Journal of Food and Nutrition Sciences

| Peer-Reviewed |

Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study

Received: Mar. 28, 2019    Accepted: May 05, 2019    Published: Jun. 03, 2019
Views:       Downloads:

Share

Abstract

Nation-wide population based studies on socio-economic inequality in exclusive breastfeeding among infants is scarce in Uganda. This study examined the socio-economic inequality in exclusive breastfeeding among 1424 infants below 6 months of age in a nation-wide population based cross-sectional study. Self-reported maternal exclusive breastfeeding practice in the first six months of their last born baby`s life was the outcome of interest. Household wealth index and maternal occupation constituted the proxy measures of socio-economic status, the exposure variable of interest. The distribution of exclusive breastfeeding practice by infant-mother dyad characteristics was calculated by conducting bivariate analysis. Multivariate binary logistic regression models were then fitted to calculate the odds ratios and their corresponding 95% confidence intervals for exclusive breastfeeding by maternal occupation and household wealth index. The results showed that half of the infants were boys, close to half of their mothers were farmers, and 23% and 16.9% of the infants lived in the poorest and richest households respectively. Overall 67% of the infants were exclusively breastfed. The odds ratios for exclusive breastfeeding by maternal occupation were 0.62 (0.26-1.50) for infants whose mothers were professionals/technical/managers, 0.97(0.50-1.87) for clerical/sales, 0.78 (0.51-1.21), for Farmers, 0.72 (0.29-1.82) for Household/Domestic/Services, 0.72 (0.39-1.36) for skilled manual workers and 0.72 (0.25-2.02) for unskilled manual workers compared to infants of non-working mothers. The odds ratios for exclusive breastfeeding by household wealth index were 2.38 (1.30-4.33), for the poorest, 2.16 (1.18-3.96) poorer, 1.91 (1.10-3.48) middle, and 1.41 (0.75-2.64), for richer households compared to infants in the richest households. In conclusion, an inverse relationship was found between household socio-economic status and exclusive breastfeeding among infants below six months of age and inadequate evidence to conclude existence of an association between maternal socio-economic status and exclusive breastfeeding. Targeting exclusive breastfeeding interventions to mother-infant dyad living in affluent families might be important in reducing socio-economic inequality in exclusive breastfeeding among infants below six months of age in Uganda.

DOI 10.11648/j.jfns.20190701.13
Published in Journal of Food and Nutrition Sciences ( Volume 7, Issue 1, January 2019 )
Page(s) 16-24
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Exclusive Breastfeeding, Socio-Economic Status, Infants, Uganda

