scholarly journals Impact of caesarean section on breastfeeding indicators: within-country and meta-analyses of nationally representative data from 33 countries in sub-Saharan Africa

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027497
Author(s):  
Engida Yisma ◽  
Ben W Mol ◽  
John W Lynch ◽  
Lisa G Smithers
Keyword(s):  
Caesarean Section ◽  
Exclusive Breastfeeding ◽  
Meta Analysis ◽  
Early Initiation ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Early Initiation Of Breastfeeding ◽  
Sub Saharan ◽  
The Impact ◽  
Initiation Of Breastfeeding

ObjectiveTo examine the impact of caesarean section on breastfeeding indicators—early initiation of breastfeeding, exclusive breastfeeding under 6 months and children ever breastfed (at least once)—in sub-Saharan Africa.DesignSecondary analysis of Demographic and Health Surveys (DHS).SettingThirty-three low-income and middle-income countries with a survey conducted between 2010 and 2017/2018.ParticipantsWomen aged 15–49 years with a singleton live last birth during the 2 years preceding the survey.Main outcome measuresWe analysed the DHS data to examine the impact of caesarean section on breastfeeding indicators using the modified Poisson regression models for each country adjusted for potential confounders. For each breastfeeding indicator, the within-country adjusted prevalence ratios (aPR) were pooled in random-effects meta-analysis.ResultsThe within-country analyses showed, compared with vaginal birth, caesarean section was associated with aPR for early initiation of breastfeeding that ranged from 0.24 (95% CI 0.17 to 0.33) in Tanzania to 0.89 (95% CI 0.78 to 1.00) in South Africa. The aPR for exclusive breastfeeding under 6 months ranged from 0.58 (95% CI 0.34 to 0.98) in Angola to 1.93 (95% CI 0.46 to 8.10) in Cote d'Ivoire, while the aPR for children ever breastfed ranged from 0.91 (95% CI 0.82 to 1.02) in Gabon to 1.02 (95% CI 0.99 to 1.04) in Gambia. The meta-analysis showed caesarean section was associated with a 46% lower prevalence of early initiation of breastfeeding (pooled aPR, 0.54 (95% CI 0.48 to 0.60)). However, meta-analysis indicated little association with exclusive breastfeeding under 6 months (pooled aPR, 0.94 (95% CI 0.88 to 1.01)) and children ever breastfed (pooled aPR, 0.98 (95% CI 0.98 to 0.99)) among caesarean versus vaginally born children.ConclusionsCaesarean section had a negative influence on early initiation of breastfeeding but showed little difference in exclusive breastfeeding under 6 months and children ever breastfed in sub-Saharan Africa.

scholarly journals Consistency of the determinants of early initiation of breastfeeding in Ghana: insights from four Demographic and Health Survey datasets

2020 ◽  
Author(s):  
Precious A Duodu ◽  
Henry O Duah ◽  
Veronica M Dzomeku ◽  
Adwoa B Boamah Mensah ◽  
Josephine Aboagye Mensah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Early Initiation ◽  
Demographic And Health Surveys ◽  
Current Estimate ◽  
Neonatal Deaths ◽  
Early Initiation Of Breastfeeding ◽  
Multiple Variable ◽  
Using Data ◽  
Initiation Of Breastfeeding

Abstract Background Early initiation of breastfeeding (EIBF) is a key strategy in averting neonatal deaths. However, studies on the facilitators and risk factors for EIBF are rare in Ghana. We examined trends in EIBF and its major facilitators and risk factors in Ghana using data from Demographic and Health Surveys from 1998 to 2014. Methods We used complete weighted data of 3194, 3639, 2909 and 5695 pairs of mothers ages 15–49 y and their children ages 0–5 y in the 1998, 2003, 2008 and 2014 surveys, respectively. We accounted for the complex sampling used in the surveys for both descriptive statistics and multiple variable risk ratio analysis. Results The proportion of children who achieved EIBF increased by about 2.5 times from 1998 to 2003 and there was a marginal increase in the proportion of children who achieved EIBF between 2003 and 2014. Children born by caesarean section were at higher risk of being breastfed later than 1 h across all four surveys. Being born in the Upper East Region (compared with the Western Region) of Ghana facilitated EIBF in 2003 and 2008. Conclusions The study revealed that the current estimate of the proportion of children achieving EIBF in Ghana was 55.1%, and delivery by caesarean section and region of residence consistently predicted the practice of EIBF in Ghana.

