Socio-demographic characteristics of the respondents
A total response rate of the study was 486 (98.2%). Mean (±SD) age of the participants was 29.5(5.4) years. The majorities were illiterate of which 232 (47.7%) unable to read and write, 412 (84.8%) of them lives in rural areas, and 248 (51.0%) of them were housewife (Table 1).
Table 1: Maternal and child socio-demographic data in Assosa Zone, BGR, Western Ethiopia, 2020.
Variables
|
Frequency
|
Percent (%)
|
Age of mother
|
<24
|
82
|
16.9%
|
25-29
|
178
|
36.6%
|
≥30
|
226
|
46.5%
|
Age of children (years)
|
0-6months
|
156
|
32.1%
|
6-12 months
|
172
|
35.4%
|
12-18 months
|
86
|
17.7%
|
19-24 months
|
72
|
14.8%
|
Sex
|
Male
|
294
|
60.5%
|
Female
|
192
|
39.5%
|
Place of residence
|
Rural
|
412
|
84.8%
|
Semi-urban
|
74
|
15.2%
|
Family size
|
<3
|
130
|
26.7%
|
4-6
|
260
|
53.5%
|
>6
|
96
|
19.8%
|
Education status of mother
|
Unable to read and write
|
232
|
47.7%
|
Able to read and write
|
108
|
22.2%
|
Primary education
|
94
|
19.3%
|
Secondary education
|
32
|
6.6%
|
College and above
|
20
|
4.1%
|
Education status of father
|
Unable to read and write
|
188
|
38.7%
|
Able to read and write
|
120
|
24.7%
|
Primary education
Secondary education
|
84
54
|
17.3%
11.1%
|
College and above
|
40
|
8.2%
|
Occupational status of mother
|
House wife
|
248
|
51%
|
Farmer
|
192
|
39.5%
|
Merchant
|
30
|
6.2%
|
Daily laborer
|
4
|
0.8%
|
Gov’t employee
|
12
|
2.5%
|
Parity
|
1
|
416
|
85.6%
|
2
|
68
|
14.0%
|
≥3
|
2
|
0.4%
|
Knowledge of Respondents about IYCF Practices
Overall, 456 (93.8%) mothers had good knowledge on IYCF practice recommendation. Majority, 408 (84%) of participants realized that breast milk was the first feed that should be consumed by the child after birth with in 1hour of birth and 416(85.6%) women knew that exclusive breast-feeding means that an infant should receive only breast milk up to 6 months of life. Four hundred four (83.1%) respondents identified exact time of complementary feeding initiation. Among all respondents, majority 442(90.9%) knew mother should take healthy food. Furthermore, four hundred forty six (91.8%) of respondents knew that breast feeding could strong the bond between mother and child. More than three quarter (76.1%) of respondents knew that breast feeding is helps to child and majority 412(84.8%) of respondents knew that frequent breastfeeding is required when child is sick (Table 2).
Table 2: Knowledge of mother towards IYCF practices
Variable
|
Frequency
|
Percent (%)
|
Colostrum is important for baby
|
Yes
|
394
|
81.1%
|
No
|
44
|
9.1%
|
Don’t know
|
48
|
9.9%
|
A neonate should start breastfeeding with in 1hr of birth
|
Yes
|
408
|
84%
|
No
|
42
|
8.6%
|
Don’t know
|
36
|
7.4%
|
An infant should exclusively breastfeed for the first 6 months
|
Yes
|
416
|
85.6%
|
No
|
56
|
11.5%
|
Don’t know
|
14
|
2.9%
|
An infant should start complementary food at 6 months
|
Yes
|
404
|
83.1%
|
No
|
64
|
13.2%
|
Don’t know
|
18
|
3.7%
|
Lactating mothers should take healthy food
|
Yes
|
442
|
90.9%
|
No
|
6
|
1.2%
|
Don’t know
|
38
|
7.8%
|
Did you wash your breast before breastfeed
|
Yes
|
248
|
51.0%
|
No
|
238
|
49.0%
|
Snack should give to the child
|
Yes
|
394
|
81.1%
|
No
|
64
|
13.2%
|
Don’t know
|
28
|
5.8%
|
BF can strong the bond between mother and child
|
Yes
|
446
|
91.8%
|
No
|
36
|
7.4%
|
Don’t know
|
4
|
0.8%
|
BF can prevent disease
|
Yes
|
226
|
54.7%
|
No
|
162
|
33.3%
|
Don’t know
|
58
|
11.9%
|
