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      Determinants of early initiation of breastfeeding in Ethiopia: a population-based study using the 2016 demographic and health survey data

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          Abstract

          Background

          Timely breastfeeding initiation is a simple but important measure that has protective effects on infants and mothers. This study aims to determine the predictors of early breastfeeding initiation among mothers residing in Ethiopia.

          Methods

          This study employed the 2016 Ethiopian Demographic and Health Survey data. A total of 5546 children born during the last 24 months at the time of survey were included for analysis from nine regional states and two city administration areas. Socio-demographic and socio-economic factors including individual, household and community-level factors were examined of their significance against the outcome variable of early initiation of breastfeeding using a mixed-effect logistic regression model.

          Results

          The proportion of infants who had timely initiation of breastfeeding was 74.3% ( n = 3064). In the multivariate logistic regression analysis, mothers who delivered with assistance of one or more health professionals had 68% (AOR 1.68; 95% CI: 1.23, 2.29) higher odds of initiating timely breastfeeding. In addition, mothers delivering by a caesarean section had 86% reduced odds of early breastfeeding initiation (AOR 0.14; 95% CI: 0.09, 0.22) when compared to mothers who had vaginal delivery. In terms of socio-demographic factors, the odds of early breastfeeding initiation were more than two and half times higher particularly for mothers residing particularly in Oromiya (AOR 2.58; 95% CI: 1.84, 3.63) and Southern Nations Nationalities and Peoples (SNNP) (AOR 2.75; 95% CI: 1.86, 4.05). In addition, timely breastfeeding initiation was also significantly associated with wealth index with wealthier mothers having 43% higher odds compared to mothers of poorest households (AOR 1.43; 95% CI: 1.07, 1.92). Other factors such as age, gender and birth order of the infant also had significant associations with early breastfeeding initiation.

          Conclusion

          Early breastfeeding initiation in Ethiopia is inextricably associated with various socio-demographic, biomedical, and socio-economic factors. The study findings can potentially inform mothers and the wider community on the benefits of timely breastfeeding initiation and policymakers and community leaders to target health promotional interventions and resources where needed.

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          Most cited references26

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          Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India.

          Using data from India, we estimate the relationship between household wealth and children's school enrollment. We proxy wealth by constructing a linear index from asset ownership indicators, using principal-components analysis to derive weights. In Indian data this index is robust to the assets included, and produces internally coherent results. State-level results correspond well to independent data on per capita output and poverty. To validate the method and to show that the asset index predicts enrollments as accurately as expenditures, or more so, we use data sets from Indonesia, Pakistan, and Nepal that contain information on both expenditures and assets. The results show large, variable wealth gaps in children's enrollment across Indian states. On average a "rich" child is 31 percentage points more likely to be enrolled than a "poor" child, but this gap varies from only 4.6 percentage points in Kerala to 38.2 in Uttar Pradesh and 42.6 in Bihar.
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            Timing of initiation, patterns of breastfeeding, and infant survival: prospective analysis of pooled data from three randomised trials.

            (2016)
            Although the benefits of exclusive breastfeeding for child health and survival, particularly in the post-neonatal period, are established, the independent beneficial effect of early breastfeeding initiation remains unclear. We studied the association between timing of breastfeeding initiation and post-enrolment neonatal and post-neonatal mortality up to 6 months of age, as well as the associations between breastfeeding pattern and mortality.
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              Determinants of early initiation of breastfeeding in Nigeria: a population-based study using the 2013 demograhic and health survey data

              Background Provision of mother’s breast milk to infants within one hour of birth is referred to as Early Initiation of Breast Feeding (EIBF) which is an important strategy to reduce perinatal and infant morbidities and mortality. This study aimed to use recent nationally representative survey data to identify individual, household and community level factors associated with EIBF and to update on previous knowlegde with regards to EIBF in Nigeria. Methods We used cross-sectional data from the 2013 Nigerian Demographic and Health Survey (NDHS). Chi-square tests and binary logistic regression were used to test for association between EIBF and individual, household and community level factors. Result The proportion of infants who initiated breastfeeding within 1 h of birth was 34.7 % (95 % Confidence Interval (CI): 33.9–35.6). In the multivariate analysis, mothers who delivered in a health facility were more likely to initiate breastfeeding early as compared to mothers who delivered at home (Adjusted Odds Ratio (AOR) =1.40, 95 % CI = 1.22–1.60). The odds of EIBF was three times higher for mothers who had vaginal delivery as compared to mothers who had caesarean section (AOR = 3.08, 95 % CI = 2.14–4.46). Other factors that were significantly associated with increased likelihood of EIBF were; multiparity, large sized infant at birth, not working mothers as compared to mothers working in sales and other sectors, wealthier household index and urban residence. Mothers in the South West were less likely to inititiate breastfeeding within 1 h of birth as compared to the North West, however, the following geopolitical zones; North East, North Central, and South South had higher likelihood of EIBF when compared to the North West geopolitical zone. Conclusion EIBF in Nigeria is not optimal with just about 34.7 % of children initiating breastfeeding within one hour of birth, the results suggest that breastfeeding programmes and policies should give special attention to “rural mothers, working mothers, primiparous mothers, mothers with ceasarean deliveries, home deliveries and poor mothers” and this intervention should cut across geopolitical zones with more emphasis to zones with lower rates of EIBF.
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                Author and article information

                Contributors
                jjohn@cmcrc.com
                sabuj.km@brac.net
                getkoo@yahoo.com
                narendar.manohar@hotmail.com
                a.arora@westernsydney.edu.au
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                13 February 2019
                13 February 2019
                2019
                : 19
                : 69
                Affiliations
                [1 ]ISNI 0000 0000 9939 5719, GRID grid.1029.a, School of Nursing and Midwifery, Western Sydney University, ; Campbelltown, NSW Australia
                [2 ]GRID grid.454004.1, Capital Markets Cooperative Research Centre, ; Sydney, Australia
                [3 ]ISNI 0000 0001 0746 8691, GRID grid.52681.38, BRAC James P Grant School of Public Health, BRAC University, ; Dhaka, Bangladesh
                [4 ]ISNI 0000 0004 1936 826X, GRID grid.1009.8, University of Tasmania, Faculty of Health, School of Health Sciences, ; Launceston, Tasmania Australia
                [5 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, ; Gondar, Ethiopia
                [6 ]ISNI 0000 0000 9939 5719, GRID grid.1029.a, School of Science and Health, , Western Sydney University, ; Campbelltown, NSW Australia
                [7 ]ISNI 0000 0000 9939 5719, GRID grid.1029.a, Translational Health Research Institute, Western Sydney University, ; Campbelltown, NSW Australia
                [8 ]Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW Australia
                [9 ]ISNI 0000 0004 1936 834X, GRID grid.1013.3, Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, , The University of Sydney, ; Westmead, NSW Australia
                Article
                2211
                10.1186/s12884-019-2211-0
                6373137
                30760226
                8d61958e-8f16-4081-9287-803455b7c2a9
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 26 September 2018
                : 1 February 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Obstetrics & Gynecology
                timely initiation,ethiopia,breastfeeding,mothers,infants
                Obstetrics & Gynecology
                timely initiation, ethiopia, breastfeeding, mothers, infants

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