Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality
Abstract Background Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breastfeeding. This study aimed to estimate the trends and magnitude of ineq...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-08-01
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| Series: | International Breastfeeding Journal |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13006-023-00584-y |
| _version_ | 1827708125309829120 |
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| author | Satyajit Kundu Syed Sharaf Ahmed Chowdhury Md Tamzid Hasan Azaz Bin Sharif |
| author_facet | Satyajit Kundu Syed Sharaf Ahmed Chowdhury Md Tamzid Hasan Azaz Bin Sharif |
| author_sort | Satyajit Kundu |
| collection | DOAJ |
| description | Abstract Background Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breastfeeding. This study aimed to estimate the trends and magnitude of inequalities in early initiation of breastfeeding practice in Bangladesh from 2004 to 2017 applying both absolute and relative measures of inequality. Methods We used data from the last five Bangladesh Demographic Health Survey (BDHS) from 2004 to 2017 to measure the inequalities in early initiation of breastfeeding practice using the WHO’s Health Equity Assessment Toolkit (HEAT) software. Following summary measures were estimated to measure the inequalities: Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) where the equity dimensions were wealth status, education level, sex of child, place of residence, and subnational regions (divisions). For each measure, point estimates along with a 95% confidence interval (CI) were reported. Results An uprising pattern in the prevalence of early initiation of breastfeeding was found, where early initiation of breastfeeding increased from 24.9% to 2004 to 59.0% in 2017. We found significant wealth-driven inequalities in early initiation of breastfeeding practice in every wave of survey favoring the poorest wealth quintile (in 2017, D -10.5; 95% CI -16.6 to -4.3). We also identified geographical disparities in early initiation of breastfeeding practice (in 2017, PAF 11.1; 95% CI 2.2 to 19.9) favoring the Rangpur (65.5%), and Sylhet (65.3%) divisions. Education-related disparities were observed in 2004 only, but not in later survey years, which was due to a much lower level of adherence among those with secondary or higher education. There were no significant disparities in early initiation of breastfeeding based on the urban vs. rural residence and sex of the child. Conclusions The highest attention should be placed in Bangladesh to attain the WHO’s 100% recommendation of timely initiation of breastfeeding. This study emphasizes on addressing the existing socioeconomic and geographic inequalities. Awareness-raising outreach programs focusing the mothers from wealthier sub-groups and divisions with lower prevalence should be planned and implemented by the joint effort of the government and non-government organizations. |
| first_indexed | 2024-03-10T16:58:21Z |
| format | Article |
| id | doaj.art-cd89b92da51c485fafa7928be5aba516 |
| institution | Directory Open Access Journal |
| issn | 1746-4358 |
| language | English |
| last_indexed | 2024-03-10T16:58:21Z |
| publishDate | 2023-08-01 |
| publisher | BMC |
| record_format | Article |
| series | International Breastfeeding Journal |
| spelling | doaj.art-cd89b92da51c485fafa7928be5aba5162023-11-20T11:03:36ZengBMCInternational Breastfeeding Journal1746-43582023-08-0118111010.1186/s13006-023-00584-yInequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequalitySatyajit Kundu0Syed Sharaf Ahmed Chowdhury1Md Tamzid Hasan2Azaz Bin Sharif3Global Health Institute, North South UniversityDepartment of Public Health, North South UniversityDepartment of Public Health, North South UniversityGlobal Health Institute, North South UniversityAbstract Background Evidence suggested that inequalities based on education, wealth status, place of residence, and geographical regions significantly influence the key breastfeeding indicators including early initiation of breastfeeding. This study aimed to estimate the trends and magnitude of inequalities in early initiation of breastfeeding practice in Bangladesh from 2004 to 2017 applying both absolute and relative measures of inequality. Methods We used data from the last five Bangladesh Demographic Health Survey (BDHS) from 2004 to 2017 to measure the inequalities in early initiation of breastfeeding practice using the WHO’s Health Equity Assessment Toolkit (HEAT) software. Following summary measures were estimated to measure the inequalities: Population Attributable Risk (PAR), Population Attributable Fraction (PAF), Difference (D), and Ratio (R) where the equity dimensions were wealth status, education level, sex of child, place of residence, and subnational regions (divisions). For each measure, point estimates along with a 95% confidence interval (CI) were reported. Results An uprising pattern in the prevalence of early initiation of breastfeeding was found, where early initiation of breastfeeding increased from 24.9% to 2004 to 59.0% in 2017. We found significant wealth-driven inequalities in early initiation of breastfeeding practice in every wave of survey favoring the poorest wealth quintile (in 2017, D -10.5; 95% CI -16.6 to -4.3). We also identified geographical disparities in early initiation of breastfeeding practice (in 2017, PAF 11.1; 95% CI 2.2 to 19.9) favoring the Rangpur (65.5%), and Sylhet (65.3%) divisions. Education-related disparities were observed in 2004 only, but not in later survey years, which was due to a much lower level of adherence among those with secondary or higher education. There were no significant disparities in early initiation of breastfeeding based on the urban vs. rural residence and sex of the child. Conclusions The highest attention should be placed in Bangladesh to attain the WHO’s 100% recommendation of timely initiation of breastfeeding. This study emphasizes on addressing the existing socioeconomic and geographic inequalities. Awareness-raising outreach programs focusing the mothers from wealthier sub-groups and divisions with lower prevalence should be planned and implemented by the joint effort of the government and non-government organizations.https://doi.org/10.1186/s13006-023-00584-yEarly initiation of breastfeedingTimely initiation of breastfeedingInequalitiesDisparitiesBangladeshBDHS |
| spellingShingle | Satyajit Kundu Syed Sharaf Ahmed Chowdhury Md Tamzid Hasan Azaz Bin Sharif Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality International Breastfeeding Journal Early initiation of breastfeeding Timely initiation of breastfeeding Inequalities Disparities Bangladesh BDHS |
| title | Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality |
| title_full | Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality |
| title_fullStr | Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality |
| title_full_unstemmed | Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality |
| title_short | Inequalities in early initiation of breastfeeding in Bangladesh: an estimation of relative and absolute measures of inequality |
| title_sort | inequalities in early initiation of breastfeeding in bangladesh an estimation of relative and absolute measures of inequality |
| topic | Early initiation of breastfeeding Timely initiation of breastfeeding Inequalities Disparities Bangladesh BDHS |
| url | https://doi.org/10.1186/s13006-023-00584-y |
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