Socioeconomic Inequality in Exclusive Breastfeeding Behavior and Ideation Factors for Social Behavioral Change in Three North-western Nigerian States: a Cross-sectional Study.

Abstract

BackgroundSocioeconomic inequalities could mitigate the impact of social and behavior change (SBC) interventions aimed at improving positive ideation towards the practice of exclusive breastfeeding. This study explores the empirical evidence of inequalities in the practice of exclusive breastfeeding (EBF) and associated ideational domains of the theory of Strategic Communication and Behavior Change in three north-western Nigeria states. MethodsWe used cross‐sectional data from 3,007 randomly selected women with under-two-year-old children; the convenient regression method was applied to estimate the concentration indexes of exclusive breastfeeding behavior, ranked by household wealth index. Inequality was decomposed to associated ideational factors and sociodemographic determinants. Avoidable inequalities and the proportion of linear redistribution to achieve zero inequality were estimated. ResultsWomen from wealthier households were more likely to practice exclusive breastfeeding (CIx = 0.1236, p-value = 0.00). Attendance of at least four antenatal clinic visits (ANC 4+) was the most significant contributor to the inequality, contributing CIx = 0.0307 (p-value = 0.00) to the estimated inequality in exclusive breastfeeding practice. The elasticity of exclusive breastfeeding behavior with respect to partners influencing decision to breastfeed and ANC4+, were 0.1484 (p-value = 0.00) and 0.0825 (p-value = 0.00) respectively. Inequality in the regular attendance at community meetings (CIx = 0.1887, p-value =0.00); ANC 4+) (CIx = 0.3722, p-value = 0.00); and maternal age (CIx = 0.0161, p-value = 0.00) were pro-rich. A 10.7% redistribution of exclusive breastfeeding behavior from the wealthier half to the poorer half of the population could eliminate the inequality (line of zero inequality). Inequalities were mainly in the cognitive and social norms domain and were all pro-poor.ConclusionSocioeconomic inequalities exist in exclusive breastfeeding behaviour: the associated ideations in the study states but are mostly avoidable. A 10.7% redistribution from wealthier to the poorer half of the population will achieve elimination. Messaging for SBC communication interventions to improve breastfeeding practices could be more effective by targeting the mitigation of these inequalities.

Fats in Human Milk: 2022 Updates on Chemical Composition

“…199 Unfortunately, rapid urbanization and social limitations have been major constraints in promoting HM feedings. 200,201 Worldwide, only 35-40% of infants receive HM from birth to 6 months of age. [202][203][204][205] Breastfeeding rates diverge widely along the lines of race, socioeconomic status, and ethnicity (summarized in Figure 4).…”

Determinantes económicos, sociales y de salud que inciden en la lactancia materna exclusiva en Colombia

“…Aún según Finnie et al 4 y el de Osorio Castaño & Botero Ortíz 38 , la práctica de amamantamiento resulta una opción rentable para las madres en la medida en que se evita la compra de leches de fórmula. No obstante, otros estudios han encontrado que el abandono a la LME era más frecuente entre las mujeres de bajo nivel socioeconómico 39,40,41 , esto potencialmente siendo el resultado de que las familias pobres tienen acceso limitado a asesoría alimentaria nutricional y, por tanto, es más difícil que construyan una ideación positiva de la apropiación de hábitos de vida saludable como la lactancia materna exclusiva y continuada. Estos hallazgos resaltan la necesidad de realizar otros estudios, en contextos culturales diversos que permitan concluir sobre el efecto de las condiciones socioeconómicas de la madre y el abandono a la LME.…”