Exclusive Breastfeeding in Ethiopia: An Umbrella Review of Prevalence and Modifiable Health System Determinants.

IF 2.1 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Breastfeeding Medicine Pub Date : 2026-09-20 DOI:10.1177/15568253261490308

Teketel Ermias Geltore, Merkin Bekele, Eden Sileshi, Tariku Laelago Ersado, Abiy Tadesse Angelo, Abebe Alemu Anshebo, Tesfahun Simon Hadaro, Lakew Lafebo Foto

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引用次数: 0

Abstract

Background: Exclusive breastfeeding (EBF) during the first 6 months of life plays a vital role in protecting infant health and supporting maternal well-being. In Ethiopia, several systematic reviews and meta-analyses (SRMAs) have examined EBF, but they report varying prevalence estimates and influencing factors. These inconsistencies make it difficult for clinicians and policymakers to clearly understand the overall picture.

Objective: This umbrella review was conducted to bring together existing evidence, provide a clearer estimate of national EBF prevalence, and identify modifiable health system factors that could improve practice.

Materials and methods: We systematically searched PubMed, Science Direct, Hinari, Google Scholar, and institutional repositories for SRMAs published between 2018 and 2024. The methodological quality of included reviews was evaluated using AMSTAR 2. To assess duplication of primary studies across reviews, we calculated the corrected covered area (CCA). Random effects models were used to generate pooled estimates of prevalence and associated determinants. The certainty of the evidence was assessed using GRADE.

Results: Five systematic reviews, including 123,083 mothers, met the inclusion criteria. The pooled national prevalence of EBF was 56.04% (95% confidence interval: 48.05-64.02), although substantial variability was observed across studies (I² > 99.88%). A high level of overlap among primary studies (CCA = 31.9%) indicated notable redundancy. Key modifiable factors associated with higher EBF rates included antenatal care attendance, institutional delivery, maternal education, and receipt of breastfeeding counseling.

Conclusions: EBF in Ethiopia remains uneven and below optimal levels. Strengthening structured breastfeeding support within routine antenatal and facility-based maternity services offers an important opportunity to improve national EBF outcomes.

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埃塞俄比亚的纯母乳喂养：流行率和可改变的卫生系统决定因素的总体审查。

背景：生命最初6个月的纯母乳喂养（EBF）在保护婴儿健康和支持孕产妇福祉方面发挥着至关重要的作用。在埃塞俄比亚，一些系统综述和荟萃分析（srma）研究了EBF，但它们报告了不同的患病率估计和影响因素。这些不一致使得临床医生和政策制定者很难清楚地了解总体情况。目的：本综述旨在汇集现有证据，对国家EBF患病率提供更清晰的估计，并确定可改变的卫生系统因素，以改善实践。材料和方法：我们系统地检索了PubMed、Science Direct、Hinari、谷歌Scholar和机构知识库，检索了2018年至2024年间发表的srma。使用AMSTAR 2对纳入的综述的方法学质量进行评价。为了评估综述中主要研究的重复，我们计算了校正覆盖面积（CCA）。随机效应模型用于产生患病率和相关决定因素的汇总估计。使用GRADE评估证据的确定性。结果：5项系统评价，123083名母亲符合纳入标准。EBF的全国总患病率为56.04%(95%可信区间：48.05-64.02)，尽管各研究之间存在很大的差异（I2 bb0 99.88%）。初级研究之间的高度重叠（CCA = 31.9%）表明了显著的冗余。与高EBF率相关的关键可修改因素包括产前护理、机构分娩、孕产妇教育和接受母乳喂养咨询。结论：埃塞俄比亚的EBF仍然不平衡，低于最佳水平。在常规产前和基于设施的产妇服务中加强有组织的母乳喂养支持，为改善国家EBF结果提供了重要机会。

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

Breastfeeding Medicine OBSTETRICS & GYNECOLOGY-PEDIATRICS

CiteScore

4.20

自引率

11.10%

发文量

130

审稿时长

6-12 weeks

期刊介绍： Breastfeeding Medicine provides unparalleled peer-reviewed research, protocols, and clinical applications to ensure optimal care for mother and infant. The Journal answers the growing demand for evidence-based research and explores the immediate and long-term outcomes of breastfeeding, including its epidemiologic, physiologic, and psychological benefits. It is the exclusive source of the Academy of Breastfeeding Medicine protocols. Breastfeeding Medicine coverage includes: Breastfeeding recommendations and protocols Health consequences of artificial feeding Physiology of lactation and biochemistry of breast milk Optimal nutrition for the breastfeeding mother Breastfeeding indications and contraindications Managing breastfeeding discomfort, pain, and other complications Breastfeeding the premature or sick infant Breastfeeding in the chronically ill mother Management of the breastfeeding mother on medication Infectious disease transmission through breast milk and breastfeeding The collection and storage of human milk and human milk banking Measuring the impact of being a “baby-friendly” hospital Cultural competence and cultural sensitivity International public health issues including social and economic issues.