What Are the Individual, Household, and Community Factors Associated With Optimal Breastfeeding Practices in Three Selected West African Countries?

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Taofik Olatunji Bankole
Bola Lukman Solanke
Luqman Adeleke Bisiriyu


Optimal breastfeeding is rarely practiced among mothers across the three studied countries: Guinea, Nigeria, and Sierra Leone. The methodological approach used in this study is the first of its kind in the study area. It provides answers to the statistical association between individual, household, and community factors and optimal breastfeeding practices. The study adopted a cross-sectional research design. It employed secondary data. The study data were extracted from the Demographic Health Surveys in Guinea (2012 GDHS), Nigeria (2013 NDHS), and Sierra Leone (2013 SLDHS). Information was extracted from mothers (20–49 years) who had at least one child before the surveys. Optimal breastfeeding was coded into “1” if adhered to and “0” if otherwise. Multilevel mixed-effect logistic regression was used. It was found that optimal breastfeeding was infrequently practiced in Guinea (5.3%), Nigeria (8.6%), and Sierra Leone (14.0%). The fixed-effects results showed that optimal breastfeeding was significantly associated with individual, household, and community-level factors (p < .05). The random effect results showed that community factors accounted for 40.4%, 20.3%, and 20.7% variation in adherence to optimal breastfeeding for mothers in Guinea, Nigeria, and Sierra Leone, respectively. The study concluded that mothers in the study area rarely practice optimal breastfeeding.


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Taofik Olatunji Bankole, Department of Public Health, College of Health Sciences, Osun State University, Osogbo, Nigeria

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• Akinwande, M. O., Dikko, H. G., & Samson, A. (2015). Variance inflation factor: As a condition for the inclusion of suppressor variable(s) in regression analysis. Open Journal of Statistics, 5(7), 754–767. http://dx.doi.org/10.4236/ojs.2015.57075

• Arora, A., Manohar, N., Hayen, A., Bhole, S., Eastwood, J., Levy, S., & Scott, J. A. (2017). Determinants of breastfeeding initiation among mothers in Sydney, Australia: Findings from a birth cohort study. International Breastfeeding Journal, 12, Article 39. https://doi.org/10.1186/s13006-017-0130-0

• Asfaw, M. M., Argaw, M. D., & Kefene, Z. K. (2015). Factors associated with exclusive breastfeeding practices in Debre Berhan District, Central Ethiopia: A cross sectional community-based study. International Breastfeeding Journal, 10, Article 23. https://doi.org/10.1186/s13006-015-0049-2

• Bankole, T. O. (2017). Socio-demographic factors, breastfeeding practices and infant mortality in Northern Nigeria. Grin Verlag.

• Bankole, T. O., & Adetutu, O. M. (2015). Exclusive breastfeeding practice and infant survival in Northern Nigeria. Journal of Demography and Social Statistics, 2(1&2), 28–36.

• Cresswell, J. A., Ganaba, R., Sarrassat, S., Cousens, S., Somé, H., Diallo, A. H., & Filippi, V. (2017). Predictors of exclusive breastfeeding and consumption of soft, semi-solid or solid food among infants in Boucle du Mouhoun, Burkina Faso: A cross-sectional survey. PLoS ONE, 12(6), Article e0179593. https://doi.org/10.1371/journal.pone.0179593

• Ekanem, I. A., Ekanem, A. P., Asuquo, A., & Eyo, V. O. (2012). Attitude of working mothers to exclusive breastfeeding in Calabar municipality, Cross River State, Nigeria. Journal of Food Research, 1(2), 71–75. http://dx.doi.org/10.5539/jfr.v1n2p71

• Fjeld, E., Siziya, S., Katepa‐Bwalya, M., Kankasa, C., Moland, K. M., & Tylleskär, T. (2008). No sister, the breast alone is not enough for my baby’ a qualitative assessment of potentials and barriers in the promotion of exclusive breastfeeding in southern Zambia. International Breastfeeding Journal, 3, Article 26. https://doi.org/10.1186/1746-4358-3-26

• Genetue, H., Yenit, M. K., & Tariku, A. (2016). Breastfeeding counseling and support are associated with continuous exclusive breastfeeding from one week to six months of age among HIV exposed infants in north Gondar zone, Ethiopia: A cross-sectional study. International Breastfeeding Journal, 12, Article 21. https://doi.org/10.1186/s13006-017-0113-1

• Haroon, S., Das, J. K., Salam, R., A., Imdad, A., & Bhutta, Z. A. (2013). Breastfeeding promotion interventions and breastfeeding practices: A systematic review. BMC Public Health, 13, Article S20. https://doi.org/10.1186/1471-2458-13-S3-S20

• Hashim, T. H., Mgongo, M., Katanga, J., Uriyo, J. G., Damian, D. J., Stray-Pedersen, B., Wandel, M., & Msuya, S. E. (2016). Predictors of appropriate breastfeeding knowledge among pregnant women in Moshi Urban, Tanzania: A cross-sectional study. International Breastfeeding Journal, 12, Article 11. https://doi.org/10.1186/s13006-017-0102-4

• Heckman, J. J. (2015). Introduction to a theory of the allocation of time by Gary Becker. The Economic Journal, 125(583), 403–409. https://doi.org/10.1111/ecoj.12228

• Horii, N., Allman, J., Martin-Prével, Y., & Waltisperger, D. (2017). Determinants of early

o initiation of breastfeeding in rural Niger: Cross-sectional study of community-based child healthcare promotion. International Breastfeeding Journal, 12, Article 41. https://doi.org/10.1186/s13006-017-0134-9

