Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010–2015)

Abstract

ObjectivesTo carry out a meta-analysis to assess the prevalence of four key breastfeeding indicators in four subregions of 29 sub-Saharan African countries.Design, settings and participantsThe 29 countries were categorised into four subregions, and using cross-sectional data from the most recent Demographic and Health Surveys (2010–2015) of these countries prevalence of each of four key breastfeeding indicators was estimated for each of the subregions by carrying out a meta-analysis. Due to the presence of significant heterogeneity among the various surveys (I2>50%), a random-effect analytic model was used, and sensitivity analysis was performed to examine the effects of outliers.Main outcome variablesEarly initiation of breast feeding, exclusive breast feeding, predominant breast feeding and bottle feeding.ResultsThe overall prevalence ofearly initiation of breast feedingvaried between a lowest of 37.84% (95% CI 24.62 to 51.05) in Central Africa to a highest of 69.31% (95% CI 67.65 to 70.97) in Southern Africa; the overall prevalence ofexclusive breast feedingranged between a lowest of 23.70% (95% CI 5.37 to 42.03) in Central Africa to a highest of 56.57% (95% CI 53.50 to 59.95) in Southern Africa; the overall prevalence ofpredominant breast feedingranged between a lowest of 17.63% (95% CI 12.70 to 22.55) in East Africa and a highest of 46.37% (95% CI 37.22 to 55.52) in West Africa; while the prevalence ofbottle feedingvaried between a lowest of 8.17% (95% CI 5.51 to 10.84) in West Africa and a highest of 30.05% (95% CI 28.42 to 31.69) in Southern Africa.ConclusionsWest Africa and Central Africa recorded lower overall prevalence ofearly initiation of breast feedingandexclusive breast feedingthan the WHO’s recommended target of 50% by the year 2025. Intervention for improved breastfeeding practices in sub-Saharan Africa should target West and Central Africa, while intervention to minimise bottle feeding should target Southern Africa.