Spatial distribution of mixed milk feeding and its determinants among mothers of infants aged under 6 months in Ethiopia: Spatial and geographical weighted regression analysis

by Mekuriaw Nibret Aweke, Muluken Chanie Agimas, Moges Tadesse Abebe, Tigabu Kidie Tesfie, Meron Asmamaw Alemayehu, Werkneh Melkie Tilahun, Gebrie Getu Alemu, Worku Necho Asferie

Background

Mixed milk feeding is defined as providing formula and/or animal milk along with breast milk to infants under six months old which is prevalent in many countries. However, this practice is generally not recommended as it can reduce the intake of breast milk, depriving the infant of its optimal nutritional and immunological benefits. Unlike formula, breast milk contains complex bioactive constituents that promote intestinal and pancreatic growth and develop mucosal defenses. The aim of this study was to analyze the spatial distribution and predictors of MMF practices in Ethiopia.

Methods

This study utilized data from the 2019 Mini-Ethiopian Demographic and Health Survey (MiniEDHS), a nationally representative cross-sectional survey conducted from March to June 2019. The total weighted sample size derived from the data examined in this study amounted to 524 infants. The data analysis used Global Moran’s I for spatial autocorrelation and the Getis-Ord Gi * statistic for local cluster analysis to assess the spatial distribution of mixed milk feeding prevalence across Ethiopia’s administrative regions and cities. Empirical Bayesian Kriging was used for spatial interpolation to estimate mixed milk feeding prevalence in unsampled areas. The analysis utilized a maximum spatial cluster size threshold of 50% of the population to detect clusters of varying sizes. Ordinary least squares regression analysis identified significant spatial predictors. In geographically weighted regression analysis, the effect of predictor variables on the spatial variation of mixed milk feeding was detected using local coefficients.

Results

The overall weighted prevalence of Mixed Milk Feeding (MMF) in Ethiopia was 10.12% (95% CI: 7.8, 13.01). This prevalence shows significant regional variations across the country emphasizing regional disparities in prevalence and distribution. The Global Moran’s I statistic was 0.14, with a Z-score of 3.18 and a p-value of Conclusion

The study found significant regional variations in mixed milk feeding practices in Ethiopia. Households with middle wealth index and baby without postnatal check were significant spatial predictors of mixed milk feeding. To reduce mixed milk feeding prevalence, targeted interventions should engage community leaders, enhance breastfeeding education in maternal health services, and integrate counseling into routine healthcare to support informed maternal choices and improve child health outcomes nationwide.

Growth monitoring and promotion service utilization and its associated factors among children less than two years in Ethiopia: A systematic review and meta-analysis

by Mulat Belay Simegn, Werkneh Melkie Tilahun, Elyas Melaku Mazengia, Aysheshim Belaineh Haimanot, Anteneh Lamesgen Mneneh, Muluye Gebrie Mengie, Bekalu Endalew, Molla Yigzaw Birhanu, Tigabu Kidie Tesfie, Lakew Asmare, Habtamu Geremew

Introduction

Growth monitoring and promotion services are strategies to promote child health and reduce child mortality. Even though Ethiopia is attempting different strategies to cope with the low rate of GMP utilization, the problem is still unresolved.

Objective

Determine the pooled proportion of GMP utilization and its contributing factors among children less than two years in Ethiopia.

Method

The review protocol was registered with PROSPERO, number CRD42023472746. The PRISMA-2020 statement guided the conduct of this review. Electronic databases and grey literature were used. Heterogeneity was evaluated using I². Subgroup analysis was conducted. The random effect model was used to summarize the pooled effect sizes with their respective 95% CI with STATA version 17. To test the small study effect, the funnel plot and Egger’s test were applied.

Result

A total of seven (7) studies with 4027 participants were considered in this meta-analysis. The pooled proportion of GMP utilization reported by seven studies was 25.71% (95%CI: 24.39, 27.04). ANC follow-up (AOR = 2.11; 95% CI: 1.47, 2.76), PNC follow-up (AOR = 1.96; 95% CI: 1.44, 2.49), counseling (AOR = 2.88; 95% CI: 2.09, 3.68), maternal education (AOR = 2.89; 95% CI: 1.66, 4.13), paternal education (AOR = 3.78; 95% CI: 2.25, 5.32), family health card (AOR = 2.31; 95% CI: 1.67, 2.96), and mothers good knowledge towards GMP (AOR = 2.90; 95% CI: 1.72, 4.07) variables were positively associated with GMP service utilization.

Conclusion and recommendation

The pooled proportion of GMP remains low in Ethiopia. ANC and PNC follow-up, counseling, maternal and paternal education, family health cards, maternal knowledge towards GMP were significantly associated. Findings are essential for evidence-based policy making, intervention, and input for ongoing research.