• Horwood, C., Haskins, L., Engebretsen, I. M., Phakathi, S., Connolly, C., Coutsoudis, A., & Spies, L. (2018). Improved rates of exclusive breastfeeding at 14 weeks of age in KwaZulu Natal, South Africa: What are the challenges now? BMC Public Health, 18, Article 757. https://doi.org/10.1186/s12889-018-5657-5

• McInnes, R. J., Love, J. G., & Stone, D. H. (2001). Independent predictors of breastfeeding intention in a disadvantaged population of pregnant women. BMC Public Health, 1, Article 10. https://doi.org/10.1186/1471-2458-1-10

• Merlo, J., Wagner, P., Ghith, N., & Leckie, G. (2016). An original stepwise multilevel logistic regression analysis of discriminatory accuracy: The case of neighbourhoods and health. PloS ONE, 11 (4), Article e0153778. https://doi.org/10.1371/journal.pone.0153778

• Mogre, V., Dery, M., & Gaa, P. K. (2016). Knowledge, attitudes & determinants of exclusive breastfeeding practice among Ghanaian rural lactating mothers. International Breastfeeding Journal, 11, Article 12. https://doi.org/10.1186/s13006-016-0071-z

• Mututho, L. N. (2013). Factors influencing exclusive breastfeeding among infants less than six months in Kasarani Informal Settlement, Molo District, Kenya [Master’s thesis, Kenyatta University]. Kenyatta University Institutional Repository. http://ir-library.ku.ac.ke/handle/123456789/6505

• National Institute of Statistics [Guinea], & ICF International. (2013). Enquête Démographique et de Santé et à Indicateurs Multiples [Guinea Demographic and Health Survey and Multiple Indicators]. https://dhsprogram.com/pubs/pdf/FR280/FR280.pdf

• National Population Commission (NPC) [Nigeria], & ICF International. (2014). Nigeria Demographic and Health Survey 2013. https://dhsprogram.com/pubs/pdf/fr293/fr293.pdf

• O’Brien, R. M. (2007). A caution regarding rules of thumb for variance inflation factors. Quality & Quantity, 41(5), 673–690. https://doi.org/10.1007/s11135-006-9018-6

• Ogunlesi, T. A. (2010). Maternal socio-demographic factors influencing the initiation and exclusive breastfeeding in a Nigerian semi-urban setting. Maternal and Child Health Journal, 14(3), 459–465. https://doi.org/10.1007/s10995-008-0440-3

• Onah, S., Osuorah, D. I. C., Ebenebe, J., Ezechukwu, C., Ekwochi, U., & Ndukwu, I. (2014). 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, 9, Article 6. https://doi.org/10.1186/1746-4358-9-6

• Population Reference Bureau. (2018). 2018 World Population Data Sheet with Focus on Changing Age Structures. https://www.prb.org/resources/2018-world-population-data-sheet-with-focus-on-changing-age-structures/

• Rees, C. P., Hawkesworth, S., Moore, S. E., Dondeh, B. L., & Unger, S. A. (2016). Factors affecting access to healthcare: An observational study of children under 5 years of age presenting to a rural Gambian Primary Healthcare Centre. PLoS One, 11(6), Article e0157790. https://doi.org/10.1371/journal.pone.0157790

• Rollins, N., & Doherty, T. (2019). Improving breastfeeding practices at scale. The Lancet Global Health, 7(3), 292–293. https://doi.org/10.1016/S2214-109X(18)30557-6

• Senbanjo, I. O., Olayiwola, I. O., Afolabi, W. A., & Senbanjo, C., O. (2013). Maternal and child under-nutrition in rural and urban communities of Lagos State, Nigeria: The relationship and risk factors. BMC Research Notes, 6, Article 286. https://doi.org/10.1186/1756-0500-6-286

• Sika-Bright, S. B. (2010). Socio-cultural factors influencing infant feeding practices of mothers attending welfare clinic in Cape Coast, Ghana. Department of Sociology and Anthropology, University of Cape Coast. http://www.ifra-nigeria.org/IMG/pdf/Sika.pdf

• StataCorp. (2011). Stata: Release 12. StataCorp LP. https://www.stata.com/support/

• Statistics Sierra Leone, & ICF International. (2014). Sierra Leone Demographic and Health Survey 2013: Key Findings. https://www.statistics.sl/images/StatisticsSL/Documents/demographic_and_health_survey_2013_key-findings.pdf

• Tampah-Naah, A. M., & Kumi-Kyereme, A. (2013). Determinants of exclusive breastfeeding among mothers in Ghana: A cross sectional study. International Breastfeeding Journal, 8, Article 13. https://doi.org/10.1186/1746-4358-8-13

• Ugboaja, J. O., Bertrand, N. O., Igwebge A. O., & OBI-Nwosu, A. L. (2013). Barriers to postnatal care and exclusive breastfeeding among urban women in South-eastern Nigeria. Nigerian Medical Journal, 54(1), 45–50. https://doi.org/10.4103/0300-1652.108895

• UNICEF. (2021, September). Infant and young child feeding [Data set]. https://data.unicef.org/topic/nutrition/infant-and-young-child-feeding

• World Health Organization. (1990). 1990 WHO/UNICEF Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding. http://waba.org.my/v3/wp-content/uploads/2019/04/1990-Innocenti-Declaration.pdf

• World Health Organization. (2014, December 30). Global targets 2025: To improve maternal, infant and young child nutrition. https://www.who.int/teams/nutrition-and-food-safety/global-targets-2025

• World Health Organization. (2018, February20). Breastfeeding. http://www.who.int/features/factfiles/breastfeeding/en/