Factors Associated with the Early Initiation of Breastfeeding in Economic Community of West African States (ECOWAS)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Outcome and Confounding Factors
2.2. Statistical Analysis
3. Results
3.1. Characteristics of the Sample and Univariate Analyses for EIBF
3.2. Factors Associated with Early Initiation of Breastfeeding
4. Discussion
5. Limitations and Strengths
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
- Collective, G.B.; UNICEF; World Health Organization. Global Breastfeeding Scorecard, 2017: Tracking Progress for Breastfeeding Policies and Programmes; World Health Organization: Geneva, Switzerland, 2017. [Google Scholar]
- UNICEF. Levels and Trends in Child Mortality: Report 2011; WHO Estimates Developed by the UN Inter-Agency Group for Child Mortality Estimation: New York, NY, USA, 2011. [Google Scholar]
- United Nations. Population Facts; United Nations, Department of Economic and Social Affairs, Population Division: New York, NY, USA, 2017; Volume 6, pp. 1–2. [Google Scholar]
- WHO; UNICEF. Planning Guide for National Implementation of the Global Strategy for Infant and Young Child Feeding; World Health Organization: Geneva, Switzerland, 2007. [Google Scholar]
- WHO; UNICEF; Health WHODoCA. Handbook IMCI: Integrated Management of Childhood Illness; World Health Organization: Geneva, Switzerland, 2005. [Google Scholar]
- Smith, E.R.; Hurt, L.; Chowdhury, R.; Sinha, B.; Fawzi, W.; Edmond, K.M.; Neovita Study Group. Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis. PLoS ONE 2017, 12, e0180722. [Google Scholar] [CrossRef]
- Horta, B.L.; Victora, C.G. Long-Term Effects of Breastfeeding; World Health Organization: Geneva, Switzerland, 2013; Volume 74. [Google Scholar]
- Agho, K.E.; Ogeleka, P.; Ogbo, F.A.; Ezeh, O.K.; Eastwood, J.; Page, A. Trends and Predictors of Prelacteal Feeding Practices in Nigeria (2003–2013). Nutrients 2016, 8, 462. [Google Scholar] [CrossRef]
- Turner, B. Economic Community of West African States (ECOWAS). In The Statesman’s Yearbook; Springer: Berlin, Germany, 2012; pp. 59–60. [Google Scholar]
- DHS. The Demographic and Health Survey Program, 2016 ed.; United States Agency for International Development: Washington, DC, USA, 2016. [Google Scholar]
- Tawiah-Agyemang, C.; Kirkwood, B.; Edmond, K.; Bazzano, A.; Hill, Z. Early initiation of breast-feeding in Ghana: Barriers and facilitators. J. Perinatol. 2008, 28, S46–S52. [Google Scholar] [CrossRef]
- Leung, A.K.C.; Sauve, R.S. Breast is best for babies. J. Nat. Med. Assoc. 2005, 97, 1010–1019. [Google Scholar]
- Hanieh, S.; Ha, T.T.; Simpson, J.A.; Thuy, T.T.; Khuong, N.C.; Thoang, D.D.; Tran, T.D.; Tuan, T.; Fisher, J.; Biggs, B.-A. Exclusive breast feeding in early infancy reduces the risk of inpatient admission for diarrhea and suspected pneumonia in rural Vietnam: A prospective cohort study. BMC Public Health 2015, 15, 1166. [Google Scholar] [CrossRef] [PubMed]
- Arifeen, S.; Black, R.E.; Antelman, G.; Baqui, A.; Caulfield, L.; Becker, S. Exclusive breastfeeding reduces acute respiratory infection and diarrhea deaths among infants in Dhaka slums. Pediatrics 2001, 108, e67. [Google Scholar] [CrossRef] [PubMed]
- Edmond, K.M.; Zandoh, C.; Quigley, M.A.; Amenga-Etego, S.; Owusu-Agyei, S.; Kirkwood, B.R. Delayed breastfeeding initiation increases risk of neonatal mortality. Pediatrics 2006, 117, e380–e386. [Google Scholar] [CrossRef] [PubMed]
