User

Does the Integrated Health Post have Contextual Effect on Exclusive Breastfeeding? A Multilevel Evidence from Karanganyar, Central Java

Lathifah ‘Arub, Eti Poncorini Pamungkasari, Yulia Lanti Retno Dewi

Abstract

Background: Breastfeeding provides amazing benefits for the health of the child and the mother. WHO and UNICEF suggest a mother should be able to practice and maintain exclusive breast­feeding during the first six months of her baby's life. This study aimed to analyze contextal effect of integrated health post on exclusive breastfeeding.

Subjects and Method: This was cross sectional study conducted in 25 integrated health posts (posyandu) in Karanganyar, Central Java, from August to September 2019. A sample of 200 nursing lactating mothers who had children aged 7 to 12 months was selected by stratified random sampling. The dependent variable was exclusive breastfeeding. The independent variables were maternal age, education, occupation, type of birth delivery, knowledge, attitude, family support, and so­cial capital. The data were collected by questionnaire. The data were analysis by multilevel mul­ti­ple logistic regression with Stata 13.

Results: Exclusive breastfeeding increased with maternal age 20 to 34 years (b= 2.38; 95% CI= 0.62 to 4.15; p= 0.008), maternal education ≥Senior high school (b= 1.64; 95% CI= 0.01 to 3.23; p= 0.049), good knowledge (b= 2.13; 95% CI= 0.41 to 3.86; p= 0.015), positive attitude (b= 1.67; 95% CI= 0.10 to 3.23; p= 0.036), strong family support (b= 1.58; 95% CI= 0.10 to 3.07; p= 0.036), and strong social capital (b= 1.64; 95% CI= 0.01 to 3.27; p= 0.049). Exclusive breast­fee­ding decreased with mother working outside the house (b= -3.54; 95% CI= -5.50 to -1.58; p<0.001) and sectio caesarea (b= -1.88; 95% CI= -3.58 to -3.58 to -0.19; p= 0.029). Integrated health post had strong contextual effect on exclusive breastfeeding with intra-class correlation (ICC)= 29.3%.

Conclusion: Exclusive breastfeeding increases with maternal age 20 to 34 years, high maternal education, good knowledge, positive attitude, strong family support, and strong social capital. Exclusive breast­fee­ding decreases with mother working outside the house and sectio caesarea. Integrated health post has strong contextual effect on exclusive breastfeeding.

Keywords: exclusive breastfeeding, multilevel analysis, posyandu

Correspondence: Lathifah ‘Arub, Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36 A, Surakarta, Central Java 57126. Email: lathifah.arub17@gmail.com. Mobile: 085789212539

Journal of Maternal and Child Health (2020), 5(1): 100-110
https://doi.org/10.26911/thejmch.2020.05.01.11

 


Full Text:

PDF

References


Abasiattai AM, Etukumana EA, Nyong E, Eyo UE (2014). Knowledge and practice of exclusive breastfeeding among antenatal attendees in Uyo, Southern Nigeria. Gaziantep Medical Journal. 20(2): 130-135. doi: 10.5455/gmj-30-45779; [Crossref]; [Google Scholar]


Alamirew MW, Bayu NH, Birhan Tebeje N, Kassa SF (2017). Knowledge and attitude towards exclusive breast feeding among mothers attending antenatal and immunization clinic at Dabat Health Center, Northwest Ethiopia: A Cross-Sectional Institution Based Study. Nurs Res Pract. 2017: 6561028. doi: 10.1155/2017/6561028; [Crossref]; [PubMed]; [Google Scholar]


Asfaw MM, Argaw MD, Kefene ZK (2015). Factors associated with exclusive breastfeeding practices in Debre Berhan District, Central Ethiopia: A cross sectional community based study. Int Breastfeed J. 2015: 1-9. doi: 10.1186/s13006-015-0049-2; [Crossref]; [PubMed]; [Google Scholar]


Boateng GO, Martin SL, Collins SM, Natamba BK, Young SL (2018). Measuring exclusive breastfeeding social support: Scale development and validation in Uganda. Matern Child Nutr. 14(3): 1-24. doi: 10.1111/mcn.12579; [Crossref]; [PubMed]; [Google Scholar]


Boateng MF (2018). Knowledge, attitude and practice of exclusive breast feeding among mothers in Techiman, Ghana Master's thesis. University of Eastern Finland. [Website]


