Mulugeta Getahun, Tesfaye Dagne, Tegegne Awoke Seyoum
Department of Statistics, Debre Berhan University, Debre Berhan, Ethiopia.
Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Nutr. 2022 Sep 22;8(1):106. doi: 10.1186/s40795-022-00601-z.
Duration of breastfeeding is the length of the time that infants who were initially breastfed continue to receive breast milk until weaning. The duration of breastfeeding is important for a child's health, growth, and development. However, the duration of breastfeeding decreases from time to time and further leads children to be exposed to malnutrition (stunting, wasting, and weight loss). Children who did not get enough breastfeeding are also exposed to different diseases. Previous studies used a simple survival model and didn't see the shared frailty model on the variable of interest. Therefore, the current study aimed to investigate the factors affecting the duration of breastfeeding among Ethiopian women of reproductive age with babies.
A cross-sectional study design was conducted on 15,400 women of childbearing age with babies in nine regional states and two city administrations. The data source for the analysis was the 2016 EDHS data. The Cox-proportional hazard model, AFT, and parametric shared frailty models were conducted for the current investigation. Weibull-gamma shared frailty model was in favor of others for current data analysis.
Among the covariates, women living in urban area (Φ = 0.96; 95% CI; (0.94,0.97); p-value = 0.001), non-educated women(Φ = 1.03; 95% CI; (1.00,1.06); p-value = 0.039), primary educated women (Φ = 1.13; 95% CI; (1.11,1.15); p-value < 0.001), age of a child (Φ = 0.99; 95% CI; (0.76.0.99); p-value < 0.001) and non-smoker mothers (Φ = 1.60; 95% CI; (1.57, 1.63); p-value < 0.001),birth interval between 2-3 years(Φ = 1.02; 95% CI;(1.09, 1.25, p-value = 0.027), birth interval, > 3 years(Φ = 1.28; 95% CI; (1.06, 1.43); p-value < 0.01 significantly affected the duration of breastfeeding. The median survival time of breastfeeding of women of reproductive age with babies considered under study was 23.4 months. Clustering had a significant effect on the variable of interest.
Residence area, level of education, age of the child, smoking status of women, and birth interval of successive birth significantly affected the duration of breastfeeding in the current investigation. Hence, the health staff should conduct health-related education for young women, educated women, urban women, smoker women, and women with a shorter interval of birth to increase the women's attitude and awareness towards the use of long-duration of breastfeeding.
母乳喂养持续时间是指最初接受母乳喂养的婴儿持续接受母乳直至断奶的时长。母乳喂养持续时间对儿童的健康、生长和发育至关重要。然而，母乳喂养持续时间时常缩短，进而导致儿童面临营养不良（发育迟缓、消瘦和体重减轻）问题。未获得充足母乳喂养的儿童还易患各种疾病。以往研究采用简单生存模型，未考察感兴趣变量上的共享脆弱性模型。因此，本研究旨在调查影响埃塞俄比亚育龄有婴儿妇女母乳喂养持续时间的因素。
对九个地区州和两个市辖区的15400名有婴儿的育龄妇女进行了横断面研究设计。分析的数据来源是2016年埃塞俄比亚 DHS 数据。本次调查采用了Cox比例风险模型、AFT模型和参数共享脆弱性模型。威布尔 - 伽马共享脆弱性模型在当前数据分析中比其他模型更适用。
在协变量中，居住在城市地区的妇女（Φ = 0.96；95%置信区间；(0.94, 0.97)；p值 = 0.001）、未受过教育的妇女（Φ = 1.03；95%置信区间；(1.00, 1.06)；p值 = 0.039）、受过小学教育的妇女（Φ = 1.13；95%置信区间；(1.11, 1.15)；p值 < 0.001）、孩子年龄（Φ = 0.99；95%置信区间；(0.76, 0.99)；p值 < 0.001）以及不吸烟的母亲（Φ = 1.60；95%置信区间；(1.57, 1.63)；p值 < 0.001）、2至3年的生育间隔（Φ = 1.02；95%置信区间；(1.09, 1.25)，p值 = 0.027）、生育间隔大于3年（Φ = 1.28；95%置信区间；(1.06, 1.43)；p值 < 0.01）对母乳喂养持续时间有显著影响。本研究中考虑的有婴儿的育龄妇女母乳喂养的中位生存时间为23.4个月。聚类对感兴趣的变量有显著影响。
在当前调查中，居住地区、教育程度、孩子年龄、妇女吸烟状况以及连续生育的生育间隔显著影响母乳喂养持续时间。因此，卫生工作人员应针对年轻女性、受过教育的女性、城市女性、吸烟女性以及生育间隔较短的女性开展健康教育，以增强她们对延长母乳喂养的态度和意识。