scholarly journals Breastfeeding Interpersonal Communication and Mobile Phone Support by Private Health Care Providers in Lagos, Nigeria Increased Exclusive Breastfeeding at 6 and 24 Weeks

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 642-642
Author(s):  
Valerie Flax ◽  
Abiodun Ipadeola ◽  
Courtney Schnefke ◽  
Uche Ralph-Opara ◽  
Olatoun Adeola ◽  
...  
Keyword(s):  
Interpersonal Communication ◽  
Support Groups ◽  
Health Care Providers ◽  
Exclusive Breastfeeding ◽  
Early Initiation ◽  
Care Providers ◽  
Logistic Regression Models ◽  
Early Initiation Of Breastfeeding ◽  
The Impact ◽  
Initiation Of Breastfeeding

Abstract Objectives Interventions to improve breastfeeding practices have not been tested in private facilities in Nigeria, although most urban facilities are private. The objective of this study was to measure the impact of Alive & Thrive's intervention on breastfeeding intentions, early initiation of breastfeeding, and exclusive breastfeeding among clients of private facilities in Lagos, Nigeria. Methods The intervention included breastfeeding interpersonal communication during facility visits, breastfeeding text/WhatsApp messages, WhatsApp support groups, and social behavior change communication materials. Logistic regression models adjusted for clustering were used to detect differences in a cohort of women (N = 1,200) at 10 intervention and 10 comparison facilities interviewed during their third trimester and at 6 and 24 weeks postpartum. Results During pregnancy, intention to exclusively breastfeed at 6 weeks postpartum was 92% in both study arms, but more women in the intervention than comparison arm intended to exclusively breastfeed at 24 weeks postpartum (78% intervention, 64% comparison, p < 0.001). Early initiation of breastfeeding did not differ by study arm (35% intervention, 33% comparison). More women in the intervention than comparison arm exclusively breastfed at 6 weeks (83% intervention, 76% comparison, p = 0.02) and 24 weeks postpartum (66% intervention, 52% comparison, p < 0.001). Among women exclusively breastfeeding at 6 weeks, the odds of continued exclusive breastfeeding at 24 weeks was higher in the intervention than comparison arm (OR 1.6, p = 0.005). Conclusions A breastfeeding intervention implemented in private health facilities in Lagos increased exclusive breastfeeding intentions and practices. Widespread implementation of breastfeeding interventions in private facilities could extend the reach of breastfeeding promotion programs in urban Nigeria. Funding Sources This research was funded by the Alive & Thrive initiative, managed by FHI Solutions, and currently funded by the Bill & Melinda Gates Foundation, Irish Aid, the Tanoto Foundation, UNICEF, and the World Bank.

scholarly journals Trends in early initiation of breastfeeding in Bangladesh and a multilevel analysis approach to find its determinants

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Foyez Ahmmed ◽  
Muhammad Mahabub Rahaman Manik
Keyword(s):  
Wealth Index ◽  
Early Initiation ◽  
Multiple Birth ◽  
Demographic And Health Surveys ◽  
Antenatal Visit ◽  
Regression Result ◽  
Chi Square ◽  
Early Initiation Of Breastfeeding ◽  
The Hierarchical Structure ◽  
Initiation Of Breastfeeding

