Abstract
Abstract
Background
Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breastfeeding. This study aimed to estimate the trends and magnitude of inequalities in early initiation of breastfeeding practice in Bangladesh from 2004 to 2017 applying both absolute and relative measures of inequality.
Methods
We used data from the last five Bangladesh Demographic Health Survey (BDHS) from 2004 to 2017 to measure the inequalities in early initiation of breastfeeding practice using the WHO’s Health Equity Assessment Toolkit (HEAT) software. Following summary measures were estimated to measure the inequalities: Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) where the equity dimensions were wealth status, education level, sex of child, place of residence, and subnational regions (divisions). For each measure, point estimates along with a 95% confidence interval (CI) were reported.
Results
An uprising pattern in the prevalence of early initiation of breastfeeding was found, where early initiation of breastfeeding increased from 24.9% to 2004 to 59.0% in 2017. We found significant wealth-driven inequalities in early initiation of breastfeeding practice in every wave of survey favoring the poorest wealth quintile (in 2017, D -10.5; 95% CI -16.6 to -4.3). We also identified geographical disparities in early initiation of breastfeeding practice (in 2017, PAF 11.1; 95% CI 2.2 to 19.9) favoring the Rangpur (65.5%), and Sylhet (65.3%) divisions. Education-related disparities were observed in 2004 only, but not in later survey years, which was due to a much lower level of adherence among those with secondary or higher education. There were no significant disparities in early initiation of breastfeeding based on the urban vs. rural residence and sex of the child.
Conclusions
The highest attention should be placed in Bangladesh to attain the WHO’s 100% recommendation of timely initiation of breastfeeding. This study emphasizes on addressing the existing socioeconomic and geographic inequalities. Awareness-raising outreach programs focusing the mothers from wealthier sub-groups and divisions with lower prevalence should be planned and implemented by the joint effort of the government and non-government organizations.
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health
Reference36 articles.
1. World Health Organization. Infant and young child feeding. 2021 (cited 2023 Aug 2). Available from: https://www.who.int/en/news-room/fact-sheets/detail/infant-and-young-child-feeding.
2. UNICEF, Breastfeeding. Too few children benefit from recommended breastfeeding practices. 2022 (cited 2023 Aug 2). Available from: https://data.unicef.org/topic/nutrition/breastfeeding/.
3. National Institute of Population Research and Training (NIPORT) and ICF. Bangladesh Demographic and Health Survey 2017-18. Dhaka, Bangladesh, and Rockville. Maryland, USA: NIPORT and ICF; 2020.
4. Kundu S, Azene AG, Kundu S, Banna MH, Al, Mahbub T, Alshahrani NZ, et al. Prevalence of and factors associated with early initiation of breastfeeding in Bangladesh: a multilevel modelling. Int Health. 2022;15:403–13.
5. World Health Organization. Infant and young child feeding: a tool for assessing national practices, policies and programmes. World Health Organization; 2003.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献