Dennis CL, Gagnon A, Van Hulst A, Dougherty G (2012). Predictors of breastfeeding exclusivity among migrant and Canadian-born women: Results from a multi-centre study. Matern Child Nutr. 10(4): 527-544. doi: 10.1016/j.jpeds.2012.06.041; [Crossref]; [PubMed]; [Google Scholar]


Ehsan A, Klaas HS, Bastianen A, Spini D (2019). Social capital and health: A systematic review of systematic reviews. SSM Popul Health. 7(8): 100425. doi: 10.1016/j.ssmph.2019.100425; [Crossref]; [PubMed]; [Google Scholar]


Habibi M, Zahra F, Aguenaou H, Doukkali L, Mrabet M, Barkat A The impact of maternal socio-demographic characteristics on breast feeding knowledge and practices: An experience from Casablanca, Moroc co. Int J Pediatr Adolesc Med. 5(2): 39–48. doi: 10.1016/j.ijpam.2018.01.003; [Crossref]; [PubMed]; [Google Scholar]


Hossain M, Islam A, Kamarul T, Hossain G. (2018). Exclusive breastfeeding practice during first six months of an infant’s life in Bangladesh: A country based cross-sectional study. BMC Pediatr. 18(1): 1-9. doi: 10.1186/s12887-018-1076-0; [Crossref]; [PubMed]; [Google Scholar]


Jaafar SH, Ho JJ, Jahanfar S, Angolkar M (2016). Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 30(8): CD007202. doi: 10.1002/14651858.cd007202.pub4; [Crossref]; [PubMed]; [Google Scholar]


Ministry of Health (2017). Pedoman penyelenggaraan pekan asi sedunia tahun 2017 (Guidelines for organizing the 2017 breastmilk World Week). [Website]


Lestari E, Pamungkasari EP, Dewi YLR (2019). Multilevel analysis on the contextual effect of posyandu on exclusive breastfeeding in Sleman, Yogyakarta. J Matern Child Health. 4(4): 250-259. doi: 10.26911/thejmch.2019.04.04.04; [Crossref]; [Google Scholar]


Mgongo M, Hussein TH, Stray-Pedersen B, Vangen S, Msuya SE, Wandel M (2019). Facilitators and barriers to breastfeeding and exclusive breast feeding in Kilimanjaro Region, Tanzania: A qualitative study. Int J Pediatr. 2019: 8651010. doi: 10.1155/2019/8651010; [Crossref]; [PubMed]; [Google Scholar]


Mogre V, Dery M, Gaa PK (2016). Knowledge, attitudes and determinants of exclusive breast feeding practice among Ghanaian rural lactating mothers. Int Breastfeed J. 11(1): 1-8. doi: 10.1186/s13006-016-0071-z; [Crossref]; [PubMed]; [Google Scholar]


Mohammed ES, Ghazawy ER, Hassan EE (2014). Knowledge, attitude, and practices of breastfeeding and weaning among mothers of children up to 2 years old in a rural area in El-Minia Governorate, Egypt. J Family Med Prim Care. 3(2): 136-140. doi: 10.4103/2249-4863.137639; [Crossref]; [PubMed]; [Google Scholar]


Moore S, Kawachi I (2017). Twenty years of social capital and health research: A glossary. J Epidemiol Community Health. 71(5): 513–517. doi: 10.1136/jech-2016-208313; [Crossref]; [PubMed]; [Google Scholar]


Mosquera PS, Lourenço BH, Gimeno S, Malta MB, Castro MC, Cardoso MA, MINA-Brazil Working Group (2019). Factors affecting exclusive breastfeeding in the first month of life among Amazonian children. PloS ONE. 14(7): 1-16. doi: 10.1371/journal.pone.0219801; [Crossref]; [PubMed]; [Google Scholar]


Onah S, Osuorah DI, Ebenebe J, Ezechuk-wu C, Ekwochi U, Ndukwu I (2014). Infant feeding practices and maternal socio-demographic factors that influence practice of exclusive breastfeeding among mothers in Nnewi South-East Nigeria: A cross-sectional and analytical study. Int Breastfeed J. 9(1): 1-10. doi: 10.1186/1746-4358-9-6; [Crossref]; [PubMed]; [Google Scholar]


