Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2024 May 16;19(5):e0302143. doi: 10.1371/journal.pone.0302143. eCollection 2024.
Early initiation of breastfeeding (EIBF), within the first hour of birth, is crucial for promoting exclusive breastfeeding and establishing optimal nursing practices. However, global EIBF rates remain low, with even lower rates observed in Africa. Despite existing research gaps, this study aims to determine the prevalence of EIBF and identify maternal and child-related factors associated with its practice in West Africa.
This study utilized West African Demographic and Health Survey (DHS) data from 13 countries, including 146,964 children's records. To assess model fit, likelihood test and deviance were used. Similarly, intraclass correlation coefficient, median odds ratio, and proportional change in variance were employed for random effect. A multilevel logistic regression model was used to identify individual- and community-level factors influencing EIBF due to the hierarchical nature of the data. Variables with p-values ≤0.2 in the binary model and <0.05 in the final analysis were considered significantly associated with EIBF.
The pooled prevalence of EIBF in West African nations was 50.60% (95% CI; 50.34-50.85%). The highest prevalence rate was observed in Serra Leone (75.33%) and the lowest prevalence was found in Senegal (33.94%). In the multilevel multiple logistic regression model, maternal education (AOR = 1.10, 95% CI, 1.03,1.16), marital status AOR = 1.07, 95% CI, 1.01,1.13), birth weight (AOR = 0.91, CI 0.86,0.96), birth orders (AOR = 1.09, CI 1.03,1.16), and (AOR = 1.11, CI 1.03,1.19), place of residence (AOR = 1.14, CI 1.07,1.21), and mode of delivery type (AOR = 0.26, CI 0.24,0.29) were significantly correlated with EIBF in West Africa.
The incidence of EIBF in West Africa was found to be low. The study emphasizes the need for targeted behavioral change communication programs to address timely breastfeeding initiation, specifically targeting mothers and child characteristics. Factors such as education, delivery mode, marital status, birth weight, birth order, and place of residence were significantly associated with EIBF. Special attention should be given to improving EIBF rates among women undergoing caesarean sections, infants with low birth weight, and primiparous mothers, along with structural improvements in the healthcare sector in West Africa.
在出生后的第一个小时内尽早开始母乳喂养（EIBF）对于促进纯母乳喂养和建立最佳哺乳实践至关重要。然而，全球 EIBF 率仍然很低，非洲的比率甚至更低。尽管存在研究空白，但本研究旨在确定西非 EIBF 的流行率，并确定与实践相关的母婴因素。
本研究使用了来自 13 个国家的西非人口与健康调查（DHS）数据，其中包括 146964 名儿童的记录。为了评估模型拟合度，使用似然检验和偏差。同样，对于随机效应，使用了组内相关系数、中位数优势比和方差的比例变化。由于数据的层次性质，使用多水平逻辑回归模型来确定影响 EIBF 的个体和社区层面的因素。在二元模型中 p 值≤0.2 且在最终分析中 p 值<0.05 的变量被认为与 EIBF 显著相关。
在西非国家，EIBF 的总体流行率为 50.60%（95%CI；50.34-50.85%）。塞拉利昂的流行率最高（75.33%），塞内加尔的流行率最低（33.94%）。在多水平多项逻辑回归模型中，母亲教育（AOR=1.10，95%CI，1.03，1.16），婚姻状况 AOR=1.07，95%CI，1.01，1.13），出生体重（AOR=0.91，CI 0.86，0.96），出生顺序（AOR=1.09，CI 1.03，1.16），（AOR=1.11，CI 1.03，1.19），居住地（AOR=1.14，CI 1.07，1.21），和分娩方式（AOR=0.26，CI 0.24，0.29）与西非的 EIBF 显著相关。
在西非，EIBF 的发生率较低。研究强调需要开展有针对性的行为改变交流计划，以解决及时开始母乳喂养的问题，特别是针对母亲和儿童的特征。教育、分娩方式、婚姻状况、出生体重、出生顺序和居住地等因素与 EIBF 显著相关。应特别关注提高在西非进行剖腹产的妇女、低出生体重婴儿和初产妇的 EIBF 率，并改善西非医疗保健部门的结构。
Zotero 插件