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Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018
Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.

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Bhattacharjee, Natalia V.
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Local Burden of Disease Exclusive Breastfeeding Collaborators (2021) Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018. Nature Human Behaviour, 5 (8), 1027-1045. (doi:10.1038/s41562-021-01108-6).

Record type: Article

Abstract

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.

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Accepted/In Press date: 31 March 2021
e-pub ahead of print date: 3 June 2021
Published date: August 2021
Additional Information: Funding Information: This work was primarily supported by grant no. OPP1132415 from the Bill & Melinda Gates Foundation. Co-authors used by the Bill & Melinda Gates Foundation (E.G.P. and R.R.3) provided feedback on initial maps and drafts of this manuscript. L.G.A. has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES), Código de Financiamento 001 and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (grant nos. 404710/2018-2 and 310797/2019-5). O.O.Adetokunboh acknowledges the National Research Foundation, Department of Science and Innovation and South African Centre for Epidemiological Modelling and Analysis. M.Ausloos, A.Pana and C.H. are partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project no. PN-III-P4-ID-PCCF-2016-0084. P.C.B. would like to acknowledge the support of F. Alam and A. Hussain. T.W.B. was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. K.Deribe is supported by the Wellcome Trust (grant no. 201900/Z/16/Z) as part of his international intermediate fellowship. C.H. and A.Pana are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project no. PN-III-P2-2.1-SOL-2020-2-0351. B.Hwang is partially supported by China Medical University (CMU109-MF-63), Taichung, Taiwan. M.Khan acknowledges Jatiya Kabi Kazi Nazrul Islam University for their support. A.M.K. acknowledges the other collaborators and the corresponding author. Y.K. was supported by the Research Management Centre, Xiamen University Malaysia (grant no. XMUMRF/2020-C6/ ITM/0004). K.Krishan is supported by a DST PURSE grant and UGC Centre of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M.Kumar would like to acknowledge FIC/NIH K43 TW010716-03. I.L. is a member of the Sistema Nacional de Investigación (SNI), which is supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panamá. M.L. was supported by China Medical University, Taiwan (CMU109-N-22 and CMU109-MF-118). W.M. is currently a programme analyst in Population and Development at the United Nations Population Fund (UNFPA) Country Office in Peru, which does not necessarily endorses this study. D.E.N. acknowledges Cochrane South Africa, South African Medical Research Council. G.C.P. is supported by an NHMRC research fellowship. P.Rathi acknowledges support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India. Ramu Rawat acknowledges the support of the GBD Secretariat for supporting the reviewing and collaboration of this paper. B.R. acknowledges support from Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal. A.Ribeiro was supported by National Funds through FCT, under the programme of ‘Stimulus of Scientific Employment—Individual Support’ within the contract no. CEECIND/02386/2018. S.Sajadi acknowledges colleagues at Global Burden of Diseases and Local Burden of Disease. A.M.S. acknowledges the support from the Egyptian Fulbright Mission Program. F.S. was supported by the Shenzhen Science and Technology Program (grant no. KQTD20190929172835662). A.Sheikh is supported by Health Data Research UK. B.K.S. acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for all the academic support. B.U. acknowledges support from Manipal Academy of Higher Education, Manipal. C.S.W. is supported by the South African Medical Research Council. Y.Z. was supported by Science and Technology Research Project of Hubei Provincial Department of Education (grant no. Q20201104) and Outstanding Young and Middle-aged Technology Innovation Team Project of Hubei Provincial Department of Education (grant no. T2020003). The funders of the study had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. All maps presented in this study are generated by the authors and no permissions are required to publish them. Funding Information: R.A. reports he received consultancy or speakers fees from UCB, Sandoz, Abbvie, Zentiva, Teva, Laropharm, CEGEDIM, Angelini, Biessen Pharma, Hofigal, AstraZeneca and Stada. A.Deshpande reports grants from Bill & Mellinda Gates Foundation, during the conduct of the study. J.J.J. reports personal fees from Boehringer Ingelheim, Zentiva, Amgen and Teva, all outside the submitted work. K.Krishan reports grants from DST PURSE and UGC Centre of Advanced Study, CAS II, awarded to the Department of Anthropology, Panjab University, Chandigarh, India, outside the submitted work. J.F.M. reports grants from Bill & Melinda Gates Foundation during the conduct of the study. S.R.P. reports non-financial support from Somnogen Canada Inc. and personal fees from editorial services, during the conduct of the study. E.U. reports having a Patent A system and method of reusable filters for anti-pollution mask pending and a Patent A system and method for electricity generation through crop stubble by using microbial fuel cells pending. All other authors declare no competing interests. Publisher Copyright: © 2021, The Author(s).

Identifiers

Local EPrints ID: 471935
URI: http://eprints.soton.ac.uk/id/eprint/471935
ISSN: 2397-3374
PURE UUID: 08c4a6c5-9eb5-477d-95d2-ea3920fddc33

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Date deposited: 22 Nov 2022 17:58
Last modified: 17 Mar 2024 13:09

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Contributors

Author: Natalia V. Bhattacharjee
Author: Lauren E. Schaeffer
Author: Simon I. Hay
Author: Dan Lu
Author: Megan F. Schipp
Author: Alice Lazzar-Atwood
Author: Katie M. Donkers
Author: Gdiom Gebreheat Abady
Author: Foad Abd-Allah
Author: Ahmed Abdelalim
Author: Zeleke Hailemariam Abebo
Author: Ayenew Negesse Abejie
Author: Akine Eshete Abosetugn
Author: Lucas Guimarães Abreu
Author: Michael R.M. Abrigo
Author: Eman Abu-Gharbieh
Author: Abdelrahman I. Abushouk
Author: Aishatu L. Adamu
Author: Isaac Akinkunmi Adedeji
Author: Adeyinka Emmanuel Adegbosin
Author: Victor Adekanmbi
Author: Olatunji O. Adetokunboh
Author: Marcela Agudelo-Botero
Author: Budi Aji
Author: Oluwaseun Oladapo Akinyemi
Author: Alehegn Aderaw Alamneh
Author: Fahad Mashhour Alanezi
Author: Turki M. Alanzi
Author: James Albright
Author: Jacqueline Elizabeth Alcalde-Rabanal
Author: Biresaw Wassihun Alemu
Author: Robert Kaba Alhassan
Author: Beriwan Abdulqadir Ali
Author: Saqib Ali
Author: Cyrus Alinia
Author: Vahid Alipour
Author: Arianna Maever L. Amit
Author: Dickson A. Amugsi
Author: Etsay Woldu Anbesu
Author: Robert Ancuceanu
Author: Mina Anjomshoa
Author: Fereshteh Ansari
Author: Carl Abelardo T. Antonio
Author: Davood Anvari
Author: Jalal Arabloo
Author: Ming Chieh Li
Author: Mohammad Hifz Ur Rahman
Author: Irfan Ullah
Author: Fang Wang
Author: Yuan Pang Wang
Corporate Author: Local Burden of Disease Exclusive Breastfeeding Collaborators

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