- Mullany, L.C.; Katz, J.; Li, Y.M.; Khatry, S.K.; LeClerq, S.C.; Darmstadt, G.L.; Tielsch, J.M. Breast-feeding patterns, time to initiation, and mortality risk among newborns in southern Nepal. J. Nutr. 2008, 138, 599–603. [Google Scholar] [CrossRef]
- Exavery, A.; Kanté, A.M.; Hingora, A.; Phillips, J.F. Determinants of early initiation of breastfeeding in rural Tanzania. Int. Breastfeed. J. 2015, 10, 27. [Google Scholar] [CrossRef] [PubMed]
- Ogbo, F.A.; Page, A.; Agho, K.E.; Claudio, F. Determinants of trends in breast-feeding indicators in Nigeria, 1999–2013. Public Health Nutr. 2015, 18, 3287–3299. [Google Scholar] [CrossRef]
- Ogbo, F.A.; Agho, K.E.; Page, A. Determinants of suboptimal breastfeeding practices in Nigeria: Evidence from the 2008 demographic and health survey. BMC Public Health 2015, 15, 259. [Google Scholar] [CrossRef] [PubMed]
- Adewuyi, E.O.; Zhao, Y.; Khanal, V.; Auta, A.; Bulndi, L.B. Rural-urban differences on the rates and factors associated with early initiation of breastfeeding in Nigeria: Further analysis of the Nigeria demographic and health survey, 2013. Int. Breastfeed. J. 2017, 12, 51. [Google Scholar] [CrossRef] [PubMed]
- Mukora-Mutseyekwa, F.; Gunguwo, H.; Mandigo, R.G.; Mundagowa, P. Predictors of early initiation of breastfeeding among Zimbabwean women: Secondary analysis of ZDHS 2015. Matern. Health Neonatol. Perinatol. 2019, 5, 2. [Google Scholar] [CrossRef] [PubMed]
- Bisrat, Z.; Kenzudine, A.; Bossena, T. Factors associated with early initiation and exclusive breastfeeding practices among mothers of infant’s age less than 6 months. J. Pediatr. Neonatal Care 2017, 7, 00292. [Google Scholar]
- Corsi, D.J.; Neuman, M.; Finlay, J.E.; Subramanian, S. Demographic and health surveys: A profile. Int. J. Epidemiol. 2012, 41, 1602–1613. [Google Scholar] [CrossRef]
- UNICEF; World Health Organization. Capture the Moment: Early Initiation of Breastfeeding: The Best Start for Every Newborn; UNICEF: New York, NY, USA; World Health Organization: Geneva, Switzerland, 2018. [Google Scholar]
- Bortz, K. WHO, UNICEF: 78 million newborns not breastfed within first hour after birth. Infect. Dis. Child. 2018, 31, 19. [Google Scholar]
- Rutstein, S.O.; Johnson, K. The DHS Wealth Index. DHS Comparative Reports No. 6. (ORC Macro, Calverton, MD, 2004). Available online: https://dhsprogram.com/pubs/pdf/CR6/CR6.pdf (accessed on 20 August 2019).
- Rutstein, S.O.; Rojas, G. Guide to DHS Statistics; ORC Macro: Calverton, MD, USA, 2006. [Google Scholar]
- Adhikari, M.; Khanal, V.; Karkee, R.; Gavidia, T. Factors associated with early initiation of breastfeeding among Nepalese mothers: Further analysis of Nepal Demographic and Health Survey, 2011. Int. Breastfeed. J. 2014, 9, 21. [Google Scholar] [CrossRef]
- Berde, A.S.; Yalcin, S.S. Determinants of early initiation of breastfeeding in Nigeria: A population-based study using the 2013 demograhic and health survey data. BMC Pregnancy Childbirth 2016, 16, 32. [Google Scholar] [CrossRef]
- Ndirangu, M.; Gatimu, S.; Mwinyi, H.; Kibiwott, D. Trends and factors associated with early initiation of breastfeeding in Namibia: Analysis of the demographic and health surveys 2000–2013. BMC Pregnancy Childbirth 2018, 18, 171. [Google Scholar] [CrossRef]