References
[1] Motee, A. and R. Jeewon, Importance of exclusive breastfeeding and complementary feeding among infants. Current Research in Nutrition and Food Science Journal, 2014. 2(2): p. 56-72.
[2] Victora, C. G. et al, Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 2016. 387(10017): p. 475-490.
[3] Sankar, M. J, et al, Optimal breastfeeding practices and infant and child mortality: a systematic review and meta‐analysis. Acta paediatrica, 2015. 104: p. 3-13.
[4] Horta, B. L, et al, Evidence on the long-term effects of breastfeeding: systematic review and meta-analyses. 2007.
[5] Unicef, Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding, 1 August 1990, Florence, Italy. 1990: Unicef.
[6] Kramer, M. S. and R. Kakuma, The optimal duration of exclusive breastfeeding, in Protecting infants through human milk. 2004, Springer. p. 63-77.
[7] Khanal, P, Millenium Development Goals. Health Prospect, 2011. 10: p. 57-60.
[8] 2018, U. W, Global breastfeeding scorecard 2018. 2018.
[9] Issaka, A. I, K. E. Agho, and A. M. Renzaho, Prevalence of key breastfeeding indicators in 29 sub-Saharan African countries: a meta-analysis of demographic and health surveys (2010–2015). BMJ open, 2017. 7(10): p. e014145.
[10] UNICEF, Tracking progress for breastfeeding policies and programmes: global breastfeeding scorecard 2017. Geneva, Switzerland: World Health Organization, 2017.
[11] ICF, U. B. o. S. U. and H. Survey, Uganda Demographic Health Survey 2016. 2016.
[12] Organization, W. H, World Health Statistics 2016: Monitoring Health for the Sustainable Development Goals (SDGs). 2016: World Health Organization.
[13] Branca, F, et al, Extension of the WHO maternal, infant and young child nutrition targets to 2030. SCN News, 2015(41): p. 55-58.
[14] Ismail, T, et al, The extended Theory of Planned Behavior in explaining exclusive breastfeeding intention and behavior among women in Kelantan, Malaysia. Nutrition research and practice, 2016. 10(1): p. 49-55.
[15] Swanson, V. and K. G. Power, Initiation and continuation of breastfeeding: theory of planned behaviour. Journal of advanced nursing, 2005. 50(3): p. 272-282.
[16] Amir, L, Social theory and infant feeding. 2011, BioMed Central.
[17] Hale, J. L, B. J. Householder, and K. L. Greene, The theory of reasoned action. The persuasion handbook: Developments in theory and practice, 2002. 14: p. 259-286.
[18] Marmot, M, et al, The Marmot review: Fair society, healthy lives. The Strategic Review of Health Inequalities in England Post-2010, 2010.
[19] Ajetunmobi, T. and B. Whyte, GCPH Breastfeeding Project: Investigation of breastfeeding rates in deprived areas. Literature review. 2012, Glasgow: GCPH.
[20] Mututho, L. N, W. K. Kiboi, and P. K. Mucheru, Factors associated with exclusive breastfeeding in Kenya: a systematic review. International Journal of Community Medicine and Public Health, 2017. 4(12): p. 4358-4362.
[21] Setegn, T, et al, Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. International breastfeeding journal, 2012. 7(1): p. 17.
[22] Onah, S, et al, Infant feeding practices and maternal socio-demographic factors that influence practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria: a cross-sectional and analytical study. International breastfeeding journal, 2014. 9(1): p. 6.
[23] Howe, L. D, et al, Measuring socio-economic position for epidemiological studies in low-and middle-income countries: a methods of measurement in epidemiology paper. International journal of epidemiology, 2012. 41(3): p. 871-886.
[24] Ickes, S. B, T. E. Hurst, and V. L. Flax, Maternal literacy, facility birth, and education are positively associated with better infant and young child feeding practices and nutritional status among Ugandan children. The Journal of nutrition, 2015. 145(11): p. 2578-2586.
[25] Bbaale, E, Determinants of early initiation, exclusiveness, and duration of breastfeeding in Uganda. Journal of health, population, and nutrition, 2014. 32(2): p. 249.
[26] Ssenyonga, R, R. Muwonge, and I. Nankya, Towards a better understanding of exclusive breastfeeding in the era of HIV/AIDS: a study of prevalence and factors associated with exclusive breastfeeding from birth, in Rakai, Uganda. Journal of tropical pediatrics, 2004. 50(6): p. 348-353.
[27] Azeze, G. A, et al, Exclusive Breastfeeding Practice and Associated Factors among Mothers in Boditi Town, Wolaita Zone, Southern Ethiopia, 2018: A Community-Based Cross-Sectional Study. International Journal of Pediatrics, 2019. 2019.
[28] Tan, K. L, Factors associated with exclusive breastfeeding among infants under six months of age in peninsular Malaysia. International breastfeeding journal, 2011. 6(1): p. 2.
[29] Zhang, Z, et al, What factors influence exclusive breastfeeding based on the theory of planned behaviour. Midwifery, 2018. 62: p. 177-182.
[30] Statistics, U. B. o, Population Projections 2015-2020. 2015.
[31] Organization, W. H, Indicators for assessing infant and young child feeding practices: part 2: measurement. 2010.
[32] Commission, U. A, The Uganda HIV and AIDS Country Progress Report. Kampala: Uganda AIDS Commission, 2016.
[33] Uganda, M, Policy Guidelines on Infant and Young Child Feeding. January 2009. 2009.
[34] Elias, P, Occupational classification (ISCO-88). 1997.
[35] Organization, W. H, Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington DC, USA. 2008: World Health Organization (WHO).
[36] Demographic, K, Health Survey 2014: key indicators. Kenya National Bureau of Statistics (KNBS) and ICF Macro, 2014.
[37] MoHCDGEC, M, NBS, Office of the Chief Government Statistician, & ICF. Demographic and health survey and malaria indicator survey (TDHS-MIS), 2015. 16.
[38] Organization, I. L, Women and men in the informal economy. A statistical picture. 2002: International Labour Organization.
Cite This Article
  • APA Style

