Teshale Achamyeleh Birhanu, Tesema Getayeneh Antehunegn
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2021 Mar 23;16(3):e0248976. doi: 10.1371/journal.pone.0248976. eCollection 2021.
Despite the significant advantages of timely initiation of breastfeeding (TIBF), many countries particularly low- and middle-income countries have failed to initiate breastfeeding on time for their newborns. Optimal breastfeeding is one of the key components of the SDG that may help to achieve reduction of under-five mortality to 25 deaths per 1000 live births.
To assess the pooled prevalence and associated factors of timely initiation of breastfeeding among mothers having children less than two years of age in sub-Saharan Africa.
We used pooled data from the 35 sub-Saharan Africa (SSA) Demographic and Health Surveys (DHS). We used a total weighted sample of 101,815 women who ever breastfeed and who had living children under 2 years of age. We conducted the multilevel logistic regression and variables with p<0.05, in the multivariable analysis, were declared significantly associated with TIBF.
The pooled prevalence of TIBF in SSA was 58.3% [95%CI; 58.0-58.6%] with huge variation between countries, ranging from 24% in Chad to 86% in Burundi. Both individual and community level variables were associated with TIBF. Among individual-level factors; being older-aged mothers, having primary education, being from wealthier households, exposure to mass media, being multiparous, intended pregnancy, delivery at a health facility, vaginal delivery, single birth, and average size of the child at birth were associated with higher odds of TIBF. Of community-level factors, rural place of residence, higher community level of ANC utilization, and health facility delivery were associated with higher odds of TIBF.
In this study, the prevalence of TIBF in SSA was low. Both individual and community-level factors were associated with TIBF. The authors recommend interventions at both individual and community levels to increase ANC utilization as well as health facility delivery that are crucial for advertising optimal breastfeeding practices such as TIBF.
尽管及时开始母乳喂养（TIBF）有显著优势，但许多国家，尤其是低收入和中等收入国家，未能让其新生儿及时开始母乳喂养。最佳母乳喂养是可持续发展目标的关键组成部分之一，有助于将五岁以下儿童死亡率降至每1000例活产25例死亡。
评估撒哈拉以南非洲地区两岁以下儿童母亲中及时开始母乳喂养的合并患病率及相关因素。
我们使用了来自撒哈拉以南非洲地区35个国家人口与健康调查（DHS）的汇总数据。我们采用了总计101815名曾母乳喂养且有2岁以下在世子女的女性的加权样本。我们进行了多水平逻辑回归分析，在多变量分析中，p<0.05的变量被宣布与TIBF显著相关。
撒哈拉以南非洲地区TIBF的合并患病率为58.3%[95%置信区间；58.0 - 58.6%]，各国之间差异巨大，从乍得的24%到布隆迪的86%不等。个体和社区层面的变量均与TIBF相关。在个体层面因素中，年龄较大的母亲、接受过小学教育、来自较富裕家庭、接触大众媒体、多胎妊娠、计划内怀孕、在医疗机构分娩、顺产、单胎分娩以及出生时婴儿的平均体型与TIBF的较高几率相关。在社区层面因素中，农村居住地点、社区层面较高的产前保健利用率以及在医疗机构分娩与TIBF的较高几率相关。
在本研究中，撒哈拉以南非洲地区TIBF的患病率较低。个体和社区层面的因素均与TIBF相关。作者建议在个体和社区层面进行干预，以提高产前保健利用率以及医疗机构分娩率，这对于宣传诸如TIBF等最佳母乳喂养做法至关重要。