- Liben, M.L.; Gemechu, Y.B.; Adugnew, M.; Asrade, A.; Adamie, B.; Gebremedin, E.; Melak, Y. Factors associated with exclusive breastfeeding practices among mothers in dubti town, afar regional state, northeast Ethiopia: A community based cross-sectional study. Int. Breastfeed. J. 2016, 11, 4. [Google Scholar] [CrossRef]
- Okafor, I.; Olatona, F.; Olufemi, O. Breastfeeding practices of mothers of young children in Lagos, Nigeria. Niger. J. Paediatr. 2014, 41, 43–47. [Google Scholar] [CrossRef]
- Awi, D.; Alikor, E. Barriers to timely initiation of breastfeeding among mothers of healthy full-term babies who deliver at the University of Port Harcourt Teaching Hospital. Niger. J. Clin. Pract. 2006, 9, 57–64. [Google Scholar] [PubMed]
- Liben, M.L.; Yesuf, E.M. Determinants of early initiation of breastfeeding in Amibara district, Northeastern Ethiopia: A community based cross-sectional study. Int. Breastfeed. J. 2016, 11, 7. [Google Scholar] [CrossRef] [PubMed]
- Tilahun, G.; Degu, G.; Azale, T.; Tigabu, A. Prevalence and associated factors of timely initiation of breastfeeding among mothers at Debre Berhan town, Ethiopia: A cross-sectional study. Int. Breastfeed. J. 2016, 11, 27. [Google Scholar] [CrossRef] [PubMed]
- Hobbs, A.J.; Mannion, C.A.; McDonald, S.W.; Brockway, M.; Tough, S.C. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. BMC Pregnancy Childbirth 2016, 16, 90. [Google Scholar] [CrossRef] [PubMed]
- Goldie, S.J.; Sweet, S.; Carvalho, N.; Natchu, U.C.M.; Hu, D. Alternative strategies to reduce maternal mortality in India: A cost-effectiveness analysis. PLoS Med. 2010, 7, e1000264. [Google Scholar] [CrossRef] [PubMed]
- Darmstadt, G.L.; Bhutta, Z.A.; Cousens, S.; Adam, T.; Walker, N.; De Bernis, L. Evidence-based, cost-effective interventions: How many newborn babies can we save? Lancet Neonatal Survival Steering Team. Lancet 2005, 365, 977–988. [Google Scholar] [CrossRef]
- Senanayake, P.; O’Connor, E.; Ogbo, F.A. National and rural-urban prevalence and determinants of early initiation of breastfeeding in India. BMC Public Health 2019, 19, 896. [Google Scholar] [CrossRef]
- Subedi, N.; Paudel, S.; Rana, T.; Poudyal, A. Infant and young child feeding practices in Chepang communities. J. Nepal Health Res. Counc. 2012, 10, 141–146. [Google Scholar]
- El Shafei, A.M.H.; Labib, J.R. Determinants of exclusive breastfeeding and introduction of complementary foods in rural Egyptian communities. Glob. J. Health Sci. 2014, 6, 236–244. [Google Scholar] [CrossRef]
- Mekuria, G.; Edris, M. Exclusive breastfeeding and associated factors among mothers in Debre Markos, Northwest Ethiopia: A cross-sectional study. Int. Breastfeed. J. 2015, 10, 1. [Google Scholar] [CrossRef]
- Walker, M. Breastfeeding the late preterm infant. J. Obstet. Gynecol. Neonatal Nurs. 2008, 37, 692–701. [Google Scholar] [CrossRef]
- Mulready-Ward, C.; Sackoff, J. Outcomes and factors associated with breastfeeding for <8 weeks among preterm infants: Findings from 6 states and NYC, 2004–2007. Matern. Child Health J. 2013, 17, 1648–1657. [Google Scholar] [CrossRef]
- Senarath, U.; Siriwardena, I.; Godakandage, S.S.; Jayawickrama, H.; Fernando, D.N.; Dibley, M.J. Determinants of breastfeeding practices: An analysis of the Sri Lanka Demographic and Health Survey 2006–2007. Matern. Child Nutr. 2012, 8, 315–329. [Google Scholar] [CrossRef]
