2019 年埃塞俄比亚 0-23 个月儿童奶瓶喂养的空间差异及决定因素：空间和多层次分析。
Spatial variations and determinants of bottle feeding among children aged 0-23 months in Ethiopia in 2019: A spatial and multi-level analysis.
机构信息
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Physiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
PLoS One. 2024 Sep 26;19(9):e0311051. doi: 10.1371/journal.pone.0311051. eCollection 2024.
BACKGROUND
Bottle feeding should be avoided since it interferes with optimal breastfeeding and it causes diarrheal-related morbidity and mortality. Despite the WHO's recommendation that children to avoid bottle feeding, it is still widely practiced in developing countries including our country, Ethiopia. Therefore, this study aimed to assess the spatial variations, and determinants of bottle feeding among children aged 0-23 months using the recent demographic and health survey data for Ethiopia.
METHODS
A secondary data analysis was conducted using the 2019 Ethiopian mini demographic and health survey data. The total weighted sample of 2067 children aged 0-23 months was included in this study. Spatial analysis was done to identify the hotspot areas of bottle feeding among children in Ethiopia. Multivariable multilevel logistic regression was used to identify predictors of bottle feeding. The spatial analysis was done using ArcGIS 10.7 and Sat Scan 9.6 software.
RESULT
The prevalence of bottle feeding among children aged 0-23 months was 21.52% with 95% CI(19.80%, 23.34%). Age of the child from 6-11 months, and 12-23 months age, having secondary and above education [AOR = 2.09; 95%CI; 1.31, 3.32], being from middle and rich household [AOR = 2.14; 95%CI; 1.37, 3.34] and [AOR = 2.30; 95%CI; 1.46, 3.63], and twin birth [AOR = 8.06; 95%CI; 2.87, 22.58] were significant predictors of bottle feeding. Hotspot areas of bottle feeding were observed in Addis Ababa, Dire Dawa, Harari, and Afar regions of Ethiopia.
CONCLUSION
Bottle feeding practice was found to be spatially clustered in Ethiopia. Education, wealth index, parity, and child's age were significant predictors of bottle feeding. Hotspot areas of bottle feeding were observed in Addis Ababa, Dire Dawa, Harari, and Afar regions. Special attention should be directed towards mothers residing in hotspot areas, educated mothers, mothers of multiple births, and mothers from rich households through community education programs focused on child feeding practices to reduce the practice of bottle-feeding in Ethiopia.
背景
奶瓶喂养应予以避免，因为它会干扰最佳母乳喂养，并导致与腹泻相关的发病率和死亡率。尽管世界卫生组织建议儿童避免奶瓶喂养，但在包括埃塞俄比亚在内的发展中国家，这种做法仍然很普遍。因此，本研究旨在利用最近的埃塞俄比亚人口与健康调查数据，评估 0-23 个月儿童奶瓶喂养的空间变化及其决定因素。
方法
使用 2019 年埃塞俄比亚微型人口与健康调查数据进行二次数据分析。本研究共纳入了 2067 名 0-23 个月龄儿童的总加权样本。对埃塞俄比亚儿童奶瓶喂养的热点地区进行了空间分析。采用多变量多层逻辑回归分析鉴定奶瓶喂养的预测因素。空间分析使用了 ArcGIS 10.7 和 Sat Scan 9.6 软件。
结果
0-23 个月儿童奶瓶喂养的流行率为 21.52%（95%CI，19.80%，23.34%）。6-11 个月和 12-23 个月龄的儿童，接受过中等或高等教育（AOR=2.09；95%CI，1.31，3.32）、来自中高收入家庭（AOR=2.14；95%CI，1.37，3.34）和（AOR=2.30；95%CI，1.46，3.63）、双胞胎（AOR=8.06；95%CI，2.87，22.58）是奶瓶喂养的显著预测因素。在埃塞俄比亚的亚的斯亚贝巴、德雷达瓦、哈拉里和阿法尔地区观察到奶瓶喂养的热点地区。
结论
在埃塞俄比亚，奶瓶喂养的做法存在空间聚集性。教育、财富指数、胎次和儿童年龄是奶瓶喂养的显著预测因素。在亚的斯亚贝巴、德雷达瓦、哈拉里和阿法尔地区观察到奶瓶喂养的热点地区。应特别关注居住在热点地区的母亲、受过教育的母亲、多胎母亲和富裕家庭的母亲，通过以儿童喂养行为为重点的社区教育方案，减少埃塞俄比亚的奶瓶喂养行为。
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