Abstract
Exclusive breastfeeding (EBF)—giving infants only breast-milk (and medications, oral rehydration salts and vitamins as needed) with no additional food or drink for their first six months of life—is one of the most effective strategies for preventing child mortality1–4. Despite these advantages, only 37% of infants under 6 months of age in Africa were exclusively breastfed in 20175, and the practice of EBF varies by population. Here, we present a fine-scale geospatial analysis of EBF prevalence and trends in 49 African countries from 2000–2017, providing policy-relevant administrative- and national-level estimates. Previous national-level analyses found that most countries will not meet the World Health Organization’s Global Nutrition Target of 50% EBF prevalence by 20256. Our analyses show that even fewer will achieve this ambition in all subnational areas. Our estimates provide the ability to visualize subnational EBF variability and identify populations in need of additional breastfeeding support.
Highlights
Some second administrative subdivisions in south-eastern Ethiopia and Tanzania with slower Exclusive breastfeeding (EBF) uptake fell short, and will fail to meet targets based on current trajectories (Supplementary Tables 11 and 12), while local-level areas in north-eastern Namibia and south-western DRC and Kenya were found to have lower prevalence (
Within-country disparities in estimated EBF prevalence were both common and widespread: in 2017, at least a twofold difference in estimated EBF prevalence existed across second administrative subdivisions in 53.1% (26 of 49) of African countries; at least a threefold difference occurred in 14.3% (7 of 49) of countries, and a more than sixfold difference was estimated in Niger and Nigeria
As of 2018, only 18 of the 49 African countries in our analyses offered community-based breastfeeding programs in all of their districts, and 21 report offering individual infant and young child feeding counselling in all of their primary health care facilities[25]; no information on the quality of services or number of women reached by these programs is available[9]
Summary
The Integrated Global Action Plan for Pneumonia and Diarrhoea (GAPPD) (WHO & UNICEF, 2013). Associations between key intervention coverage and child mortality: an analysis of 241 sub-national regions of sub-Saharan Africa. 3. Darmstadt, G. et al Evidence-based, cost-effective interventions: how many newborn babies can we save? A comprehensive analysis of breastfeeding patterns across the developing world and what we can learn from them. D. et al Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017.
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