- John, J.R.; Mistry, S.K.; Kebede, G.; Manohar, N.; Arora, A. Determinants of early initiation of breastfeeding in Ethiopia: A population-based study using the 2016 demographic and health survey data. BMC Pregnancy Childbirth 2019, 19, 69. [Google Scholar] [CrossRef] [Green Version]
- Nguyen, P.H.; Keithly, S.C.; Nguyen, N.T.; Nguyen, T.T.; Tran, L.M.; Hajeebhoy, N. Prelacteal feeding practices in Vietnam: Challenges and associated factors. BMC Public Health 2013, 13, 932. [Google Scholar] [CrossRef] [Green Version]
- Khanal, V.; Adhikari, M.; Sauer, K.; Zhao, Y. Factors associated with the introduction of prelacteal feeds in Nepal: Findings from the Nepal demographic and health survey 2011. Int. Breastfeed. J. 2013, 8, 9. [Google Scholar] [CrossRef] [Green Version]
- Khanal, V.; Scott, J.; Lee, A.; Karkee, R.; Binns, C. Factors associated with early initiation of breastfeeding in Western Nepal. Int. J. Environ. Res. Public Health Nutr. 2015, 12, 9562–9574. [Google Scholar] [CrossRef] [Green Version]
- Rowe-Murray, H.J.; Fisher, J.R. Baby friendly hospital practices: Cesarean section is a persistent barrier to early initiation of breastfeeding. Birth 2002, 29, 124–131. [Google Scholar] [CrossRef]
- Tamiru, D.; Mohammed, S. Maternal knowledge of optimal breastfeeding practices and associated factors in rural communities of Arba Minch Zuria. Int. J. Nutr. Food Sci. 2013, 2, 122–129. [Google Scholar] [CrossRef]
- Hailemariam, T.W.; Adeba, E.; Sufa, A. Predictors of early breastfeeding initiation among mothers of children under 24 months of age in rural part of West Ethiopia. BMC Public Health 2015, 15, 1076. [Google Scholar] [CrossRef] [Green Version]
- Lessen, R.; Crivelli-Kovach, A. Prediction of initiation and duration of breast-feeding for neonates admitted to the neonatal intensive care unit. J. Perinat. Neonatal Nurs. 2007, 21, 256–266. [Google Scholar] [CrossRef]
Characteristic | n * | % * | % | EIBF | |||
---|---|---|---|---|---|---|---|
OR | 95% CI | p-Value | |||||
Demographic factors | |||||||
Country | |||||||
Benin | 5937 | 7.7 | 9.2 | 1.00 | |||
Burkina Faso | 6887 | 9.0 | 10.0 | 0.58 | 0.50 | 0.67 | <0.001 |
Cote d’ivoire | 4554 | 5.9 | 5.2 | 0.43 | 0.33 | 0.56 | <0.001 |
The Gambia | 5387 | 7.0 | 6.0 | 0.76 | 0.52 | 1.11 | 0.151 |
Ghana | 3412 | 4.4 | 4.0 | 1.07 | 0.88 | 1.31 | 0.483 |
Guinea | 3574 | 4.6 | 4.7 | 0.17 | 0.13 | 0.22 | <0.001 |
Liberia | 4241 | 5.5 | 5.1 | 1.30 | 0.96 | 1.77 | 0.093 |
4843 | 6.3 | 6.7 | 1.11 | 0.93 | 1.32 | 0.242 | |
Niger | 7044 | 9.2 | 8.1 | 0.90 | 0.75 | 1.08 | 0.262 |
Nigeria | 15,993 | 20.8 | 20.7 | 0.42 | 0.36 | 0.48 | <0.001 |
Senegal | 5790 | 7.5 | 8.1 | 0.35 | 0.29 | 0.41 | <0.001 |
Sierra Leone | 6230 | 8.1 | 7.4 | 0.85 | 0.67 | 1.08 | 0.173 |
Togo | 3042 | 4.0 | 4.8 | 1.49 | 1.23 | 1.79 | <0.001 |
Residence | |||||||
Urban | 27,769 | 36.1 | 31.0 | 1.00 | |||
Rural | 49,165 | 63.9 | 69.0 | 0.96 | 0.85 | 1.08 | 0.468 |
Mothers’ age in years | |||||||
15–19 | 25,575 | 33.2 | 33.4 | 1.00 | |||
20–34 | 36,855 | 47.9 | 46.9 | 1.09 | 1.02 | 1.17 | 0.012 |
35–49 | 14,503 | 18.9 | 19.8 | 1.08 | 0.99 | 1.17 | 0.084 |
Marital status | |||||||
Currently married | 70,916 | 92.2 | 92.7 | 1.00 | |||
Formerly married ^ | 1875 | 2.4 | 2.5 | 1.13 | 0.91 | 1.39 | 0.269 |
Never married | 4142 | 5.4 | 4.8 | 0.98 | 0.83 | 1.17 | 0.863 |
