Are childbirth location and mode of delivery associated with favorable early breastfeeding practices in hard to reach areas of Bangladesh?

Abstract

Background Early initiation of breastfeeding within one hour of birth (EIBF) and no prelacteal feeding are WHO recommended practices for improving maternal and newborn health outcomes. Globally, EIBF can avert around 22% of newborn death. In recent years, Bangladesh has experienced increasing facility delivery coverage and cesarean section rates. However, the impact of these changes on early breastfeeding initiation in hard to reach areas (HtR) of the country is still poorly understood. Therefore, this study aimed to examine the independent associations between childbirth locations and mode of delivery with favorable early breastfeeding practices in four hard to reach areas of Bangladesh. Method We extracted data from a cross-sectional study conducted in four HtR areas of Bangladesh in 2017. A total of 2768 women, having birth outcomes in the past 12 months of the survey, were interviewed using structured questionnaires. EIBF and no prelacteal feeding were considered as favorable early breastfeeding practices. The categories of childbirth locations were defined by the place of birth (home vs. facility) and the delivery sector (public/NGO vs. private). The mode of delivery was categorized into vaginal delivery and cesarean section. Generalized linear models were used to test the independent associations while adjusting for potential confounders. Results The prevalence of EIBF practices were 69.6%(95% CI:67.8–71.3); 72.2%(95% CI:67.8–71.3) among home births Vs 63.0%(95% CI:59.5%-66.4%) among facility births. Around 73.9% (95% CI:72.3–75.6) mother’s in the study areas reported no-prelacteal feeding. Compared to home births, women delivering in the facilities had lower adjusted odds of EIBF (aOR = 0.51; 95%CI:0.35–0.75). Cesarean section was found to be negatively associated with EIBF (aOR = 0.20; 95%CI:0.12–0.35), after adjusting for potential confounders. We could not find any significant associations between the place of birth and mode of delivery with no prelacteal feeding. Discussions This study found that facility births and cesarean deliveries were negatively associated with EIBF. Although the implementation of "Baby-Friendly Hospital Initiatives" could be a potential solution for improving EIBF and no prelacteal feeding practices, the challenges of reduced service availability and accessibility in HtR areas must be considered while devising effective intervention strategies. Future studies can explore potential interventions to promote early breastfeeding for facility births and cesarean deliveries in HtR areas.

Bottleneck analysis of maternal and newborn health services in hard-to-reach areas of Bangladesh using ‘TANAHASHI’ framework’: An explanatory mixed-method study

“…To ensure full coverage through UHC packages for maternal and newborn health (MNH) a strong, efficient, well-functioning health system is required to ensure availability, easy accessibility, acceptability, and effective utilization of existing health services by the poor population without facing any financial hardship [ 14 ]. In the last few decades, the government has focused on the improvement of Primary Health Care (PHC) infrastructure has sought the attention of the government [ 15 , 16 ], but yet, challenges exist regarding health of the people living in the Hard to Reach (HtR) areas like insufficient health professionals and medical logistics, which causes high maternal and child mortality, malnutrition, and other infections, as suggested by the studies conducted in those regions, and gaps exist in comparison to the recent most national representative survey for maternal and newborn health indicators [ 9 , 14 , 17 – 19 ]. For instance, the immunization rate among the children aged 12–23 months was 44% in comparison to the national coverage of 71%, as documented by a study conducted in 2009 [ 20 ].…”

Determinants of Exclusive Breastfeeding Practice in Gorontalo Province

“…Mothers giving birth at home were 5 times more likely to exclusively breastfeed than mothers giving birth at hospitals [35]. For women who had delivered in the facilities, the adjusted odds of initiating breastfeeding within one hour of birth were 49% lower than the women who had delivered at home [36].…”

Continuing breastfeeding for at least two years after birth in rural Vietnam: prevalence and psychosocial characteristics

“…We also found that mothers who gave birth in commune health centres or at another location were more likely to continue breastfeeding for two or more years than mothers who gave birth in provincial or district hospitals evening after adjusting for socioeconomic status (other factors such as mother’s age, education and occupation; and father’s education and occupation); and sex of child. Women in Bangladesh were significantly more likely to initiate breastfeeding within the first hour of birth if they gave birth at home than if they gave birth in a facility [ 48 ]. In a hospital in Ho Chi Minh City, the prevalence of exclusive breastfeeding was lower than the national prevalence in Vietnam [ 49 ].…”