Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis

Abstract

Background Despite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS). Methods Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response. Result Among children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys. Conclusion Early initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.

Trends and determinants of early initiation of breastfeeding in Indonesia: A multivariate decomposition analysis

“…Fewer infants perceived as small at birth in the last survey contributed to the progress of EIBF prevalence in Indonesia. The result also aligned with a previous analysis of LMIC settings [ 39 ]. Determinants analyses also conclude that EIBF is less common among infants who are smaller than average as perceived by mothers [ 32 , 49 , 50 ], as these infants may have specific conditions, such as an illness, that require them to be separated from the mothers for necessary treatments in the Neonatal Intensive Care Unit (NICU).…”

“…Our decomposition analysis showed an expected additional increase in the EIBF growth if the percentage of caesarean delivery in 2017 was at the same level as in the previous ten years. This result was in line with the decomposition analysis from Ethiopia [39]. Further, as the number of women having caesarean deliveries keeps increasing globally and in Indonesia, our findings become more concerning [38].…”

“…Our analysis aligns with that conclusion: the downward trend in the percentage of first-time mothers within a decade positively contributed to the change in EIBF. Previous decomposition analysis in Ethiopia also has a similar result: increasing the number of infants of second and higher birth order positively contributes to the increase in EIBF [ 39 ]. Besides not having breastfeeding experience, first-time mothers are less likely to have adequate knowledge of EIBF and general breastfeeding practices, which influences their attitudes, confidence and decision to adopt this practice [ 45 ].…”

“…This finding aligned with systematic reviews/meta-analyses showing that more educated mothers tend to perform EIBF [ 23 , 36 ]. However, decomposition analysis of the 2005 and 2016 Ethiopian DHS finds maternal education is not among the contributing factors [ 39 ]. The difference might be attributed to variations in methodologies, particularly in which maternal education categories are aggregated and the contextual circumstances in each respective country.…”

Current findings and gaps in early initiation of breastfeeding practices in sub-Saharan African countries: A scoping review

“…Fourteen studies examined the mode of delivery; caesarean sections were found to be associated with higher odds of delayed initiation of breastfeeding across different countries [ 14 - 16 , 19 , 21 , 25 , 27 - 29 , 32 - 36 ]. Seven studies reported that institutional delivery was associated with higher odds of EIBF [ 19 , 22 , 24 , 32 , 34 , 35 , 37 ]. Other studies identified that deliveries by skilled birth attendants were positively associated with EIBF [ 14 , 15 , 17 , 18 , 21 , 38 ].…”