Background
Methods
Study setting
Data source and population
Variables of the study and operational definition
Data management and analysis
Ethical consideration
Results
Infant characteristics
Variables | Categories | Weighted frequency (%) | EBF prevalence | |
---|---|---|---|---|
No (%) | Yes (%) | |||
Age of infant | 0–1 month | 388 (32.78) | 101 (25.78) | 288 (74.22) |
2–3 months | 378 (31.96) | 136 (35.89) | 243 (64.11) | |
4–5 months | 418 (35.26) | 267 (64.02) | 150 (35.98) | |
Sex of infant | Male | 580 (48.93) | 248 (42.75) | 331 (57.25) |
Female | 605 (51.07) | 255 (42.14) | 350 (57.85) | |
Birth interval | No previous birth | 278 (23.43) | 137 (49.28) | 141 (50.71) |
< 24 months | 118 (9.92) | 53 (45.29) | 64 (54.71) | |
≥24 months | 790 (66.65) | 314 (39.74) | 476 (60.26) | |
Birth order | First | 278 (23.43) | 137 (49.45) | 141 (50.54) |
2–3 | 335 (28.27) | 131 (39.10) | 204 (60.89) | |
4+ | 572 (48.29) | 236 (41.25) | 336 (58.74) | |
Infant Comorbidities* | Yes | 296 (24.99) | 162 (54.72) | 134 (45.27) |
No | 885 (74.64) | 342 (38.64) | 543 (61.36) | |
TimeofBF initiation** | Immediatelyafter birth | 817 (68.95) | 317 (38.80) | 500 (61.20) |
Within hours | 284 (23.92) | 126 (44.36) | 158 (55.64) | |
Within days | 60 (5.06) | 36 (60.00) | 24 (40.00) | |
Birth weight | Low | 24 (2.02) | 14 (58.34) | 10 (41.66) |
Normal | 165 (13.93) | 69 (41.82) | 96 (58.18)) | |
Macrosomia | 21.27 (1.80) | 10 (47.62) | 11 (52.38) | |
Didn’t weighted | 841 (70.97) | 365 (43.40) | 476 (56.6) | |
Don’t know | 134 (11.24) | 46 (34.32) | 88 (65.68) |
Maternal socio-demographic and socioeconomic factors
Variables | Categories | Weighted frequency (%) | EBF prevalence | |
---|---|---|---|---|
No (%) | Yes (%) | |||
Age of the mother (years) | 15–24 | 397 (33.49) | 166 (41.81) | 231 (58.19) |
25–34 | 573 (48.41) | 246 (42.85) | 328 (57.15) | |
35–49 | 215 (18.11) | 92 (42.99) | 122 (57.01) | |
Marital status | Not in union | 44 (3.70) | 22 (50.00) | 22 (50.00) |
Currently in union | 1141 (96.30) | 482 (42.24) | 659 (57.76) | |
Maternal education | No formal education | 698 (60.96) | 298 (42.69) | 400 (57.31) |
Primary | 368 (31.01) | 152 (41.30) | 216 (58.70) | |
Secondary and above | 119 (10.07) | 54 (45.37) | 65 (54.63) | |
Maternal occupation | Currently Not working | 738 (62.28) | 332 (44.98) | 406 (55.01) |
Currently Working | 447 (37.72) | 172 (38.47) | 275 (61.53) | |
household family size | < 5 | 312 (26.31) | 130 (41.66) | 182 (58.34) |
5–6 | 401 (33.87) | 153 (38.15) | 248 (61.85) | |
7–8 | 320 (27.03) | 150 (46.88) | 170 (52.12) | |
≥9 | 152 (12.78) | 70 (46.35) | 81 (53.65) | |
Number of under five children | 0–1 | 401 (33.87) | 168 (41.89) | 233 (58.10) |
2 | 504 (42.52) | 203 (40.27) | 301 (49.73) | |
3 | 278 (23.61) | 133 (47.50) | 147 (52.50) | |
Wealth index | Poorest | 291 (24.53) | 131 (45.01) | 160 (54.09) |
Poorer | 277 (23.40) | 101 (36.46) | 176 (63.54) | |
Middle | 217 (18.35) | 98 (45.16) | 119 (54.84) | |
Richer | 215 (18.18) | 114 (52.77) | 102 (47.23) | |
Richest | 184 (15.53) | 61 (33.15) | 123 (66.84) | |
Media exposure | No | 781 (65.92) | 324 (41.48) | 457 (58.51) |
Yes | 404 (34.08) | 180 (44.55) | 224 (55.45) |
Obstetric and health care related factors
