Factors associated with exclusive breastfeeding of children under six months of age in Cote d'Ivoire.

BACKGROUND: Despite benefits of exclusive breastfeeding (EBF) and its strategic place in the national guidelines for infant and young child feeding, its practice remains insufficient in Cote d'Ivoire. It is therefore important to identify its early stopping associated factors. We aimed to (i) assess the extent of children's exposure to exclusive breastfeeding and the associated explanatory factors for discontinuation before six months, and (ii) to profile non-exclusively breastfed children and interrelationships between these factors. METHODS: A secondary analysis of data from the 2016 Cote d'Ivoire Fifth Multi Indicator Cluster Survey (MICS5) of 980 children under six months of age was conducted in this study. Data were analyzed using the actuarial method of survival hazard estimation combined with the Wilcoxon (Gehan) test, discrete time proportional hazards regression models, and Multiple Correspondence Analysis (MCA) to profile the children. RESULTS: Maternal exposure to counseling session, age at delivery, and child sex were significantly associated with the likelihood of discontinuing exclusive breastfeeding before the first six months of life. Children deprived of EBF resided in urban areas, in high and very high economic welfare households. Their mothers had a secondary education or higher and had three or fewer children. Logistic analysis showed that health status and sex of the child were significantly associated (P < 0.001) with exclusive breastfeeding. An extremely important and rarely studied factor is that children who were sick in weeks prior to the survey were more likely to remain exclusive breastfeeding (adjusted OR 1.80; 95% Confidence Interval (CI) 1.452, 2.234). Girls are less likely to be exclusively breastfed than boys (adjusted OR 1.48; 95% CI 1.22, 1.798). Low standard of living was associated with early cessation of EBF (adjusted OR 2.15; CI 1.325, 3.499). The duration of the exclusive breastfeeding was significantly longer among mothers with high exposure to medical discourse (adjusted OR 0.74; CI 0.595, 0.91). CONCLUSIONS: Improving the practice of exclusive breastfeeding in Cote d'Ivoire requires strengthening the capacities of health professionals in terms of advice and assistance to mothers for the practice of exclusive breastfeeding and its maintenance until six months of age, regardless of the health status and sex of the child.

Profil des femmes ayant des besoins non satisfaits en planification familiale en Cote d'Ivoire

Objectif : Décrire le profil des groupes spécifiques de femmes qui portent le plus lourd fardeau des besoins non satisfaits en planification familiale. Méthodologie : Analyse secondaire des données de l'EDS 2012 portant sur les besoins non satisfaits de PF chez les femmes en âge de procréer, sexuellement actives et exposées aux grossesses. Chi 2 de Pearson et Ttest de Student réalisés. Analyse multivariée par technique CHAID de l'arbre de décision. Interprétation des résultats au seuil (α=5%, IC à 95%). Résultats : les BNSPF de l'ordre de 50 à 58% sont portées par moins de 4% de la population féminine. Plus de 21% ont des BNSPF de l'ordre de 32 à 39% et sont majoritairement sans instruction, multipares, venant du Centre et du Sud du pays. Conclusion : Développer des stratégies desensibilisation et de communication spécifiquement adaptés à ces groupes pour combler le gap d'utilisation des méthodes contraceptives