Maternal Health Care Utilization and Early Initiation of Breastfeeding in South Western and East Central Uganda

Abstract

The objective of this study was to investigate the interrelationship between maternal health care utilization and early initiation breastfeeding among mothers (15-49 years) in East-Central and South Western Uganda. Maternal health care utilization was assessed based on health facility delivery and ANC 4th attendance. In addition to early initiation of breastfeeding, these three factors were the endogenous variables. The exogenous variables were socio-demographic characteristic of women namely marital status, education level, age, wealth status, and region as well as knowledge and exposure to media on breast feeding. The study utilized secondary data based on the 2014 baseline for Strengthening Partnerships Results and Innovations in Nutrition Globally (SPRING) in Uganda. However, only 1,144 records of mothers of children aged 0-23 months were adopted in the analysis. The analysis was undertaken using frequency distributions, differentials in endogenous by explanatory variables and a Structural Equation Modeling approach based on a logistic link function.

In the findings, the majority of the women confirmed having health facility deliveries (71%) and breastfeeding their babies within the first one hour after birth (77%). Almost four out of ten (41.6%) never attended ANC at least four times during the pregnancy of the index child. The factors that were directly associated with early initiation of breastfeeding are health facility delivery (OR = 1.41, 95% CI 1.02-1.94), knowledge of the timing of breastfeeding after birth (OR = 6.21, CI 95% 4.320-8.932) and age group 25-29 (OR = 0.51, 95% 0.274-0.968). The factors that were directly associated with health facility delivery are post-primary level of education (OR = 1.96, 95% CI 1.195-3.242), ANC 4th attendance (OR = 1.45, 95% CI 1.101-1.923) and residence in East Central region (OR = 1.60, 95% CI 1.140-2.257). On the other hand, ANC 4th attendance was directly associated with post-primary education level (OR = 1.81, 95% CI 1.073-3.058). All the factors were significant.

The study recommends that efforts towards enhancing early initiation of breastfeeding after birth. A behavior change strategy based on the Essential Nutrition Actions framework, which targets health workers, community members, families, and women with practical skills-based training to promote optimal infant feeding practices, is likely to hold much potential for improving the adoption of the initiation of breastfeeding within 1 hour after birth and, by extension, the adoption of exclusive breastfeeding during the first 6 months of life.