埃塞俄比亚新兴地区的母亲中，实行纯母乳喂养的不到五分之一：对 2016 年埃塞俄比亚人口与健康调查的多层次分析。
Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey.
机构信息
Department of Health Systems and Policy, Institute of Public health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia.
出版信息
BMC Public Health. 2021 Jan 4;21(1):18. doi: 10.1186/s12889-020-10071-2.
BACKGROUND
The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia.
METHODS
In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices.
RESULTS
Overall, 17.6% (95% CI: 15.6-19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21-0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16-0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21-4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16-0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44-4.82) was the community-level factors associated with the exclusive breastfeeding practices.
CONCLUSIONS
Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother's employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.
背景
纯母乳喂养（EBF）覆盖率低对新生儿健康以及家庭和社会经济都有重大影响。尽管埃塞俄比亚的 EBF 实践普及率较低，但在牧区，这一比例尤其低，受到个人和社区层面因素的影响。此外，其不良后果大多未被认识到。因此，本研究旨在评估埃塞俄比亚新兴地区 EBF 实践覆盖率低的个人和社区层面因素。
方法
本分析使用了 2016 年埃塞俄比亚人口与健康调查（EDHS）的数据。采用两阶段分层抽样技术，在埃塞俄比亚新兴地区确定了 1406 名 0 至 23 月龄儿童。采用多水平混合效应二元逻辑回归分析，确定与纯母乳喂养实践相关的个人和社区层面因素。在最终模型中，p 值<0.05 且具有 95%置信区间（CI）的调整比值比（AOR）被认为是影响纯母乳喂养实践的统计学显著因素。
结果
总体而言，0 至 23 月龄的儿童中，有 17.6%（95%CI：15.6-19.6）接受了纯母乳喂养。母亲就业（AOR：0.33，95%CI：0.21-0.53）、较富裕的家庭财富状况（AOR：0.39，95%CI：0.16-0.96）、母亲尚未决定要生育更多子女（AOR：2.29，95%CI：1.21-4.29）、儿童有腹泻史（AOR：0.31，95%CI：0.16-0.61）是个人层面因素，而本尚古勒-古马兹州（AOR：2.63，95%CI：1.44-4.82）是与纯母乳喂养实践相关的社区层面因素。
结论
埃塞俄比亚新兴地区不到五分之一的母亲实施了纯母乳喂养。个人层面的因素，如母亲的就业状况、家庭财富状况、对生育更多子女的愿望、腹泻的存在，以及社区层面的因素，如地区，都导致了纯母乳喂养的低覆盖率。因此，联邦和地区卫生局及其他执行者应通过提高认识和加强现有的社区为基础的扩展方案，向这些新兴地区强调这一点，以增强纯母乳喂养实践。
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