The impact of breast feeding practices on infant and child mortality in Amagoro division of busia, kenya

Abstract

This study examined the impact of breastfeeding duration and age at supplementation on infant and child mortality, under prevailing socio-economic, environmental and demographic conditions. Primary data was collected for the last births and next to last births; from 1030 women aged 15-49 years resident in Amagoro Division, Busia District. The data was analysed using frequencies, cross tabulations, the Chi-Square, Trussell Method of Mortality Estimation and Logistic Regression. The frequency distributions showed that most children are breastfed for 19-24 months and supplemented at 3-4 months. Cross-tabulation and the Chi-Square results have shown that for both the last and next to last births breastfeeding duration, age at supplementation, education, source of water, type of toilet facility and immunization were significant in child survival. The crude mortality estimates have shown an infant mortality rate of 60 deaths per 1000 live births and childhood mortality of 97 deaths per 1000 live births. The q(2) estimates were 62 and 71 and q(5) were 70 and 72 using the North and West Models respectively. The logistic regression results have significantly indicated less chances of child deaths in relation to breastfeeding duration, supplementation, type of toilet facility used by the household, work status of the mother, and immunizations received by the child. Longer breastfeeding durations (13-24 months) decreased the chances of child deaths as compared to no or shorter breastfeeding durations (0-12 months). Children who were supplemented between ages 4-6 months had higher chances of survival as compared to those who were supplemented at earlier (0-3 months) or later ages (7+ months). Type of toilet facility used by the household was very significant in influencing child deaths. Those children whose households used bush had higher probabilities of dying than those whose households used pit toilets. Again, when this variable was controlled, it became the most significant to breastfeeding and age at supplementation. The children who had received all the immunizations had higher survival chances than those who had none or only some. Work status (employed away from home or not) was not significant in influencing child deaths for the case of last births, but was very significant for the next to last births. For the next to last births, those children whose mothers did not work had higher chances of dying than for those whose mothers worked. The logistic regression results showed no significant relationship between age of mother, parity, marital status of the mother and infant and child deaths for both the last births and next to last births. The major conclusion that was derived from the results of the study was that environmental factors (type of toilet facility) and socio-economic factors (immunization and work status) are very significant in influencing infant and child deaths. The impact of breastfeeding and age at supplementation was greatly modified by these factors. The study therefore recommended that female employment opportunities should be increased because maternal education highly determines the nutritional, health care and sanitary conditions of the household as the woman would have more decision-making roles when her income is high. The study further recommended that public health education be intensified by the government and other agencies, especially on the importance of breastfeeding, proper nutrition and sanitation to the health of the children.