Geospatial variation of exclusive breastfeeding and its determinants among mothers of infants under 6 months in Ethiopia: spatial and geographical weighted regression analysis

Getaneh Awoke Yismaw; Habtamu Wagnew Abuhay; Meron Asmamaw Alemayehu; Nebiyu Mekonnen Derseh; Muluken Chanie Agimas; Tigabu Kidie Tesfie

doi:10.1136/bmjpo-2024-002573

Geospatial variation of exclusive breastfeeding and its determinants among mothers of infants under 6 months in Ethiopia: spatial and geographical weighted regression analysis

BMJ Paediatr Open. 2024 Apr 29;8(Suppl 2):e002573. doi: 10.1136/bmjpo-2024-002573.

Authors

Getaneh Awoke Yismaw¹, Habtamu Wagnew Abuhay², Meron Asmamaw Alemayehu², Nebiyu Mekonnen Derseh², Muluken Chanie Agimas², Tigabu Kidie Tesfie²

Affiliations

¹ Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia getanehawoke9@gmail.com.
² Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract

Background: Exclusive breastfeeding (EBF) is a major public health problem in Ethiopia. However, the spatial variation of EBF and the associated factors have not been studied as much as we have searched. This study aimed at assessing geospatial variation and the predictors of EBF using geographically weighted regression.

Methods: A cross-sectional study was conducted using the 2019 Mini-Ethiopian Demographic and Health Survey data set. The study used a total weighted sample of 548 infants. Hotspot spatial analysis showed the hotspot and cold spot areas of EBF. The spatial distribution of EBF was interpolated for the target population using spatial interpolation analysis. SaTScan V.9.6 software was used to detect significant clusters. Ordinary least squares regression analysis identified significant spatial predictors. In geographically weighted regression analysis, the effect of predictor variables on the spatial variation of EBF was detected using local coefficients.

Results: The weighted prevalence of EBF in Ethiopia was 58.97% (95% CI 52.67% to 64.99%), and its spatial distribution was found to be clustered (global Moran's I=0.56, p<0.001). Significant hotspot areas were located in Amhara, Tigray, Southern Nations, Nationalities, and Peoples' Region, and Somali regions, while significant cold spots were located in Dire Dawa, Addis Ababa and Oromia regions. Kulldorff's SaTScan V.9.6 was used to detect significant clusters of EBF using a 50% maximum cluster size per population. The geographically weighted regression model explained 35.75% of the spatial variation in EBF. The proportions of households with middle wealth index and married women were significant spatial predictors of EBF.

Conclusion: Middle wealth index and married women were significant spatial predictors of EBF. Our detailed map of EBF hotspot areas will help policymakers and health programmers encourage the practice of EBF in hotspot areas and set national and regional programmes focused on improving EBF in cold spots by considering significant predictor variables.

Keywords: breastfeeding; growth; infant; neonatology.

MeSH terms

Adolescent
Adult
Breast Feeding* / statistics & numerical data
Cross-Sectional Studies
Ethiopia
Female
Humans
Infant
Infant, Newborn
Male
Mothers / statistics & numerical data
Socioeconomic Factors
Spatial Analysis*
Spatial Regression*
Young Adult