Exclusive breast feeding and its determinants in Yaounde Cameroon: a retrospective survival analysis

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Sokoine University of Agriculture


Exclusive breastfeeding (EBF) of infants for the first six months of life is now considered a global public health goal that is linked to reduction of morbidity and mortality in infants especially in developing countries. These morbidities and mortalities are attributed to increased incidences of upper and lower respiratory tract and gastrointestinal tract infections in infants. The purpose of this study was to assess adherence of mothers to the six-month exclusive breastfeeding as recommended by the World Health Organisation (WHO). A retrospective survival analysis study was carried out with a simple random sample of 503 participants at the Chantal Biya Foundation, consultation and vaccination unit in Yaoundé Cameroon. Qualitative and quantitative data were collected using formal interviews and structured questionnaires respectively for duration of six months between November 2019 and May 2020. A Cox proportional hazard model was used to explore the hazard ratio of associated risk factors. A log-rank test was used to test the hypothesis of differences in survival rates for each variable of the prognostic factors. This study revealed that mean time for mothers to practise EBF was 3.61± 0.095 months within a time range of one to six months. In addition, more than 90% of the mothers were aware of EBF requirements and procedures and attended antenatal clinics. Notwithstanding, only 38% of mothers could survive EBF (Censored) and 62% of mothers could not adhere to EBF practices or failed to practice EBF (95% CI: 0.9056-0.7701). Prognostic factors like mother’s marital status were highly significant (P=0.003; HR: 0.70; 95% CI= 0.55-0.89) whereby, married mothers practised EBF at higher rates than unmarried mothers. Mother’s education level also played a significant role to the adherence of EBF practices (P=0.005; HR: 1.43; 95% CI=1.11-1.84). Mothers who had attained higher education level significantly reported a lower rate of EBF compared to mothers with basic or no formal education. Continuous mass sensitization and enforcement measures is recommended to be done by various health workers at ANC clinics on the importance of proper EBF. Meanwhile, policy review by policy-makers in the health sector like the Ministry of Public Health and Family Planning when designing policies for nursing mothers is recommended.



Breast feeding, Retrospective survival analysis, Yaounde, Cameroon, Infants