Age of child (months) | |||||||
0–5 | 19,736 | 25.7 | 25.8 | 1.00 | |||
6–11 | 20,308 | 26.4 | 26.9 | 1.02 | 0.93 | 1.12 | 0.657 |
12–17 | 20,402 | 26.5 | 26.0 | 1.07 | 0.98 | 1.16 | 0.138 |
18–23 | 16,488 | 21.4 | 21.3 | 1.10 | 1.00 | 1.21 | 0.047 |
Birth order or birth rank | |||||||
First-born | 15,935 | 20.7 | 20.0 | 1.00 | |||
Second–fourth | 36,840 | 47.9 | 46.6 | 1.26 | 1.16 | 1.36 | <0.001 |
Fifth or more | 24,159 | 31.4 | 33.4 | 1.19 | 1.09 | 1.31 | <0.001 |
Preceding birth interval (n = 76,748) | |||||||
No previous birth | 15,935 | 20.7 | 20.0 | 1.00 | |||
<24 months | 8163 | 10.6 | 10.6 | 1.13 | 1.00 | 1.28 | 0.042 |
≥24 months | 52,650 | 68.4 | 69.2 | 1.25 | 1.16 | 1.35 | <0.001 |
Combined birth rank and birth interval | |||||||
Second/third birth rank, more than two years interval | 30,717 | 39.9 | 39.0 | 1.00 | |||
First birth rank | 15,935 | 20.7 | 20.0 | 0.78 | 0.72 | 0.85 | <0.001 |
Second/third birth rank, less than or equal to two years interval | 6123 | 8.0 | 7.7 | 0.90 | 0.79 | 1.02 | 0.097 |
Fourth birth rank, more than two years interval | 20,520 | 26.7 | 28.4 | 0.94 | 0.87 | 1.02 | 0.120 |
Fourth birth rank, less than or equal to two years interval | 3638 | 4.7 | 5.0 | 0.89 | 0.77 | 1.02 | 0.103 |
Sex of baby | |||||||
Male | 38,723 | 50.3 | 50.6 | 1.00 | |||
Female | 38,211 | 49.7 | 49.4 | 1.05 | 0.99 | 1.11 | 0.120 |
Size of baby (n = 76,255) | |||||||
Small | 13,689 | 17.8 | 17.5 | 1.00 | |||
Average | 32,517 | 42.3 | 42.6 | 1.22 | 1.11 | 1.34 | <0.001 |
Large | 30,049 | 39.1 | 38.9 | 1.19 | 1.07 | 1.31 | 0.001 |
Socio-economic factors | |||||||
Household Wealth Index | |||||||
Poorest | 12,753 | 16.6 | 20.1 | 1.00 | |||
Poorer | 13,520 | 17.6 | 19.7 | 1.35 | 1.19 | 1.54 | <0.001 |
Middle | 15,088 | 19.6 | 19.8 | 1.55 | 1.36 | 1.78 | <0.001 |
Richer | 14,854 | 19.3 | 20.1 | 1.33 | 1.16 | 1.52 | <0.001 |
Richest | 20,719 | 26.9 | 20.5 | 1.25 | 1.07 | 1.46 | 0.005 |
Work in the last 12 months (n = 76,918) | |||||||
Not working | 30,637 | 39.8 | 38.2 | 1.00 | |||
Working | 46,281 | 60.2 | 61.8 | 0.94 | 0.86 | 1.02 | 0.150 |
Maternal education (n = 76,926) | |||||||
No education | 45,527 | 59.2 | 61.6 | 1.00 | |||
Primary | 13,319 | 17.3 | 18.1 | 1.06 | 0.96 | 1.17 | 0.239 |
Secondary and above | 18,080 | 23.5 | 20.4 | 1.03 | 0.93 | 1.14 | 0.549 |
Maternal Literacy (n = 76,549) | |||||||
Cannot read at all | 57,292 | 74.5 | 77.4 | 1.00 | |||
Able to read only part of sentences | 19,257 | 25.0 | 22.1 | 0.96 | 0.88 | 1.04 | 0.341 |
Access to media | |||||||
Frequency of reading newspaper or magazine (n = 76,736) | |||||||
Not at all | 68,490 | 89.0 | 91.5 | 1.00 | |||
Less than once a week | 4575 | 5.9 | 4.8 | 0.93 | 0.81 | 1.08 | 0.356 |
At least once a week | 3644 | 4.7 | 3.7 | 1.10 | 0.92 | 1.32 | 0.281 |
Almost every day | 27 | 0.0 | 0.0 | 2.13 | 0.80 | 5.69 | 0.132 |
Frequency of listening to radio (n = 76,808) | |||||||
Not at all | 25,977 | 33.8 | 36.0 | 1.00 | |||
Less than once a week | 19,798 | 25.7 | 25.0 | 0.95 | 0.87 | 1.04 | 0.300 |
At least once a week | 30,250 | 39.3 | 37.8 | 0.97 | 0.88 | 1.06 | 0.466 |
Almost every day | 783 | 1.0 | 1.1 | 3.27 | 2.49 | 4.29 | <0.001 |
Frequency of watching Television (n = 76,760) | |||||||
Not at all | 42,468 | 55.2 | 59.8 | 1.00 | |||
Less than once a week | 12,287 | 16.0 | 15.1 | 1.01 | 0.90 | 1.13 | 0.861 |
