It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India

Evidence on strategies to improve infant and young child feeding in India, a country that carries the world's largest burden of undernutrition, is limited. In the context of a programme evaluation in two districts in Uttar Pradesh, we sought to understand the multiple influences on breastfeeding pra...

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Main Authors: Young, Melissa F., Nguyen, Phuong Hong, Kachwaha, Shivani, Tran, Lan Mai, Ghosh, Sebanti, Agrawal, Rajeev, Escobar-Alegria, Jessica, Menon, Purnima, Avula, Rasmi
Format: Journal Article
Language:Inglés
Published: John Wiley & Sons 2020
Subjects:
Online Access:https://hdl.handle.net/10568/142800
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author Young, Melissa F.
Nguyen, Phuong Hong
Kachwaha, Shivani
Tran, Lan Mai
Ghosh, Sebanti
Agrawal, Rajeev
Escobar-Alegria, Jessica
Menon, Purnima
Avula, Rasmi
author_browse Agrawal, Rajeev
Avula, Rasmi
Escobar-Alegria, Jessica
Ghosh, Sebanti
Kachwaha, Shivani
Menon, Purnima
Nguyen, Phuong Hong
Tran, Lan Mai
Young, Melissa F.
author_facet Young, Melissa F.
Nguyen, Phuong Hong
Kachwaha, Shivani
Tran, Lan Mai
Ghosh, Sebanti
Agrawal, Rajeev
Escobar-Alegria, Jessica
Menon, Purnima
Avula, Rasmi
author_sort Young, Melissa F.
collection Repository of Agricultural Research Outputs (CGSpace)
description Evidence on strategies to improve infant and young child feeding in India, a country that carries the world's largest burden of undernutrition, is limited. In the context of a programme evaluation in two districts in Uttar Pradesh, we sought to understand the multiple influences on breastfeeding practices and to model potential programme influence on improving breastfeeding. A cross‐sectional survey was conducted among 1,838 recently delivered women, 1,194 husbands, and 1,353 mothers/mothers‐in‐law. We used bivariate and multivariable logistic regression models to examine the association between key determinants (maternal, household, community, and health services) and breastfeeding outcomes [early initiation of breastfeeding (EIBF)], prelacteal feed, and exclusive breastfeeding (EBF). We used population attributable risk analysis to estimate potential improvement in breastfeeding practices. Breastfeeding practices were suboptimal: EIBF (26.3%), EBF (54%), and prelacteal feeding (33%). EIBF was positively associated with maternal knowledge, counselling during pregnancy/delivery, and vaginal delivery at a health facility. Prelacteal feeds were less likely to be given when mothers had higher knowledge, beliefs and self‐efficacy, delivered at health facility, and mothers/mothers‐in‐law had attended school. EBF was positively associated with maternal knowledge, beliefs and self‐efficacy, parity, and socio‐economic status. High maternal stress and domestic violence contributed to lower EBF. Under optimal programme implementation, we estimate EIBF can be improved by 25%, prelacteal feeding can be reduced by 25%, and EBF can be increased by 23%. A multifactorial approach, including maternal‐, health service‐, family‐, and community‐level interventions has the potential to lead to significant improvements in breastfeeding practices in Uttar Pradesh.
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spelling CGSpace1428002025-04-03T21:29:26Z It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India Young, Melissa F. Nguyen, Phuong Hong Kachwaha, Shivani Tran, Lan Mai Ghosh, Sebanti Agrawal, Rajeev Escobar-Alegria, Jessica Menon, Purnima Avula, Rasmi health households families family structure infant feeding marriage breastfeeding parents Evidence on strategies to improve infant and young child feeding in India, a country that carries the world's largest burden of undernutrition, is limited. In the context of a programme evaluation in two districts in Uttar Pradesh, we sought to understand the multiple influences on breastfeeding practices and to model potential programme influence on improving breastfeeding. A cross‐sectional survey was conducted among 1,838 recently delivered women, 1,194 husbands, and 1,353 mothers/mothers‐in‐law. We used bivariate and multivariable logistic regression models to examine the association between key determinants (maternal, household, community, and health services) and breastfeeding outcomes [early initiation of breastfeeding (EIBF)], prelacteal feed, and exclusive breastfeeding (EBF). We used population attributable risk analysis to estimate potential improvement in breastfeeding practices. Breastfeeding practices were suboptimal: EIBF (26.3%), EBF (54%), and prelacteal feeding (33%). EIBF was positively associated with maternal knowledge, counselling during pregnancy/delivery, and vaginal delivery at a health facility. Prelacteal feeds were less likely to be given when mothers had higher knowledge, beliefs and self‐efficacy, delivered at health facility, and mothers/mothers‐in‐law had attended school. EBF was positively associated with maternal knowledge, beliefs and self‐efficacy, parity, and socio‐economic status. High maternal stress and domestic violence contributed to lower EBF. Under optimal programme implementation, we estimate EIBF can be improved by 25%, prelacteal feeding can be reduced by 25%, and EBF can be increased by 23%. A multifactorial approach, including maternal‐, health service‐, family‐, and community‐level interventions has the potential to lead to significant improvements in breastfeeding practices in Uttar Pradesh. 2020-12-01 2024-05-22T12:11:05Z 2024-05-22T12:11:05Z Journal Article https://hdl.handle.net/10568/142800 en https://doi.org/10.1093/cdn/nzz034.P10-149-19 Open Access John Wiley & Sons Young, Melissa F.; Nguyen, Phuong Hong; Kachwaha, Shivani; Mai, Lan Tran; Ghosh, Sebanti; Agrawal, Rajeev; Escobar-Alegria, Jessica; Menon, Purnima; and Avula, Rasmi. 2020. It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India. Maternal and Child Nutrition 16(2): e12892. https://doi.org/10.1111/mcn.12892
spellingShingle health
households
families
family structure
infant feeding
marriage
breastfeeding
parents
Young, Melissa F.
Nguyen, Phuong Hong
Kachwaha, Shivani
Tran, Lan Mai
Ghosh, Sebanti
Agrawal, Rajeev
Escobar-Alegria, Jessica
Menon, Purnima
Avula, Rasmi
It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India
title It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India
title_full It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India
title_fullStr It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India
title_full_unstemmed It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India
title_short It takes a village: An empirical analysis of how husbands, mothers‐in‐law, health workers, and mothers influence breastfeeding practices in Uttar Pradesh, India
title_sort it takes a village an empirical analysis of how husbands mothers in law health workers and mothers influence breastfeeding practices in uttar pradesh india
topic health
households
families
family structure
infant feeding
marriage
breastfeeding
parents
url https://hdl.handle.net/10568/142800
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