Department of Nutrition, Faculty of Medicine, Universitas Indonesia Indonesia-Dr. Cipto Mangunkusumo National Central Hospital, Jakarta, Indonesia.
Department of Nutrition Science, Faculty of Health Science, Universitas Muhammadiyah Surakarta, Surakarta, Indonesia.
PLoS One. 2023 Nov 28;18(11):e0294900. doi: 10.1371/journal.pone.0294900. eCollection 2023.
Early initiation of breastfeeding (EIBF) is key to reducing neonatal morbidity and mortality, however, little is known about the determinants of the trends of EIBF prevalence in Indonesia. This study aims to assess the contributing factors to the changes in the prevalence of EIBF between 2007 and 2017.
We analysed data from the 2007, 2012, and 2017 Indonesia Demographic and Health Surveys to estimate the trends in EIBF. A multivariate logistic decomposition model was fitted to examine variables associated with changes in the percentage of EIBF from 2007 to 2017. The contributing factors to changes in EIBF prevalence were categorized into either compositional or behavioural changes, with each of them divided into portions or percentages of contribution (pct) of the independent variables. The former refers to the changes in the distribution of samples, while the latter refers to the changes in the behavioural responses toward EIBF in both surveys. All analyses accounted for the complex study design and potential confounding factors.
An increase in the prevalence of EIBF from 49.9% to 56.5% was recorded between 2012 and 2017, with an overall increase of 16.9 percentage points from 2007 to 2017. At the aggregate level, the compositional differences did not significantly contribute to the changes in the percentage of EIBF, while 98.3pct (p < 0.001) was associated with changes in mothers' behavioural response towards EIBF. The composition changes in the geographical region of Sumatra, and caesarean delivery negatively contributed to the changes in EIBF prevalence with -0.6pct and -14.2pct, respectively. However, the compositional differences in those living in Kalimantan & Sulawesi, first-time mothers, and small-born infants positively contributed to the change. Behaviour changes in mothers with higher education (8.8pct), from higher income households (-17.5pct), and those residing in Sumatra (-8.2pct) and Kalimantan & Sulawesi (-10.2pct) significantly contributed to the upward trend in EIBF prevalence.
Almost half of the newborns experienced delayed breastfeeding initiation despite the improvement in the prevalence of EIBF. Therefore, further research and interventions on behaviour change in mother's attitudes towards EIBF, especially among those undergoing caesarean delivery, living in Kalimantan or Sulawesi, and from wealthier households, are recommended to close this gap.
尽早开始母乳喂养（EIBF）是降低新生儿发病率和死亡率的关键，但人们对印度尼西亚 EIBF 流行率趋势的决定因素知之甚少。本研究旨在评估 2007 年至 2017 年间 EIBF 流行率变化的促成因素。
我们分析了 2007 年、2012 年和 2017 年印度尼西亚人口与健康调查的数据，以估计 EIBF 的趋势。使用多变量逻辑分解模型来检查 2007 年至 2017 年 EIBF 百分比变化相关的变量。将导致 EIBF 流行率变化的因素分为构成性或行为性变化，其中每一种变化都分为样本分布变化的部分或百分比（pct）和对 EIBF 的行为反应变化。前者是指样本分布的变化，后者是指对两个调查中 EIBF 的行为反应的变化。所有分析都考虑了复杂的研究设计和潜在的混杂因素。
2012 年至 2017 年间，EIBF 的流行率从 49.9%上升到 56.5%，2007 年至 2017 年间总体上升了 16.9 个百分点。在总体水平上，构成性差异对 EIBF 百分比的变化没有显著贡献，而 98.3pct（p<0.001）与母亲对 EIBF 的行为反应变化有关。苏门答腊地区的地理区域以及剖腹产分娩的构成变化分别对 EIBF 流行率的变化产生负面影响，分别为-0.6pct 和-14.2pct。然而，在那些生活在加里曼丹和苏拉威西、初产妇以及出生体重较小的婴儿中，构成性差异对变化有积极影响。母亲教育程度较高（8.8pct）、收入较高的家庭（-17.5pct）以及居住在苏门答腊（-8.2pct）和加里曼丹和苏拉威西（-10.2pct）的母亲行为变化对 EIBF 流行率的上升趋势有显著贡献。
尽管 EIBF 的流行率有所提高，但仍有近一半的新生儿经历了延迟母乳喂养的开始。因此，建议进一步研究和干预母亲对 EIBF 的态度的行为变化，特别是在接受剖腹产、居住在加里曼丹或苏拉威西以及来自富裕家庭的母亲中，以缩小这一差距。
Zotero 插件