Soomro JA, Shaikh ZN, Bijarani SA, Saheer TB(2015). Factors affecting breastfeeding practices in working women of Pakistan. East Mediterr Health J. 22(11): 810-816. doi: 10.26719/2016.22.11.810; [Crossref]; [PubMed]; [Google Scholar]


Souza SNDH, Migoto MT, Rossetto EG, Mello DF (2012). Prevalence of breast¬feeding and associated factors in the municipality of Londrina (PR, Brazil). Acta Paul Enferm. 25(1): 29-35. doi: 10.1590/s0103-21002012000100006; [Crossref]; [Google Scholar]


Sipahutar S, Lubis NL, Siregar FA (2019). The association between maternal knowledge, family support, and exclusive breastfeeding in Siborong Borong Community Health Center, North Tapanuli, North Sumatera. J Matern Child Health. 4: 338-341. doi: 10.26911/thejmch.2019.04.05.06; [Crossref]; [Google Scholar]


Tadesse F, Alemayehu Y, Shine S, Asresahegn H, Tadesse TT (2019). Exclusive breastfeeding and maternal employment among mothers of infants from three to five months old in the Fafan zone, Somali regional state of Ethiopia: A comparative cross-sectional study. BMC Public Health. 19: 1015. doi: 10.1186/s12889-019-7345-5; [Crossref]; [PubMed]; [Google Scholar]


Tewabe T, Mandesh A, Gualu T, Alem G, Mekuria G, Zeleke H (2017). Exclusive breastfeeding practice and associated factors among mothers in Motta town, East Gojjam zone, Amhara Regional State, Ethiopia, 2015: A cross-sectional study. Int Breastfeed J. 27 (12): 1-7. doi: 10.1186/s13006-017-0103-3; [Crossref]; [PubMed]; [Google Scholar]


Tiyas DW, Murti B, Indarto D (2016). Qualitative analysis on the factors affecting exclusive breastfeeding among working mothers at community health center in Bangkalan, Madura. J Matern Child Health. 1(2): 110-118. doi: 10.26911/thejmch.2016.01.02.06; [Crossref]; [Google Scholar]


Tsegaye M, Ajema D, Shiferaw S, Yirgu R (2019). Level of exclusive breastfeeding practice in remote and pastoralist community, Aysaita woreda, Afar, Ethiopia. Int Breastfeed J 6: 1-15. doi: 10.1186/s13006-019-0200-6; [Crossref]; [PubMed]; [Google Scholar]


Villalonga-Olives E, Kawachi I (2015). The measurement of bridging social capital in population health research. Health Place. 36(2015): 47–56. doi: 10.1016/j.healthplace.2015.09.002; [Crossref]; [PubMed]; [Google Scholar]


World Health Organization (2017a). Breastfeeding. Health topics. [Website]


World Health Organization (2017b). World breastfeeding week. World Health Organization. [Website]


World Health Organization (2018a). Mater-nal, newborn, child and adolescent health. World Health Organization. [Website]


World Health Organization (2018b). Guideline: counseling of women to improve breastfeeding practices. Geneva: World Health Organization; 20-18. Licence: CC BY-NC-SA 3.0 IGO. [Website]


Daftar Pustaka berbentuk website tanpa tulisan retrieved from. [Website]


Wowor M, Laoh JM, Pangemanan DHC (2013). Hubungan pengetahuan dan sikap dengan pemberian ASI eksklusif pada ibu menyusui di Puskesmas Bahu Kota Manado (Relationship between knowledge and attitude with exclusive breastfeeding for breastfeeding mothers at Manado City Health Center). E jurnal Keperawatan. 1(1): 77-88. [Website]


Zakar R, Zakar MZ, Zaheer L, Fischer F (2018). Exploring parental perceptions and knowledge regarding breast feeding practices in Rajanpur, Punjab Province, Pakistan. Int Breastfeed J. 3(13): 24. doi: 10.1186/s13006-018-0171-z; [Crossref]; [PubMed]; [Google Scholar]


Zhang Z, Zhu Y, Zhang L, Wan H (2018). What factors influence exclusive breastfeeding based on the theory of planned behaviour. Midwifery. 62: 177-182. doi: 10.1016/j.midw.2018.04.006; [Crossref]; [PubMed]; [Google Scholar]

Refbacks

  • There are currently no refbacks.