    Ratib Mawa, Caroline Kambugu Nabasirye, James Mulira, Catherine Nakidde, Frank Kalyango, et al. (2019). Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study. Journal of Food and Nutrition Sciences, 7(1), 16-24. https://doi.org/10.11648/j.jfns.20190701.13

    Copy | Download

    ACS Style

    Ratib Mawa; Caroline Kambugu Nabasirye; James Mulira; Catherine Nakidde; Frank Kalyango, et al. Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study. J. Food Nutr. Sci. 2019, 7(1), 16-24. doi: 10.11648/j.jfns.20190701.13

    Copy | Download

    AMA Style

    Ratib Mawa, Caroline Kambugu Nabasirye, James Mulira, Catherine Nakidde, Frank Kalyango, et al. Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study. J Food Nutr Sci. 2019;7(1):16-24. doi: 10.11648/j.jfns.20190701.13

    Copy | Download

  • @article{10.11648/j.jfns.20190701.13,
      author = {Ratib Mawa and Caroline Kambugu Nabasirye and James Mulira and Catherine Nakidde and Frank Kalyango and Dolorence Mary Angulo Alaki Wakida and Margaret Chota and Tracy Leigh Schumacher and Stephen Lawoko and Krishna Nand Sharma},
      title = {Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study},
      journal = {Journal of Food and Nutrition Sciences},
      volume = {7},
      number = {1},
      pages = {16-24},
      doi = {10.11648/j.jfns.20190701.13},
      url = {https://doi.org/10.11648/j.jfns.20190701.13},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.jfns.20190701.13},
      abstract = {Nation-wide population based studies on socio-economic inequality in exclusive breastfeeding among infants is scarce in Uganda. This study examined the socio-economic inequality in exclusive breastfeeding among 1424 infants below 6 months of age in a nation-wide population based cross-sectional study. Self-reported maternal exclusive breastfeeding practice in the first six months of their last born baby`s life was the outcome of interest. Household wealth index and maternal occupation constituted the proxy measures of socio-economic status, the exposure variable of interest. The distribution of exclusive breastfeeding practice by infant-mother dyad characteristics was calculated by conducting bivariate analysis. Multivariate binary logistic regression models were then fitted to calculate the odds ratios and their corresponding 95% confidence intervals for exclusive breastfeeding by maternal occupation and household wealth index. The results showed that half of the infants were boys, close to half of their mothers were farmers, and 23% and 16.9% of the infants lived in the poorest and richest households respectively. Overall 67% of the infants were exclusively breastfed. The odds ratios for exclusive breastfeeding by maternal occupation were 0.62 (0.26-1.50) for infants whose mothers were professionals/technical/managers, 0.97(0.50-1.87) for clerical/sales, 0.78 (0.51-1.21), for Farmers, 0.72 (0.29-1.82) for Household/Domestic/Services, 0.72 (0.39-1.36) for skilled manual workers and 0.72 (0.25-2.02) for unskilled manual workers compared to infants of non-working mothers. The odds ratios for exclusive breastfeeding by household wealth index were 2.38 (1.30-4.33), for the poorest, 2.16 (1.18-3.96) poorer, 1.91 (1.10-3.48) middle, and 1.41 (0.75-2.64), for richer households compared to infants in the richest households. In conclusion, an inverse relationship was found between household socio-economic status and exclusive breastfeeding among infants below six months of age and inadequate evidence to conclude existence of an association between maternal socio-economic status and exclusive breastfeeding. Targeting exclusive breastfeeding interventions to mother-infant dyad living in affluent families might be important in reducing socio-economic inequality in exclusive breastfeeding among infants below six months of age in Uganda.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study