AbstractEarly initiation of breastfeeding (EIBF) is an essential practice for child health as well as for maternal health. This study aims to determine trends, prevalence, and factors associated with EIBF in Bangladesh. Data for this study were extracted from Bangladesh demographic and health surveys (BDHS) 2004, 2007, 2011, and 2014. This study found an increasing trend in EIBF in Bangladesh irrespective of the different characteristics of mothers and children. Chi-square test was conducted to find the association between EIBF and different factors. Multilevel logistic regression analysis was used to consider the hierarchical structure of the data. Regression result showed that educated parents [Adjusted odds ratio (AOR) = 1.14, 95% Confidence Interval (CI) = 1.04, 1.26 ], exposure to media [AOR = 1.13, CI = 1.05, 1.21], 2nd or 3rd birth order [AOR = 1.13, CI = 1.04, 1.23], wanted child [AOR = 1.12, CI = 1.02, 1.23], antenatal visit [AOR = 1.07, CI = 1.00, 1.15], antenatal visit by medically trained provider [AOR = 1.06, CI = 1.00,1.13] and rich wealth index [AOR = 1.10, CI = 1.01, 1.20] were positively associated with EIBF. In contrast, mothers with caesarian delivery [AOR = 0.36, CI = 0.31, 0.40], delivery in private facility [AOR = 0.83, CI = 0.73, 0.95], multiple birth, and higher maternal age were less likely to EIBF.

scholarly journals A systematic review and meta-analysis reveal that Campylobacter spp. and antibiotic resistance are widespread in humans in sub-Saharan Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Meta Analysis ◽  
Random Effect ◽  
Research Priorities ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
African Countries ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
The Impact

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.

scholarly journals Intimate Partner Violence against Women Living in Inadequate Conditions in Sub-Saharan Africa: A Meta-Analysis of Demographic and Health Survey Data

2021 ◽  
Vol 18 (19) ◽  
pp. 10138
Author(s):  
Yaqing Gao ◽  
Yinping Wang ◽  
Xiaoyi Mi ◽  
Mo Zhou ◽  
Siyu Zou ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Partner Violence ◽  
Meta Analysis ◽  
Intimate Partner ◽  
Living Conditions ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Major Public Health Problem ◽  
Sub Saharan ◽  
Country Specific

Intimate partner violence (IPV) against women is a major public health problem and is widespread in sub-Saharan Africa (SSA). However, little is known about its environmental determinants. This study aimed to investigate whether inadequate living conditions are associated with IPV victimization in women in SSA. We analyzed cross-sectional data for 102,714 women in 25 SSA countries obtained from the Demographic and Health Surveys Program. Logistic regression was used to estimate the country-specific effects of inadequate living conditions (housing with at least one of four characteristics of unimproved water, unimproved sanitation, insufficient space, and unfinished materials) on multiple forms of IPV. Random effects meta-analysis was used to combined the country-specific estimates. We found an association between inadequate living conditions and a higher likelihood of experiencing any (OR = 1.12, 95% CI 1.03 to 1.23, p = 0.012), sexual (OR = 1.18, 95% CI 1.05 to 1.34, p = 0.008), emotional (OR = 1.12, 95% CI 1.02 to 1.23, p = 0.023), and physical (OR = 1.15, 95% CI 1.03 to 1.28, p = 0.010) IPV. The associations were stronger for rural and less-educated women. These findings suggest that future research to establish a causal link between living conditions and IPV and to elucidate the underlying pathways is crucial to design IPV interventions in SSA.

scholarly journals The impact of antenatal care on neonatal mortality in sub-Saharan Africa: A systematic review and meta-analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (9) ◽  
pp. e0222566 ◽  
Author(s):  
Tesfalidet Tekelab ◽  
Catherine Chojenta ◽  
Roger Smith ◽  
Deborah Loxton
Keyword(s):  
Systematic Review ◽  
Antenatal Care ◽  
Neonatal Mortality ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Sub Saharan ◽  
The Impact
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