scholarly journals OP101 The impact of caesarean section on breastfeeding indicators in sub-saharan africa: a meta-analysis of demographic and health surveys

Author(s):  
E Yisma ◽  
B Mol ◽  
J Lynch ◽  
L Smithers
BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e027497
Author(s):  
Engida Yisma ◽  
Ben W Mol ◽  
John W Lynch ◽  
Lisa G Smithers

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.


2007 ◽  
Vol 7 (1) ◽  
Author(s):  
Henry Wamani ◽  
Anne Nordrehaug Åstrøm ◽  
Stefan Peterson ◽  
James K Tumwine ◽  
Thorkild Tylleskär

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0177338 ◽  
Author(s):  
Blessing J. Akombi ◽  
Kingsley E. Agho ◽  
Dafna Merom ◽  
Andre M. Renzaho ◽  
John J. Hall

Author(s):  
Mona Abdelhady ◽  
Anna Alfeus ◽  
Ndinomholo Hamatui

Abstract Important milestones in reducing child mortality rates have been achieved internationally and in Africa. With 76 deaths per 1,000 live births, sub-Saharan Africa (SSA) continues to have the world's highest under-five mortality (U5M) rate. In SSA, one child in every 13 dies from preventable causes before reaching their fifth birthday. This study sought to determine the impact of demographic, socio-economic, and environmental determinants on child health in Namibia, using the Namibian demographic and health surveys (NDHS) from 2006 and 2013. A logistic regression model was used to determine the association between improved sanitary facilities and water sources and U5M in Namibia. Improved access to sanitation facilities in Namibia is associated with less U5M rate, according to the 2013 survey. No significant association was observed between improved access to safe water and child's death. In 2013, the greater the mother's level of education, the lower the chance of child death. Finally, the findings demonstrate that mothers with HIV-positive are more likely to experience under-five death. Hence, the Namibian government should increase sanitation facilities and promote maternal healthcare services for less fortunate households to lower the U5M rate.


2021 ◽  
pp. 1-11
Author(s):  
Michel Garenne ◽  
Susan Thurstans ◽  
André Briend ◽  
Carmel Dolan ◽  
Tanya Khara ◽  
...  

Abstract The study investigates sex differences in the prevalence of undernutrition in sub-Saharan Africa. Undernutrition was defined by Z-scores using the CDC-2000 growth charts. Some 128 Demographic and Health Surveys (DHS) were analysed, totalling 700,114 children under-five. The results revealed a higher susceptibility of boys to undernutrition. Male-to-female ratios of prevalence averaged 1.18 for stunting (height-for-age Z-score <−2.0); 1.01 for wasting (weight-for-height Z-score <−2.0); 1.05 for underweight (weight-for-age Z-score <−2.0); and 1.29 for concurrent wasting and stunting (weight-for-height and height-for-age Z-scores <−2.0). Sex ratios of prevalence varied with age for stunting and concurrent wasting and stunting, with higher values for children age 0–23 months and lower values for children age 24–59 months. Sex ratios of prevalence tended to increase with declining level of mortality for stunting, underweight and concurrent wasting and stunting, but remained stable for wasting. Comparisons were made with other anthropometric reference sets (NCHS-1977 and WHO-2006), and the results were found to differ somewhat from those obtained with CDC-2000. Possible rationales for these patterns are discussed.


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