Tesfa Dejenie Habtewold1,2,3, Aklilu Endalamaw4, Shimels Hussien Mohammed5, Henok Mulugeta6, Getenet Dessie7, Getachew Mullu Kassa6, Yared Asmare8, Mesfin Tadese9, Yihun Mulugeta Alemu10, Nigussie Tadesse Sharew8, Abera Kenay Tura11,12, Balewgizie Sileshi Tegegne13, Sisay Mulugeta Alemu14. 1. Department of Nursing, Institute of Medicine and Health Science, Debre Berhan University, P.O. BOX 445, Debre Berhan, Ethiopia. tesfadej2003@gmail.com. 2. Department of Quantitative Economics, School of Business and Economics, Maastricht University, Maastricht, The Netherlands. tesfadej2003@gmail.com. 3. Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. tesfadej2003@gmail.com. 4. Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. 5. Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 6. Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, Ethiopia. 7. Department of Nursing, School of Health Science, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia. 8. Department of Nursing, Institute of Medicine and Health Science, Debre Berhan University, P.O. BOX 445, Debre Berhan, Ethiopia. 9. Department of Midwifery, Institute of Medicine and Health Science, Debre Berhan University, Debre Berhan, Ethiopia. 10. Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia. 11. Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. 12. School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia. 13. Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. 14. Global Health Unit, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Abstract
OBJECTIVES: To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia. METHODS: PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2, and I2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were conducted. RESULTS: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03-1.89; I2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05-1.55; I2 = 60.9%) and being married (OR 1.39; 95% CI 1.05-1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status. CONCLUSIONS: In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia.
OBJECTIVES: To investigate the association between EBF and educational status, household income, marital status, media exposure, and parity in Ethiopia. METHODS: PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases were searched using key terms for all studies published in English between September 2009 and March 2019. The methodological quality of studies was examined using the Newcastle-Ottawa Scale (NOS) for cross-sectional studies. To obtain the pooled odds ratio (OR), extracted data were fitted in a random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2, and I2 statistics. In addition, Jackknife sensitivity analysis, cumulative meta-analysis, and meta-regression analysis were conducted. RESULTS: Out of 553 studies retrieved, 31 studies fulfilled our inclusion criteria. Almost all included studies were conducted among mothers with newborn less than 23 months old. Maternal primary school education (OR 1.39; 95% CI 1.03-1.89; I2 = 86.11%), medium household income (OR 1.27; 95% CI 1.05-1.55; I2 = 60.9%) and being married (OR 1.39; 95% CI 1.05-1.83; I2 = 76.96%) were found to be significantly associated with EBF. We also observed an inverse dose-response relationship of EBF with educational status and income. However, EBF was not significantly associated with parity, media exposure, and paternal educational status. CONCLUSIONS: In this meta-analysis, we showed the relevant effect of maternal education, income, and marital status on EBF. Therefore, multifaceted, effective, and evidence-based efforts are needed to increase the national level of exclusive breastfeeding in Ethiopia.
Entities:
Keywords:
Breast milk; Breastfeeding; Ethiopia; Exclusive breastfeeding; Meta-analysis
Authors: Karen M Edmond; Charles Zandoh; Maria A Quigley; Seeba Amenga-Etego; Seth Owusu-Agyei; Betty R Kirkwood Journal: Pediatrics Date: 2006-03 Impact factor: 7.124