BF helps to child
|
Yes
|
370
|
76.1%
|
No
|
96
|
19.8%
|
Don’t know
|
20
|
4.1%
|
BF is important economically
|
Yes
|
252
|
51.9%
|
No
|
190
|
39.1%
|
Don’t know
|
44
|
9.1%
|
BF more frequently when child is sick
|
Yes
|
412
|
84.8%
|
No
|
74
|
15.2%
|
Don’t know
|
-
|
|
Who is usually feed child
|
Mother
|
436
|
89.7%
|
Father
|
4
|
0.8%
|
Sibling
|
44
|
9.1%
|
Guardian
|
2
|
0.4%
|
Involvement and support of father on IYCF
|
Yes
|
398
|
81.9%
|
No
|
60
|
12.3%
|
Don’t know
|
28
|
5.8%
|
Did you discuss with husband about child nutritional and feeding
|
Yes
|
268
|
55.1%
|
No
|
218
|
44.9%
|
Overall knowledge of IYCF
|
Good
|
456
|
93.8%
|
Poor
|
30
|
6.2%
|
Source of information
|
TV/ Radio
|
12
|
2.5
|
Health facility
|
270
|
55.6%
|
On ANC/PNC follow up
|
200
|
41.2%
|
Relative/ Neighbor
|
4
|
0.8%
|
Social media (Facebook, ...)
|
-
|
|
other
|
-
|
|
ANC= Antenatal care, BF= Breast feeding, hrs= hours, IYCF= Infant and young children feeding, PNC=Post natal care, TV=Television
Attitude of Respondents towards IYCF Practices
With regard to attitude about IYCF, 410(84.4%) participants agreed that breast feeding should start immediately after delivery and 372(76.5%) also agreed that exclusive breast feeding for the first six months is necessary. Approximately three quarter reported that babies shouldn’t be given anything except breast feed until 6 months. Majorities 444(91.4%) were agreed that complementary feeding should be started after 6 months (Table 3). Concerning the level of attitudes, more than half (88.9%) of the participants had positive attitude towards IYCF recommendations.
Table 3 : Attitude of Respondents towards IYCF Practices
Attitude question
|
Disagree
|
Not sure
|
Agree
|
Breast feeding should start immediately after delivery
|
44(9.1%)
|
32(6.6%)
|
410(84.4%)
|
Babies shouldn’t be given anything except BF ≤6 months
|
88(18.1%)
|
26(5.3%)
|
372(76.5%)
|
A child can be given butter, sugar and water≤6 months
|
276(56.8%)
|
22(4.5%)
|
188(38.7%)
|
Complementary feeding should be started after 6 months
|
36(7.4%)
|
6(1.2%)
|
444(91.4%)
|
Formal meal is more convenient
|
322(66.2%)
|
28(17.3%)
|
136(28%)
|
Cow milk is more convenient
|
370(76.2%)
|
8(1.6%)
|
108(22.2%)
|
BF should continue up to 2 years
|
22(4.5%)
|
2(0.4%)
|
462(95%)
|
A child should be breastfeed 10 and more than 10/24 hrs
|
18(3.7%)
|
4(0.8%)
|
464(95.5%)
|
The child food to eat at one time should include VitA, and Fruit etc…
|
34(6.9%)
|
14(2.9%)
|
438(90.1%)
|
Snack should be given to the children between meal
|
12(2.4%)
|
30(0.8%)
|
444(91.3%)
|
Serving balanced foods prevent malnutrition disposal
|
28(5.7%)
|
16(3.3%)
|
442(90.9%)
|
Serving only starchy food prevent malnutrition
|
274(56.4%)
|
38(7.8%)
|
174(35.8%)
|
Malnutrition can be caused by disease
|
76(15.6%)
|
28(5.8%)
|
382(78.6%)
|
Serving indigenous fruit/vegetable can keep children healthy
|
106(21.8%)
|
24(4.9%)
|
356(73.2%)
|
BF= Breast feeding, hrs= hours
IYCF Practices
A total of 406(83.5%) children were breast-fed within an hour of their birth and majority 370(76.1%) of children had more than ten frequency of breast feeding. In addition, three hundred eight (87.2%) of children were exclusively breast-fed for the first six months of life and nearly half 240(49.4%) children started with complementary feeds at 6 months. However, 334(68.7%) children were complementary food at least 3times/day. Overall, 380 (78.2%) mothers had good practice on IYCF (Table 4).
