Tigray Regional Health Bureau, Adi-Daero Health Office, Adi-Daero, Ethiopia.
School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
PLoS One. 2021 Apr 29;16(4):e0241428. doi: 10.1371/journal.pone.0241428. eCollection 2021.
Optimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 children and 20,000 women lost due to in appropriate breastfeeding each year. In Ethiopia, 50,000 children lost related to malnutrition with 18% were due to poor breastfeeding habit. Little is known on the determinants of breastfeeding with hierarchical level. Therefore, this study aimed to identify factors influencing optimal breastfeeding among children under six month in Ethiopia using a multilevel analysis.
The data of this study were obtained from Ethiopian Demographic and health survey conducted from January to June 2016. A total 1,087 children aged 0-5 months were selected using two stage stratified sampling technique. Multilevel logistic regression analysis was done to identify significant explanatory variables. Akaike information criteria were used to select the best model fit. Fixed effect was done to estimate the association between the outcome and explanatory variable and also random effect to measure the variation explained by the higher level.
Among the total of 1,087 children, 45.4% were optimally breastfeed. Children from the richest wealth index (AOR = 2.87; 95% CI: 1.53-5.43) was positively associated with optimal breastfeeding but, children aged 4-5 months (AOR = 0.19; 95%CI: 0.12-0.27), children born through cesarean section (AOR = 0.18; 955 CI: 0.07-0.51) and residing in Afar region (AOR = 0.13; 95%CI: 0.02-0.92) were found inversely associated with optimal breastfeeding. The random-effects showed that the variation between communities was statistically significant.
Individual and community level factors play a significant role in shaping optimal breastfeeding. Future strategies and health interventions should be strengthen to target individual and community level factors that enhance optimal breastfeeding.
最佳母乳喂养对儿童的健康成长至关重要。全球每年有 82 万名儿童和 2 万名妇女因不当母乳喂养而死亡。在埃塞俄比亚，有 5 万名儿童因营养不良而死亡，其中 18%是由于母乳喂养习惯不良。关于母乳喂养与层次水平的决定因素知之甚少。因此，本研究旨在利用多水平分析确定影响埃塞俄比亚 6 个月以下儿童最佳母乳喂养的因素。
本研究的数据来自于 2016 年 1 月至 6 月进行的埃塞俄比亚人口与健康调查。使用两阶段分层抽样技术选择了 1087 名 0-5 个月大的儿童。采用多水平逻辑回归分析确定显著的解释变量。采用赤池信息量准则选择最佳模型拟合。固定效应用于估计结局与解释变量之间的关联，随机效应用于衡量较高水平解释的变异。
在总共 1087 名儿童中，有 45.4%接受了最佳母乳喂养。来自最富裕的财富指数的儿童（AOR = 2.87；95%CI：1.53-5.43）与最佳母乳喂养呈正相关，但 4-5 个月大的儿童（AOR = 0.19；95%CI：0.12-0.27）、通过剖腹产出生的儿童（AOR = 0.18；95%CI：0.07-0.51）和居住在阿法尔地区的儿童（AOR = 0.13；95%CI：0.02-0.92）与最佳母乳喂养呈负相关。随机效应显示社区之间的差异具有统计学意义。
个人和社区层面的因素在塑造最佳母乳喂养方面发挥着重要作用。未来的战略和卫生干预措施应加强针对个人和社区层面的因素，以增强最佳母乳喂养。