At least once a week | 21,294 | 27.7 | 24.1 | 0.84 | 0.76 | 0.93 | 0.001 |
Almost every day | 711 | 0.9 | 0.8 | 2.60 | 1.97 | 3.44 | <0.001 |
Healthcare utilization factors | |||||||
Place of delivery | |||||||
Home | 31,183 | 40.5 | 41.3 | 1.00 | |||
Health facility | 45,751 | 59.5 | 58.7 | 1.34 | 1.23 | 1.47 | <0.001 |
Mode of delivery (n = 76,729) | |||||||
Non-caesarean | 73,763 | 95.9 | 96.3 | 1.00 | |||
Caesarean section ⱡ | 2966 | 3.9 | 3.5 | 0.39 | 0.32 | 0.49 | <0.001 |
Type of delivery assistance (n = 63,553) | |||||||
Health professional | 49,991 | 65.0 | 62.8 | 1.00 | |||
Traditional birth attendant | 1884 | 2.4 | 2.8 | 0.73 | 0.61 | 0.88 | 0.001 |
Other untrained | 6959 | 9.0 | 10.7 | 0.76 | 0.64 | 0.90 | 0.001 |
No one | 4699 | 6.1 | 6.0 | 0.61 | 0.51 | 0.72 | <0.001 |
Antenatal clinic visits (n = 74,550) | |||||||
None | 9478 | 12.3 | 12.6 | 1.00 | |||
1–3 | 23,314 | 30.3 | 31.9 | 1.55 | 1.36 | 1.77 | <0.001 |
4+ | 41,758 | 54.3 | 52.7 | 1.67 | 1.45 | 1.91 | <0.001 |
Characteristic | Model 1 | Model 2 | Model 3 | Model 4 | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AOR | 95% CI | p-Value | AOR | 95% CI | p-Value | AOR | 95% CI | p-Value | AOR | 95% CI | p-Value | |||||
Demographic factors | ||||||||||||||||
Benin | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
Burkina Faso | 0.58 | 0.50 | 0.67 | <0.001 | 0.56 | 0.48 | 0.65 | <0.001 | 0.56 | 0.48 | 0.66 | <0.001 | 0.58 | 0.48 | 0.69 | <0.001 |
Cote d’ivoire | 0.42 | 0.32 | 0.54 | <0.001 | 0.43 | 0.33 | 0.56 | <0.001 | 0.43 | 0.33 | 0.56 | <0.001 | 0.43 | 0.33 | 0.55 | <0.001 |
The Gambia | 0.75 | 0.51 | 1.09 | 0.134 | 0.73 | 0.50 | 1.07 | 0.109 | 0.75 | 0.51 | 1.11 | 0.148 | 0.67 | 0.44 | 1.02 | 0.062 |
Ghana | 1.08 | 0.88 | 1.34 | 0.460 | 1.11 | 0.89 | 1.38 | 0.351 | 1.15 | 0.92 | 1.43 | 0.212 | 1.33 | 1.03 | 1.72 | 0.028 |
Guinea | 0.17 | 0.13 | 0.22 | <0.001 | 0.17 | 0.13 | 0.23 | <0.001 | 0.17 | 0.13 | 0.23 | <0.001 | 0.19 | 0.14 | 0.25 | <0.001 |
Liberia | 1.30 | 0.95 | 1.79 | 0.106 | 1.34 | 0.96 | 1.87 | 0.081 | 1.34 | 0.96 | 1.87 | 0.085 | 1.44 | 1.04 | 1.98 | 0.028 |
Mali | 1.10 | 0.93 | 1.32 | 0.271 | 1.30 | 1.07 | 1.58 | 0.009 | 1.34 | 1.09 | 1.63 | 0.005 | 1.36 | 1.09 | 1.71 | 0.006 |
Niger | 0.94 | 0.78 | 1.13 | 0.520 | 0.86 | 0.71 | 1.04 | 0.132 | 0.87 | 0.72 | 1.05 | 0.144 | 0.98 | 0.80 | 1.22 | 0.882 |
Nigeria | 0.41 | 0.36 | 0.48 | <0.001 | 0.44 | 0.38 | 0.51 | <0.001 | 0.44 | 0.38 | 0.52 | <0.001 | 0.51 | 0.43 | 0.61 | <0.001 |
Senegal | 0.36 | 0.30 | 0.43 | <0.001 | 0.37 | 0.31 | 0.45 | <0.001 | 0.38 | 0.32 | 0.46 | <0.001 | 0.40 | 0.33 | 0.48 | <0.001 |
Sierra Leone | 0.86 | 0.67 | 1.10 | 0.230 | 0.84 | 0.65 | 1.07 | 0.151 | 0.83 | 0.65 | 1.07 | 0.147 | 0.78 | 0.60 | 1.03 | 0.075 |
Togo | 1.50 | 1.25 | 1.81 | 0.000 | 1.50 | 1.24 | 1.81 | <0.001 | 1.29 | 1.05 | 1.59 | 0.015 | 1.56 | 1.25 | 1.94 | <0.001 |
Residence | ||||||||||||||||
Urban | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
Rural | 0.95 | 0.84 | 1.06 | 0.335 | 0.94 | 0.83 | 1.07 | 0.373 | 0.94 | 0.82 | 1.07 | 0.355 | 0.92 | 0.81 | 1.04 | 0.200 |
Mothers’ age in years | ||||||||||||||||
15–19 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
20–34 | 0.98 | 0.90 | 1.07 | 0.732 | 0.99 | 0.91 | 1.08 | 0.777 | 0.98 | 0.90 | 1.07 | 0.605 | 0.98 | 0.90 | 1.08 | 0.731 |
