，但在低收入和中等收入国家，近54%的儿童无法在建议的时间内开始母乳喂养。了解母乳喂养的起始时间对于优化儿童健康和产妇福祉至关重要：本研究使用了最近的埃塞俄比亚人口与健康调查（EDHS）数据（2019 年），对 1982 名埃塞俄比亚 24 个月以下婴儿的母亲进行了加权抽样调查。数据提取时间为 2023 年 8 月 1 日至 30 日。延迟 "开始母乳喂养定义为未能在婴儿出生后一小时内开始母乳喂养。非空间分析使用 STATA 17 版本。ArcGIS Pro 和 Sat Scan 9.6 版用于绘制母乳喂养延迟的直观图。计算了全局莫兰 I 值，以确定母乳喂养延迟是随机分布、集中分布还是分散分布。通过 Getis-Ord Gi* 空间统计来确定冷点和热点区域的重要空间集群。计算了多层次混合效应逻辑回归分析，以确定延迟开始母乳喂养的决定因素：结果：母乳喂养延迟的发生率为 26.4%（95% CI 24.4，28.3）。延迟开始母乳喂养的情况在索马里地区有明显的聚集。在北阿姆哈拉、亚的斯亚贝巴和德雷达瓦发现的聚集程度较低。年轻母亲（15-24 岁）（AOR 1.66；95% CI 1.06，2.62）、无产前护理（AOR 1.45；95% CI 1.04，2.02）、剖腹产（AOR 4.79；95% CI 3.19，7.21）和在家分娩（AOR 1.53；95% CI 1.14，2.06）被认为是延迟开始母乳喂养的决定因素：结论：在埃塞俄比亚，母乳喂养延迟的分布是非随机的。在埃塞俄比亚东部地区发现了一些重要的热点地区。因此，建议在热点地区部署更多资源。计划的重点应放在促进医疗机构分娩和增加产前检查次数上。应考虑进一步强调对年轻母亲和剖腹产母亲的支持，以提高母乳喂养的及时性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Breastfeeding Journal Medicine-Obstetrics and Gynecology

CiteScore

6.30

自引率

11.40%

发文量

审稿时长

32 weeks

期刊介绍： Breastfeeding is recognized as an important public health issue with enormous social and economic implications. Infants who do not receive breast milk are likely to experience poorer health outcomes than breastfed infants; mothers who do not breastfeed increase their own health risks. Publications on the topic of breastfeeding are wide ranging. Articles about breastfeeding are currently published journals focused on nursing, midwifery, paediatric, obstetric, family medicine, public health, immunology, physiology, sociology and many other topics. In addition, electronic publishing allows fast publication time for authors and Open Access ensures the journal is easily accessible to readers.