Study setting and period
A Community based cross-sectional study was conducted from December to May 2017/18 in Axum Town central zone of Tigray regional administration. Axum town is located in North part of Ethiopia. Axum Town is located at a distant of 1,024 km from Addis Ababa capital city of Ethiopia & 190 km from Mekelle capital city of Tigray and it is the administrative town of central zone of Tigray region. Axum town has total Population of 74,007 (according to the 2015 projection of CSA). Based on Tigray Regional Health Bureau estimate, in the town administration there are 3008 target mother-infant pairs. The town has one specialized and comprehensive hospital one general hospital 2 health centres and 6 private health institutions. The Town has 5 kebeles and children age less than 2years in the town.
Sample size determination and sampling procedure
The sample size was determined by using formula below, where P is drown from study done in Amhara region, Ethiopia, March 2016 where proportion (p) was 61.5% (16). A sample size of 358 was determined using the single population proportion formula by using assumptions: n= required sample size Za/2- Standard normal score =1.96, P - Population proportion =61.5%, d – marginal error = 0.05 and none response rate 10%. All mothers of children aged less than 2 years in the kebeles were included.
Due to technical limitations, equation 1 has been placed in the supplementary files section.
Women who were unable to communicate and mothers of children aged less than 2 years whose child did not initiate weaning were not included in the study.
Initiation time of weaning was the outcome variable measured by timely and early initiation of weaning. The independent variables were age of mother, parity, occupation, return to work during post partum period, marital status, educational level of the mother and the husband, sex of child, family professional advice, institutional delivery, having ANC service, having PNC service, advice from health workers/formal advice, immunization, mode of delivery , knowledge on initiation of weaning
Weaning:- Weaning is the period of time when infants introduce food different from milk in their diet (1).
Timely weaning: - Additional food given at 6 months age.
Early weaning: - Foods given in addition to breastfeeding before the age of 6 months(31).
Knowledge: Is the information in which an individual is aware on initiation of weaning. In this study it was measured based on the ability of the mothers to correctly identify and respond to knowledge questions related to the initiation time of weaning. The level of knowledge was determined on a knowledge index. The highest possible score is 5 points. Weaning Knowledge was categorized as either poor (0-2 points), average (3 points) or high (4-5 points) (17, 23).
Data collection tools and procedures
Semi structured questionnaire was used as a tool of data collection which is adapted from different literatures and the component of the questionnaire (16, 18, 19, 26-28). The questionnaire was translated to the local language Tigrigna and back to English to have equal understanding among the data collectors and participants. Study participants were selected by simple random sampling method from 5 kebeles of Axum town using the sampling frame obtained from the town health extension workers. Households’ number that are used by the health extension workers were used to identify the selected households.
Data management and analysis
After checking its completeness and appropriateness, it was coded and entered to Epi Info version18.104.22.168 and analyse using SPSS version 22.0. Different statistical analyses including descriptive statistics, Bivariable and multivariable analysis was implemented to determine the relationship between the dependent and independent variables. The analysed data were presented using percents, texts, tables, graphs and charts. The result was described, interpreted and compared with similar studies.
To conduct this research ethical clearance was obtain from Mekelle University College of health sciences Ethical Review Board (ERB). Formal letter of cooperation was written From TRHB to Axum Health office. Permission letter was received from the health office and from each kebeles. Verbal and written informed consent was also obtained from each study participants. Study participant were informed about the objective of the study. Participants were also informed about the confidentiality of the data that obtained from them by using codes instead of personal identifiers.