35–49 | 0.98 | 0.86 | 1.11 | 0.725 | 0.98 | 0.86 | 1.11 | 0.727 | 0.96 | 0.85 | 1.09 | 0.538 | 0.94 | 0.82 | 1.08 | 0.372 |
Marital status | ||||||||||||||||
Currently married | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
Formerly married ^ | 0.99 | 0.79 | 1.26 | 0.957 | 0.99 | 0.78 | 1.26 | 0.940 | 0.99 | 0.78 | 1.26 | 0.952 | 0.98 | 0.76 | 1.26 | 0.894 |
Never married | 0.96 | 0.78 | 1.18 | 0.692 | 0.93 | 0.76 | 1.14 | 0.501 | 0.95 | 0.77 | 1.17 | 0.610 | 0.98 | 0.79 | 1.21 | 0.843 |
Birth rank and birth interval | ||||||||||||||||
Second/third birth rank, more than two years interval | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
First birth rank | 0.78 | 0.71 | 0.86 | <0.001 | 0.78 | 0.70 | 0.86 | <0.001 | 0.77 | 0.70 | 0.85 | <0.001 | 0.78 | 0.69 | 0.87 | <0.001 |
Second/third birth rank, less than or equal to two years interval | 0.89 | 0.78 | 1.03 | 0.123 | 0.89 | 0.77 | 1.02 | 0.098 | 0.89 | 0.77 | 1.03 | 0.105 | 0.91 | 0.78 | 1.07 | 0.268 |
Fourth birth rank, more than two years interval | 0.98 | 0.89 | 1.08 | 0.699 | 0.99 | 0.89 | 1.09 | 0.791 | 1.00 | 0.90 | 1.11 | 0.978 | 1.03 | 0.93 | 1.15 | 0.551 |
Fourth birth rank, less than or equal to two years interval | 0.92 | 0.79 | 1.07 | 0.268 | 0.92 | 0.78 | 1.07 | 0.288 | 0.93 | 0.79 | 1.09 | 0.359 | 0.98 | 0.82 | 1.17 | 0.808 |
Sex of baby | ||||||||||||||||
Male | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
Female | 1.07 | 1.01 | 1.13 | 0.027 | 1.07 | 1.01 | 1.13 | 0.024 | 1.07 | 1.01 | 1.13 | 0.025 | 1.08 | 1.01 | 1.16 | 0.021 |
Age of child (months) | ||||||||||||||||
0–5 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
6–11 | 1.03 | 0.94 | 1.13 | 0.546 | 1.03 | 0.94 | 1.13 | 0.538 | 1.03 | 0.93 | 1.13 | 0.570 | 1.02 | 0.92 | 1.14 | 0.664 |
12–17 | 1.09 | 1.00 | 1.20 | 0.056 | 1.10 | 1.00 | 1.20 | 0.045 | 1.09 | 0.99 | 1.19 | 0.071 | 1.10 | 0.98 | 1.22 | 0.096 |
18–23 | 1.10 | 1.00 | 1.21 | 0.048 | 1.10 | 1.00 | 1.21 | 0.047 | 1.10 | 1.00 | 1.21 | 0.052 | 1.10 | 0.99 | 1.23 | 0.075 |
Size of baby | ||||||||||||||||
Small | 1.00 | 1.00 | 1.00 | 1.00 | ||||||||||||
Average | 1.21 | 1.09 | 1.33 | <0.001 | 1.20 | 1.08 | 1.32 | <0.001 | 1.20 | 1.09 | 1.32 | <0.001 | 1.19 | 1.07 | 1.32 | 0.002 |
Large | 1.23 | 1.11 | 1.37 | <0.001 | 1.22 | 1.10 | 1.36 | <0.001 | 1.22 | 1.10 | 1.36 | <0.001 | 1.20 | 1.07 | 1.36 | 0.002 |
Socio-economic factors | ||||||||||||||||
Household Wealth Index | ||||||||||||||||
Poorest | 1.00 | 1.00 | 1.00 | |||||||||||||
Poorer | 1.29 | 1.13 | 1.48 | <0.001 | 1.32 | 1.15 | 1.51 | <0.001 | 1.19 | 1.02 | 1.38 | 0.028 | ||||
Middle | 1.38 | 1.20 | 1.59 | <0.001 | 1.42 | 1.23 | 1.63 | <0.001 | 1.22 | 1.03 | 1.43 | 0.018 | ||||
Richer | 1.34 | 1.17 | 1.55 | <0.001 | 1.39 | 1.20 | 1.60 | <0.001 | 1.17 | 0.98 | 1.39 | 0.077 | ||||
Richest | 1.16 | 0.98 | 1.36 | 0.083 | 1.19 | 1.00 | 1.43 | 0.052 | 1.03 | 0.84 | 1.26 | 0.782 | ||||
Work in the last 12 months | ||||||||||||||||
Not working | 1.00 | 1.00 | 1.00 | |||||||||||||
Working | 0.95 | 0.86 | 1.04 | 0.243 | 0.95 | 0.87 | 1.04 | 0.291 | 0.95 | 0.87 | 1.05 | 0.329 | ||||
Maternal education | ||||||||||||||||
No education | 1.00 | 1.00 | 1.00 | |||||||||||||
Primary | 1.02 | 0.92 | 1.13 | 0.732 | 1.03 | 0.92 | 1.14 | 0.627 | 1.00 | 0.90 | 1.12 | 0.992 | ||||
Secondary and above | 0.98 | 0.80 | 1.21 | 0.860 | 0.96 | 0.78 | 1.19 | 0.717 | 0.89 | 0.73 | 1.10 | 0.291 | ||||
