Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 10, 2024
Date Accepted: Aug 13, 2024
Socio-economic Moderators of the Association between Delayed Initiation and Place of Delivery: Insights from a Large Indian Cross-sectional Survey
ABSTRACT
Background:
Breastfeeding is a crucial and irreplaceable method of feeding infants. Despite the well-established advantages of early breastfeeding initiation, there are constraints to achieving progress in this area. Various factors have been pinpointed as influencing the initiation of breastfeeding, with institutional deliveries emerging as a crucial factor among them.
Objective:
To test the hypothesized association between institutional delivery and initiation delays and identify how various socio-economic variables moderate (weaken/strengthen/ reverse) the association between breastfeeding initiation and institutional deliveries.
Methods:
This cross-sectional study includes data from 1,06,569 breastfeeding mothers from data of NFHS -5 (2019-2021) for analysis. The main focus of the study was on the timing of breastfeeding initiation for the most recent child, with the choice of delivery location serving as the explanatory variable. Additionally, socio-economic factors such as age, education level, marital status, place of residence, and wealth index were considered moderating variables. Regression-based Moderation analysis explored how the aforementioned variables moderate the relationship between breastfeeding initiation and delivery location. Statistical analysis was conducted using IBM SPSS Statistics 26.
Results:
The highest occurrence of delayed breastfeeding initiation was observed among mothers aged 36 and older (58.3%), lacking formal education (60.9%), belonging to lower wealth groups (58.1%), residing in rural areas (57.4%), and delivering their babies at home (64.1%). There is a significant association between delayed breastfeeding initiation and the place of delivery. The introduction of age as a moderating variable weakened the impact of institutional delivery on delayed initiation (aOR=0.823, P≤.05). Notably, education level (aOR=1.474, P≤ .01) and wealth index (aOR=1.238, P≤.01) as a moderating factor have reversed the impact of institutional delivery on delayed initiation.
Conclusions:
The study offers valuable insights into the intricate moderating effects of socio-economic variables affecting breastfeeding initiation within institutional childbirth contexts in India. Outreach initiatives aimed at promoting healthcare service utilization during pregnancy and delivery, as well as raising awareness about breastfeeding practices, are essential measures to improve the adoption and implementation of early breastfeeding initiation.
Citation
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Copyright
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