Variables | Categories | Weighted N (%) | EBF prevalence | |
---|---|---|---|---|
No (%) | Yes (%) | |||
Parity | Nulliparous | 278 (23.43) | 137 (49.3) | 141 (50.7) |
Multiparous | 907 (76.57) | 367 (40.46) | 540 (59.53) | |
ANC visit* | No | 412 (34.80) | 195 (47.33) | 217 (52.67) |
Yes | 770 (64.95) | 309 (40.12) | 461 (59.87) | |
Place of delivery | Home | 732 (61.80) | 318 (43.44) | 414 (56.56) |
Health institution | 453 (38.20) | 186 (41.05) | 267 (58.95) | |
Caesarian delivery | No | 1150 (97.06) | 486 (42.26) | 664 (57.74) |
Yes | 35 (2.94) | 18 (51.42) | 17 (48.58) | |
Delivery assistance | Professionals | 741 (62.52) | 323 (43.58) | 418 (56.42) |
TBAs | 444 (37.48) | 181 (40.76) | 263 (59.23) | |
PNC visit | No | 1111 (93.77) | 465 (41.85) | 646 (58.15) |
Yes | 74 (6.23) | 39 (52.70) | 35 (47.29) |
Community level factors
Variables | Categories | Weighted frequency N (%) | EBF prevalence | |
---|---|---|---|---|
No (%) | Yes (%) | |||
Residence | Urban | 137 (11.56) | 58 (42.33) | 79 (57.67) |
Rural | 1048 (88.44) | 446 (42.55) | 602((57.45) | |
Contextual region | Agrarian | 1086 (91.66) | 451 (41.52) | 635 (58.47) |
Pastoralist | 65 (5.50) | 38 (58.46) | 27 (41.54) | |
City based | 34 (2.84) | 15 (44.11) | 19 (55.89) | |
Community ANC utilization | Low | 253 (21.37) | 109 (43.09) | 144 (56.91) |
Moderate | 719 (60.70) | 304 (42.29) | 415 (57.71) | |
High | 213 (17.93) | 112 (43.07) | 148((56.92) | |
Community PNC utilization | Low | 1168 (98.56) | 498 (42.63) | 670 (57.37) |
High | 17 (1.44) | 6 (35.30) | 11 (64.70) | |
Community poverty level | High | 344 (29.01) | 143 (41.70) | 200 (58.30) |
Moderate | 346 (29.22) | 149 (43.06) | 197 (56.93) | |
Low | 495 (41.77) | 211 (42.63) | 284 (57.37) | |
Community media utilization | Low | 840 (70.89) | 346 (41.19) | 494 (58.80) |
Moderate | 217 (18.29) | 96 (44.23) | 121 (55.76) | |
High | 128 (10.82) | 63 (49.22) | 65 (50.78) | |
Community women | Low | 840 (70.85) | 359 (42.73) | 481 (57.26) |
education | Moderate | 244 (20.62) | 90 (36.89) | 154 (63.11) |
High | 101 (8.52) | 55 (54.45) | 46 (45.54) | |
Community maternal employment status | Low | 838 (70.73) | 377 (44.99) | 461 (55.01) |
High | 347 (29.27) | 127 (36.70) | 220 (63.40) |
Individual and community level determinants of exclusive breastfeeding practice
Fixed effects (measures of association)
Variables | Categories | Model one | Model two AOR (95%CI) | Model three AOR (95%CI) | Model four AOR (95%CI) |
---|---|---|---|---|---|
Age of infant | 0–1 month | 1 | 1 | ||
2–3 months | 0.34 (0.21,0.56)*** | 0.39 (0.23, 0.65) *** | |||
4–5 months | 0.05 (0.02,0.08)*** | 0.042(.02, 0.07) *** | |||
Sex of infant | Male | 1 | 1 | ||
Female | 2.43 (1.61,3.65) *** | 2.51 (1.61, 3.91) *** | |||
Birth interval | No previous birth | 1 | 1 | ||
< 24 months | 4.27 (1.36, 13.39)* | 3.44 (0 1.19, 9.92) | |||
> = 24 months | 2.73 (1.00, 7.41) | 1.84 (0.74, 4.54) | |||
Birth order | First | 1 | 1 | ||
2–3 | 2.71 (0.99, 7.34) | 1.821 (0.15, 2.86) | |||
4+ | 3.32 (0.93,11.87) | 1.46 (0.97, 2.18) | |||
Infant comorbidities | No | 1 | 1 | ||
Yes | 0.34 (0.19, 0.56)*** | 0.35 (0 .21, 0.57)*** | |||
Time of BF initiation | Immediately after birth | 1 | 1 | ||
Within hours | 1.05 (0.63, 1.76) | 1.96 (0 .68, 5.65) | |||