Maternal Literacy | ||||||||||||||||
Cannot read at all | 1.00 | 1.00 | 1.00 | |||||||||||||
Able to read only part of sentences | 1.04 | 0.87 | 1.24 | 0.690 | 1.00 | 0.82 | 1.21 | 0.985 | 1.02 | 0.85 | 1.23 | 0.811 | ||||
Access to media | ||||||||||||||||
Frequency of reading newspaper or magazine | ||||||||||||||||
Not at all | 1.00 | 1.00 | ||||||||||||||
Less than once a week | 1.11 | 0.93 | 1.32 | 0.255 | 1.06 | 0.89 | 1.27 | 0.508 | ||||||||
At least once a week | 1.33 | 1.09 | 1.63 | 0.006 | 1.36 | 1.10 | 1.67 | 0.004 | ||||||||
Almost every day | 0.91 | 0.33 | 2.51 | 0.856 | 1.01 | 0.40 | 2.50 | 0.990 | ||||||||
Frequency of listening to Radio | ||||||||||||||||
Not at all | 1.00 | 1.00 | ||||||||||||||
Less than once a week | 0.90 | 0.82 | 0.99 | 0.037 | 0.86 | 0.78 | 0.95 | 0.002 | ||||||||
At least once a week | 0.92 | 0.83 | 1.01 | 0.089 | 0.92 | 0.83 | 1.02 | 0.099 | ||||||||
Almost every day | 1.47 | 1.11 | 1.95 | 0.007 | 1.45 | 1.07 | 1.95 | 0.016 | ||||||||
Frequency of watching Television | ||||||||||||||||
Not at all | 1.00 | 1.00 | ||||||||||||||
Less than once a week | 1.03 | 0.90 | 1.18 | 0.660 | 1.00 | 0.86 | 1.17 | 0.967 | ||||||||
At least once a week | 0.95 | 0.84 | 1.06 | 0.333 | 0.90 | 0.80 | 1.02 | 0.104 | ||||||||
Almost every day | 1.17 | 0.85 | 1.60 | 0.335 | 1.14 | 0.82 | 1.60 | 0.438 | ||||||||
Healthcare utilization factors | ||||||||||||||||
Place of delivery | ||||||||||||||||
Home | 1.00 | |||||||||||||||
Health facility | 1.38 | 1.21 | 1.57 | <0.001 | ||||||||||||
Mode of delivery | ||||||||||||||||
Non-caesarean | 1.00 | |||||||||||||||
Caesarean section ⱡ | 0.28 | 0.22 | 0.36 | <0.001 | ||||||||||||
Type of delivery assistance | ||||||||||||||||
Health professional | 1.00 | |||||||||||||||
Traditional birth attendant. | 0.77 | 0.60 | 0.98 | 0.037 | ||||||||||||
Other untrained | 0.96 | 0.79 | 1.16 | 0.663 | ||||||||||||
No one | 0.76 | 0.62 | 0.92 | 0.005 | ||||||||||||
Antenatal Clinic visits | ||||||||||||||||
None | 1.00 | |||||||||||||||
1–3 | 1.17 | 1.00 | 1.37 | 0.052 | ||||||||||||
4+ | 1.20 | 1.01 | 1.41 | 0.034 |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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Ezeh, O.K.; Ogbo, F.A.; Stevens, G.J.; Tannous, W.K.; Uchechukwu, O.L.; Ghimire, P.R.; Agho, K.E.; Global Maternal and Child Health Research Collaboration (GloMACH). Factors Associated with the Early Initiation of Breastfeeding in Economic Community of West African States (ECOWAS). Nutrients 2019, 11, 2765. https://0-doi-org.brum.beds.ac.uk/10.3390/nu11112765
Ezeh OK, Ogbo FA, Stevens GJ, Tannous WK, Uchechukwu OL, Ghimire PR, Agho KE, Global Maternal and Child Health Research Collaboration (GloMACH). Factors Associated with the Early Initiation of Breastfeeding in Economic Community of West African States (ECOWAS). Nutrients. 2019; 11(11):2765. https://0-doi-org.brum.beds.ac.uk/10.3390/nu11112765
Chicago/Turabian StyleEzeh, Osita Kingsley, Felix Akpojene Ogbo, Garry John Stevens, Wadad Kathy Tannous, Osuagwu Levi Uchechukwu, Pramesh Raj Ghimire, Kingsley Emwinyore Agho, and Global Maternal and Child Health Research Collaboration (GloMACH). 2019. "Factors Associated with the Early Initiation of Breastfeeding in Economic Community of West African States (ECOWAS)" Nutrients 11, no. 11: 2765. https://0-doi-org.brum.beds.ac.uk/10.3390/nu11112765