Individual and community-level factors associated with introduction of prelacteal feeding in Ethiopia

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Study Justification:
– Ethiopia has low optimal breastfeeding practices and prelacteal feeding is still common.
– Understanding the factors associated with prelacteal feeding is important for improving breastfeeding practices.
– This study aimed to identify individual and community-level factors that contribute to the introduction of prelacteal feeding in Ethiopia.
Highlights:
– The study used data from the 2011 Ethiopia Demographic and Health Survey.
– 28.92% of children in the sample were fed prelacteals.
– Common prelacteals used were butter, plain water, and milk other than breast milk.
– Factors positively associated with prelacteal feeding were caesarean mode of delivery and late initiation of breastfeeding.
– Factors negatively associated with prelacteal feeding were higher economic status, non-health personnel birth assistance, large birth size of child, and high community antenatal care use.
– Significant variation in prelacteal feeding practice was observed among ethnic and religious groups, and across regions.
Recommendations:
– Increase access to health education to improve maternal healthcare service coverage and community involvement.
– Focus on reducing caesarean deliveries and promoting early initiation of breastfeeding.
– Address economic disparities and improve access to healthcare services for all.
– Target interventions towards specific ethnic and religious groups and regions with high prevalence of prelacteal feeding.
Key Role Players:
– Ministry of Health: Responsible for implementing and coordinating interventions to improve breastfeeding practices.
– Community Health Workers: Involved in providing health education and promoting breastfeeding within communities.
– Non-Governmental Organizations: Support the implementation of breastfeeding programs and provide resources.
– Health Facilities: Provide maternal healthcare services and support breastfeeding education and counseling.
Cost Items for Planning Recommendations:
– Health Education Materials: Budget for the development and distribution of educational materials on breastfeeding.
– Training and Capacity Building: Allocate funds for training healthcare workers and community health workers on breastfeeding counseling.
– Community Engagement Activities: Set aside a budget for community events and campaigns to raise awareness about breastfeeding.
– Monitoring and Evaluation: Allocate resources for monitoring and evaluating the impact of interventions on breastfeeding practices.
– Research and Data Collection: Budget for future studies to monitor changes in breastfeeding practices and identify new challenges.

Background: Ethiopia is a country with low optimal breast feeding practice, and prelacteal feeding is still a norm. Introduction of prelacteal feeding is a known barrier for optimal breast feeding practices. However, knowledge on determinants of introduction of prelacteal feeding is minimal. This study aimed to identify the effects of individual and community-level factors in the introduction of prelacteal feeding in Ethiopia. Methods: Data for this study was extracted from the nationally representative 2011 Ethiopia Demographic and Health Survey (EDHS) and focused on a sample from child data, with a sample from 576 clusters of 7692 children who were last-born in the past five years preceding the survey. The data was collected using two-stage cluster design, in which enumeration areas forming the first stage and households making the second stage. A two-level mixed effect multivariable logistic regression model was fitted to determine the individual and community-level factors associated with introduction of prelacteal feeding. Results: From the total sample of children 28.92 % were fed prelacteals. Butter (n = 1143), plain water (n = 395) and milk-other than breast milk (n = 323) were commonly used prelacteals. In multivariable two-level mixed effect model; caesarean mode of delivery (Adjusted odds ratio (AOR) = 1.87; 95 % CI 1.28, 2.73), and late initiation of breastfeeding (AOR = 5.32; 95 % CI 4.65, 6.09) were both positively associated with the odds of giving prelacteals. Higher economic status 28 % (AOR = 0.72; 95 % CI 0.54, 0.98), giving birth at hand of non-health personnel birth assistance (AOR = 0.68; 95 % CI 0.54, 0.87), large birth size of child (AOR = 0.80; 95 % CI 0.68, 0.95) and high community antenatal care use (AOR = 0.58; 95 % CI 0.38, 0.87) were negatively associated with the odds of giving prelacteals. Significant variation in prelacteal feeding practice was also seen among ethnic and religious groups, and across regions. Conclusions: The prevalence of prelacteal feeding was high that remained a challenge for optimal breastfeeding in Ethiopia. Not only individual-level factors, but also community-level factors contribute to prelacteal feeding practice. Increasing access to health education through increasing maternal health care service coverage and community involvement is crucial.

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Based on the provided description, here are some potential innovations that could be recommended to improve access to maternal health:

1. Mobile Health (mHealth) Applications: Develop and implement mobile applications that provide educational resources and information on optimal breastfeeding practices, including the risks and consequences of prelacteal feeding. These apps can be easily accessible to mothers and caregivers, providing them with accurate and up-to-date information.

2. Community-Based Education Programs: Establish community-based education programs that focus on promoting optimal breastfeeding practices and raising awareness about the negative effects of prelacteal feeding. These programs can involve local health workers, community leaders, and volunteers to deliver targeted education sessions and workshops.