    AU  - Ratib Mawa
    AU  - Caroline Kambugu Nabasirye
    AU  - James Mulira
    AU  - Catherine Nakidde
    AU  - Frank Kalyango
    AU  - Dolorence Mary Angulo Alaki Wakida
    AU  - Margaret Chota
    AU  - Tracy Leigh Schumacher
    AU  - Stephen Lawoko
    AU  - Krishna Nand Sharma
    Y1  - 2019/06/03
    PY  - 2019
    N1  - https://doi.org/10.11648/j.jfns.20190701.13
    DO  - 10.11648/j.jfns.20190701.13
    T2  - Journal of Food and Nutrition Sciences
    JF  - Journal of Food and Nutrition Sciences
    JO  - Journal of Food and Nutrition Sciences
    SP  - 16
    EP  - 24
    PB  - Science Publishing Group
    SN  - 2330-7293
    UR  - https://doi.org/10.11648/j.jfns.20190701.13
    AB  - Nation-wide population based studies on socio-economic inequality in exclusive breastfeeding among infants is scarce in Uganda. This study examined the socio-economic inequality in exclusive breastfeeding among 1424 infants below 6 months of age in a nation-wide population based cross-sectional study. Self-reported maternal exclusive breastfeeding practice in the first six months of their last born baby`s life was the outcome of interest. Household wealth index and maternal occupation constituted the proxy measures of socio-economic status, the exposure variable of interest. The distribution of exclusive breastfeeding practice by infant-mother dyad characteristics was calculated by conducting bivariate analysis. Multivariate binary logistic regression models were then fitted to calculate the odds ratios and their corresponding 95% confidence intervals for exclusive breastfeeding by maternal occupation and household wealth index. The results showed that half of the infants were boys, close to half of their mothers were farmers, and 23% and 16.9% of the infants lived in the poorest and richest households respectively. Overall 67% of the infants were exclusively breastfed. The odds ratios for exclusive breastfeeding by maternal occupation were 0.62 (0.26-1.50) for infants whose mothers were professionals/technical/managers, 0.97(0.50-1.87) for clerical/sales, 0.78 (0.51-1.21), for Farmers, 0.72 (0.29-1.82) for Household/Domestic/Services, 0.72 (0.39-1.36) for skilled manual workers and 0.72 (0.25-2.02) for unskilled manual workers compared to infants of non-working mothers. The odds ratios for exclusive breastfeeding by household wealth index were 2.38 (1.30-4.33), for the poorest, 2.16 (1.18-3.96) poorer, 1.91 (1.10-3.48) middle, and 1.41 (0.75-2.64), for richer households compared to infants in the richest households. In conclusion, an inverse relationship was found between household socio-economic status and exclusive breastfeeding among infants below six months of age and inadequate evidence to conclude existence of an association between maternal socio-economic status and exclusive breastfeeding. Targeting exclusive breastfeeding interventions to mother-infant dyad living in affluent families might be important in reducing socio-economic inequality in exclusive breastfeeding among infants below six months of age in Uganda.
    VL  - 7
    IS  - 1
    ER  - 

    Copy | Download

Author Information
  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University, Lira, Uganda

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Rural Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Department of Public Health, Faculty of Health Sciences, Victoria University, Kampala, Uganda

  • Section