Tariku Amare, Persson Lars, Schellenberg Joanna, Marchant Tanya, Berhanu Della, Lemma Seblewengel, Defar Atkure, Zemedu Theodros Getachew, Denu Zewditu Abdissa, Delele Tadesse Guadu, Shiferaw Solomon, Zeleke Girum Taye, Zelalem Meseret, Gelaye Kassahun Alemu
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Department of Disease Control, London School of Hygiene & Tropical Medicine, London, UK.
BMJ Open. 2025 Jan 2;15(1):e088762. doi: 10.1136/bmjopen-2024-088762.
To assess the geographical equity in Ethiopian infants' exclusive breastfeeding at 5 months and dietary diversity at 12 months and whether social factors explained the spatial inequities.
Secondary analysis of a birth cohort study.
Analysis of data from the Ethiopian Performance Monitoring for Action panel study conducted from July 2020 to August 2021 in five regions (ie, Oromia, Amhara, Afar and Southern Nations, Nationalities and Peoples regions and the Addis Ababa City administration). We analysed geographical autocorrelation to assess geographical variations in exclusive breastfeeding and dietary diversity. Areas with higher and lower coverage of appropriate infant feeding outcomes were analysed using hotspot analyses. We performed geographically weighted regression to investigate whether sociodemographic factors explained the geographical feeding differences.
1850 infants were prospectively followed from birth to 12 months.
Exclusive breastfeeding at 5 months and minimum-level dietary diversity at 12 months.
Sixty-nine percent (95% CI 67 to 71) of infants were exclusively breastfed at 5 months, while at 12 months, only 16% (95% CI 13 to 19) had complementary feeding from five or more food groups. There were geographical variations in the coverage of exclusive breastfeeding and minimum dietary diversity. Higher proportions of infants were exclusively breastfed at 5 months in northern areas, and more 12-month-old infants in central parts of the country had complementary feeding from at least five food groups. Sociodemographic factors explained a quarter of the geographical variation in dietary diversity.
Most Ethiopian infants were exclusively breastfed, which was in line with global recommendations but with some geographical differences. There was prominent geographical variation in dietary diversity, partly explained by social factors, but overall, very few 12-month-old infants were fed from at least five food groups. This low dietary quality could impair Ethiopian children's physical growth, development and health.
评估埃塞俄比亚5个月婴儿纯母乳喂养情况和12个月婴儿饮食多样性的地理公平性，以及社会因素是否能解释空间不平等现象。
对一项出生队列研究进行二次分析。
分析2020年7月至2021年8月在五个地区（即奥罗米亚、阿姆哈拉、阿法尔、南方各族州和亚的斯亚贝巴市行政区）开展的埃塞俄比亚行动绩效监测小组研究的数据。我们分析了地理自相关性，以评估纯母乳喂养和饮食多样性的地理差异。使用热点分析对适当婴儿喂养结果覆盖率较高和较低的地区进行了分析。我们进行了地理加权回归，以研究社会人口因素是否能解释地理喂养差异。
1850名婴儿从出生到12个月进行前瞻性随访。
5个月时纯母乳喂养情况和12个月时最低水平饮食多样性。
69%（95%可信区间67%至71%）的婴儿在5个月时进行纯母乳喂养，而在12个月时，只有16%（95%可信区间13%至19%）的婴儿从五个或更多食物组获得辅食。纯母乳喂养覆盖率和最低饮食多样性存在地理差异。北部地区5个月时纯母乳喂养的婴儿比例较高，该国中部地区更多12个月大的婴儿从至少五个食物组获得辅食。社会人口因素解释了饮食多样性地理差异的四分之一。
大多数埃塞俄比亚婴儿进行纯母乳喂养，这符合全球建议，但存在一些地理差异。饮食多样性存在显著的地理差异，部分由社会因素解释，但总体而言，很少有12个月大的婴儿从至少五个食物组获取食物。这种低饮食质量可能会损害埃塞俄比亚儿童的身体生长、发育和健康。