Table 4: IYCF practice among respondent
Variables
|
Frequency
|
Percent (%)
|
At what time you started BF after birth
|
Within one hour
|
406
|
83.5%
|
After one hour
|
80
|
16.5%
|
Frequency of BF in the last 24 hours
|
<10 times
|
116
|
23.9%
|
≥10 times
|
370
|
76.1%
|
Exclusive breast feeding for the first 6 months
|
Yes
|
308
|
63.4%
|
No
|
178
|
36.6%
|
Time you started complementary
|
<6 months
|
172
|
35.4%
|
At 6 months
|
240
|
49.4%
|
>6 months
|
74
|
15.2%
|
For how many years continued BF
|
<2 years
|
88
|
18.1%
|
≥2 years
|
398
|
81.9%
|
Minimum meal frequency of complementary food
|
Once
|
30
|
6.2%
|
Twice
|
122
|
25.1%
|
≥three times
|
334
|
68.7%
|
Overall status of IYCF practice
|
Good
|
380
|
78.2%
|
Poor
|
106
|
21.8%
|
BF= Breast feeding, IYCF= Infant and young children feeding
Factors associated with mothers’ knowledge
In bivariate analysis, the data showed that there was no association between mothers’ knowledge and the variables analyzed, these variables include place of respondent, sex, marital status, religion, occupation, family size etc.
In the binary logistic regression analysis age of mothers, educational status of mother, place of delivery, educational status of the father’s, father’s involvement & support, previous knowledge about IYCF, discussion with their husband about IYCF and ANC follow up were statistically associated with mothers knowledge on IYCF recommendation (Table 5).
After controlling the effect of other variables (confounders), the likelihood of good knowledgeable mother was 71 % times less likely for mothers age between <24 years old than mothers who were ≥30 years old. Additionally, mother who had delivered in health institution were 4.47 time more knowledgeable than who had delivered at home.
More mothers who had ever heard information about IYCF were 3.66 times more knowledgeable than had not ever heard information about IYCF. Furthermore, mothers who had ANC follow up were 12 times more knowledgeable than their counter parts who had no ANC follow up.
Table 5 : Factors associated with mother’s knowledge regarding IYCF
Variables
|
Mothers knowledge on IYCF
|
COR(95%CI)
|
AOR(95%CI)
|
P.value
|
Poor
|
Good
|
Age of mothers
|
<24 years
|
8
|
74
|
0.8(0.33,1.92)
|
0.29(0.1,0.85)*
|
0.024
|
24-29 years
|
4
|
174
|
3.76(1.25,11.3)
|
1.92(0.58,6.34)
|
≥30 years
|
18
|
208
|
1
|
1
|
Educational status of mother
|
Literate
|
24
|
316
|
1.77(0.71,4.43)
|
|
|
Illiterate
|
6
|
140
|
1
|
|
|
Place of delivery
|
Home
|
8
|
32
|
1
|
1
|
0.009
|
Health institution
|
22
|
424
|
4.82(1.99,11.68)
|
4.47(1.46,13.68)
|
Father educational status
|
Illiterate
|
22
|
286
|
1
|
|
|
Literate
|
8
|
170
|
1.64(0.71,3.75)
|
|
|
Father involvement &support
|
Yes
|
22
|
376
|
1.71(0.74,3.98)
|
|
|
No
|
8
|
80
|
1
|
|
|
Did you ever heard information about IYCF
|
Yes
|
24
|
436
|
5.45(2.0,14.8)
|
3.66(1.16,11.61)
|
0.027
|
No
|
6
|
20
|
1
|
1
|
Did you discuss with your husband about IYCF
|
Yes
|
10
|
256
|
2.56(1.17,5.59)
|
|
|
No
|
20
|
200
|
1
|
|
|
ANC follow up
|
Yes
|
2
|
278
|
21.9(5.14,92.9)
|
12(4.84,25.1)
|
0.001
|
No
|
28
|
178
|
1
|
|
ANC= Antenatal care, AOR= Adjusted odd ratio, CIs= Confidence intervals, COR= Crude odds ratio, IYCF= Infant and young children feeding