Exclusive breastfeeding practice in Ethiopia and its association with antenatal care and institutional delivery: a systematic review and meta-analysis

Abstract

BackgroundDespite the World Health Organization recommendation of exclusive breastfeeding (EBF) for the first six months of life, the rate remains low both in developed and developing countries. In Ethiopia, findings regarding the prevalence of EBF have been highly variable. Antenatal care and institutional delivery are the most important factors contributing to the practice of EBF however; their effect has not been investigated in Ethiopia.MethodsIn this systematic review and meta-analysis, international databases were systematically searched. All observational studies reporting the prevalence of EBF and its association with antenatal care and institutional delivery in Ethiopia were considered. Two authors independently extracted all necessary data using a standardized data extraction format. A random effects meta-analysis model was computed to estimate the pooled prevalence of exclusive breastfeeding. Moreover, the association of antenatal care and institutional delivery with EBF was determined.ResultsAfter reviewing 619 studies, 32 studies fulfilled the inclusion criteria and were included in the meta-analysis. The pooled prevalence of EBF in Ethiopia was 59.3% (95% Confidence Interval [CI] 53.8, 64.8). The subgroup analysis indicated that the highest prevalence was observed in Afar region (65.6%), followed by SNNP (63.8%), and then by Oromia (61.8%). Additionally, mothers who attended antenatal visits were 2.1 times more likely to practice EBF compared to their counterparts (Odds Ratio [OR] 2.1; 95% CI 1.5, 2.8). Moreover, mothers who gave birth at a health institution were 2.2 times more likely to practice EBF compared to mothers who gave birth at home (OR 2.2; 95% CI 1.3, 3.5).ConclusionsExclusive breastfeeding in Ethiopia was significantly lower than the global recommendations. There was evidence that mothers who attended antenatal visits and who gave birth at health institutions had better EBF practices. Based on our findings, we strongly recommended that the utilization of antenatal care and institutional delivery should be improved through health extension workers.

The role of maternal health care services as predictors of time to modern contraceptive use after childbirth in Northwest Ethiopia: Application of the shared frailty survival analysis

“…It is evidenced that these group of women oftentimes do not realize that they are at risk of pregnancy when they are amenorrheic or breastfeeding [15,20,26]. Though breastfeeding is universal in Ethiopia, and exclusive breastfeeding up to 6 months after birth is an important contraceptive method which is highly recommended by the Ministry of Health of Ethiopia, the status of exclusive breastfeeding in the country is less than the global recommendations [31].…”

The state of child nutrition in Ethiopia: an umbrella review of systematic review and meta-analysis reports

“…Additionally, one article was found by hand searching of the reference lists of the included studies. Thus, a total of 9 studies [4,[22][23][24][25][26][27][28][29] were included in the current umbrella review. The study selection and screening process is shown in Fig.…”

“…Health [22][23][24][26][27][28][29] Lack of antenatal care Lack of postnatal care Place of delivery Sociodemographic [22][23][24][26][27][28][29] [26][27][28][29] Place of residence IYCF, Infant and young child feeding.…”

“…Table 3 shows the reported and calculated (pooled) summary estimates of IYCF practices. Seven SRM studies [22][23][24][26][27][28][29] examined factors associated with sub-optimal IYCF practices and reported a number of health, sociodemographic, and environmental factors. Home delivery (i.e., instead of intuitional delivery), not attending antenatal care, postnatal care, and nutritional counseling services were the main health-related factors often found linked to sub-optimal IYCF practices.…”

Effect of gender of new-born, antenatal care and postnatal care on breastfeeding practices in Ethiopia: Evidence from systematic review and meta-analysis of national studies

“…In Ethiopia, two meta-analyses studies were conducted. 10,11 In our previous meta-analysis, we investigated the association between maternal employment, lactation counseling, mode of delivery, place of delivery, maternal age, new-born age and discarding colostrum and, TIBF and EBF. 7,12 We also investigated whether TIBF associated with EBF.…”