Within days | 0.57 (0.19, 1.71) | 2.02 (0 .66, 6.15) | |||
Birth weight | Low | 1 | 1 | ||
Normal | 4.40 (0.67,28.74) | 2.91 (0.49, 17.20) | |||
Macrosomia | 2.72 (0.23, 31.39) | 2.28 (0.21, 24.30) | |||
Didn’t weighted | 2.64 (0.39, 17.77) | 1.86 (0.30, 11.49) | |||
Don’t know | 2.05 (0.30, 13.95) | 1.67 (0 .271, 10.360) | |||
Marital status | Not in union | 1 | 1 | ||
Currently in union | 2.36 (0.93, 6.04) | 1.98 (0.75, 5.21) | |||
Maternal education | No formal education | 1 | 1 | ||
Primary | 1.18 (0.64, 2.17) | 1.50 (0.84, 2.70) | |||
> = Secondary | 0.50 (0.15,1.66) | 0.90 (0.30, 2.69) | |||
Maternal occupation | Currently not working | 1 | 1 | ||
Currently Working | 0.58 (0.32,1.02) | 0.65 (0 .37, 1.12) | |||
Number of household members | < 5 | 1 | 1 | ||
5–6 | 2.20 (1.11,4.36) | 0.84 (0 .36, 1.97) | |||
7–8 | 0.61 (0.26,1.42) | 1.27 (0.623, 2.60) | |||
> = 9 | 1.16 (0.427,3.16) | 0.48 (0.23, 0.96) | |||
Number of under five children | 0–1 | 1 | 1 | ||
2 | 1.052 (0.49,2.22) | 1.65 (0.72, 3.82) | |||
> = 3 | 0.876 (0.36,2.09) | 1.52 (0 .86, 2.69) | |||
Wealth index | Poorest | 1 | 1 | ||
Poorer | 1.99 (1.01, 3.93)* | 1.72 (0.90, 3.31) | |||
Middle | 1.33 (0.58, 3.05) | 1.37 (0 .61, 3.07) | |||
Richer | 0 .90 (0.34,2.36) | 0.94 (0.37, 2.39) | |||
Richest | 15.79 (4.2, 59.39)*** | 10.34 (3.14, 34.03)*** | |||
Parity | Nuliparous | 1 | 1 | ||
Multiparous | 1.61 (1.11, 2.33)* | 2.21 (0.95, 5.11) | |||
ANC visit | No | 1 | 1 | ||
Yes | 2.75 (1.53, 4.94)** | 2.25 (1.32, 3.82)** | |||
Caesarian delivery | No | 1 | 1 | ||
Yes | 0.53 (0.14, 2.04) | 0.47 (0 .128, 1.73) | |||
PNC visit in 2 months | No | 1 | 1 | ||
Yes | 0.10 (0.03, 0.30) * | 0.15 (0 .054, 1 .45) | |||
Residence | Urban | 1 | 1 | ||
Rural | 0.85 (0.36, 2.027) | 3.414 (0 .82, 14.109) | |||
Contextual region | Agrarian | 1 | 1 | ||
Pastoralist | 0.38 (0.17, 0.85)* | 0.30 (0 .10, 0.86)* | |||
City based | 0.99 (0.32 3.00) | 0.56 (0 .12, 2.52) | |||
Community ANC utilization | Low | 1 | 1 | ||
Moderate | 0.97 (0.51, 1.87) | 1.07 (0 .56, 2.02) | |||
High | 1.09 (0.46, 2.56) | 1.30 (0 .62, 2.71) | |||
Community PNC utilization | Low | 1 | 1 | ||
High | 1.42 (0.34, 5.97) | 2.77 (1.26, 6.58)* | |||
Community poverty level | High | 1 | 1 | ||
Moderate | 0.79 (0.39, 1.60) | 0.97 (0.33, 2.84) | |||
Low | 0.83 (0.42,1.62) | 0.99 (0.31, 3.10) | |||
Community media utilization | Low | 1 | 1 | ||
Moderate | 0.83 (0.45, 1.53) | 0.86 (0 .351, 2.13) | |||
High | 0.60 (0.26, 1.42) | 0.84 (0.23, 3.02) | |||
Community women education | Low | 1 | |||
Moderate | 1.16 (0.63, 2.14) | 1.13 (0 .454, 2.83) | |||
High | 0.52 (0.22,1.21) | 0.53 (0.13, 2.06) | |||
Community employment status | Low | 1 | 1 | ||
High | 1.536 (0.91, 2.59) | 2.81 (1.207, 6.47)* |
Random effects (measures of variation)
Characters | Model 1 | Model 2 | Model 3 | Model 4 | |
---|---|---|---|---|---|
Random effect | Variance | 0.54 | 0.45 | 0.31 | 0.32 |
Measure of variation | ICC | 14.08% | 12.13% | 8.64% | 8.77% |
PCV | Reference | 20.77% | 42.3% | 46.8%a | |
MOR | 2.01 | 1.83 | 1.69 | 1.71a | |
Model diagnostics | Log-likelihood | − 750.82 | − 593.21 | −745.80 | − 571.89a |
DIC | 1501.64 | 1186.42 | 1491.6 | 1183.78a | |
AIC | 1505.64 | 1248.41 | 1511.60 | 1235.77a |