3. Maternal Health Care Service Expansion: Increase access to maternal health care services, including antenatal care, by expanding healthcare facilities and improving their availability in rural and underserved areas. This can be achieved through the establishment of mobile clinics, community health centers, and the recruitment and training of more healthcare professionals.

4. Training for Birth Attendants: Provide comprehensive training for birth attendants, including traditional birth attendants, on the importance of exclusive breastfeeding and the risks associated with prelacteal feeding. This training should emphasize the benefits of early initiation of breastfeeding and the role of birth attendants in promoting and supporting breastfeeding practices.

5. Policy and Advocacy: Advocate for the development and implementation of policies that support and protect breastfeeding rights, including regulations to discourage the use of prelacteal feeding. This can involve working with government agencies, non-governmental organizations, and international bodies to create and enforce policies that prioritize optimal breastfeeding practices.

These innovations aim to address both individual and community-level factors that contribute to the introduction of prelacteal feeding, ultimately improving access to maternal health and promoting optimal breastfeeding practices in Ethiopia.
AI Innovations Description
Based on the study titled “Individual and community-level factors associated with introduction of prelacteal feeding in Ethiopia,” the following recommendation can be developed into an innovation to improve access to maternal health:

Innovation Recommendation: Development of a comprehensive maternal health education program targeting both individuals and communities to reduce the practice of prelacteal feeding in Ethiopia.

Explanation:
1. Targeting Individuals: The program should focus on educating mothers and families about the importance of exclusive breastfeeding and the negative effects of prelacteal feeding. This can be done through antenatal care visits, postnatal care visits, and community health workers. Providing accurate and culturally sensitive information will help mothers make informed decisions about breastfeeding practices.

2. Targeting Communities: The program should involve community leaders, religious leaders, and local influencers to raise awareness about the benefits of exclusive breastfeeding and the risks associated with prelacteal feeding. Community engagement activities such as group discussions, community meetings, and awareness campaigns can be organized to reach a wider audience and promote behavior change.

3. Increasing Maternal Health Care Service Coverage: Improving access to maternal health care services is crucial for providing accurate information and support to mothers. This can be achieved by expanding the availability of antenatal and postnatal care services, ensuring trained healthcare professionals are present during childbirth, and providing breastfeeding support services.

4. Community Involvement: Engaging the community in promoting optimal breastfeeding practices is essential. This can be done by establishing support groups for breastfeeding mothers, training community health workers to provide breastfeeding counseling, and involving community members in the planning and implementation of maternal health programs.

By implementing this comprehensive maternal health education program, Ethiopia can work towards reducing the prevalence of prelacteal feeding and improving access to maternal health services, ultimately leading to better maternal and child health outcomes.
AI Innovations Methodology
Based on the provided description, here are some potential recommendations for improving access to maternal health in Ethiopia:

1. Strengthen Health Education: Increase access to health education for pregnant women and their families, focusing on the importance of optimal breastfeeding practices and the risks associated with prelacteal feeding. This can be done through community-based programs, antenatal care visits, and mobile health initiatives.

2. Improve Maternal Health Care Service Coverage: Increase the availability and accessibility of maternal health care services, including antenatal care, skilled birth attendance, and postnatal care. This can be achieved by expanding health facilities, training more healthcare providers, and ensuring adequate resources and supplies.

3. Enhance Community Involvement: Engage community leaders, religious institutions, and local organizations in promoting optimal breastfeeding practices and discouraging prelacteal feeding. This can be done through community awareness campaigns, support groups, and peer education programs.

4. Address Socioeconomic Factors: Implement interventions to address socioeconomic factors that contribute to prelacteal feeding, such as poverty and low economic status. This can include providing financial support for vulnerable families, promoting income-generating activities, and improving access to social safety nets.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Data Collection: Gather data on the current prevalence of prelacteal feeding, maternal health care service coverage, and socioeconomic indicators in Ethiopia. This can be done through surveys, interviews, and existing data sources such as the Ethiopia Demographic and Health Survey.

2. Modeling: Develop a simulation model that incorporates the individual and community-level factors associated with prelacteal feeding identified in the study. This model should also consider the potential impact of the recommended interventions on improving access to maternal health.

3. Parameter Estimation: Estimate the parameters of the simulation model using the available data. This may involve statistical analysis, regression modeling, and data synthesis techniques.

4. Scenario Analysis: Conduct scenario analysis to simulate the impact of different combinations of interventions on improving access to maternal health. This can involve varying the coverage and effectiveness of the interventions and assessing their potential impact on reducing prelacteal feeding rates.

5. Evaluation: Evaluate the results of the simulation model to assess the potential impact of the recommended interventions on improving access to maternal health. This can include analyzing the changes in prelacteal feeding rates, maternal health care service coverage, and socioeconomic indicators.

6. Policy Recommendations: Based on the findings of the simulation model, provide evidence-based policy recommendations for improving access to maternal health in Ethiopia. These recommendations should consider the feasibility, cost-effectiveness, and sustainability of the interventions.

It is important to note that the methodology described above is a general framework and the specific details may vary depending on the available data, resources, and context of the study.

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