Prevalence and Factors Associated with Non-Exclusive Breastfeeding Among Infants Aged Between 0 and 6 Months in Rwanda. Secondary Data Analysis, Findings from the Rwanda Demographic & Health Survey 2019/20

Abstract

In Rwanda, despite global efforts to promote exclusive breastfeeding (EBF) during the first six months of infants' lives, non-exclusive breastfeeding (NEBF) practices persist. NEBF contributes up to 45% of neonatal infection-related deaths, 30% of deaths linked to diarrhoea, and 18% of deaths associated with acute respiratory infections in young children, and these infections are responsible for 10% of the overall disease burden in infants. This study aimed to determine the prevalence of NEBF and to identify the factors associated with it among infants aged 0-6 months in Rwanda. A cross-sectional quantitative design was used, based on secondary analysis of the Rwanda Demographic and Health Survey (RDHS) 2019/20. A nationally representative sample of 442 mothers with infants aged 0-6 months, selected through the RDHS two-stage stratified sampling design, was included. Descriptive statistics and bivariate (chi-square) analyses were performed to determine the prevalence and examine the relationship between associated factors and NEBF, and multivariable binary logistic regression was performed to identify the factors independently associated with NEBF while controlling for confounding factors, at a significance level of p ≤ 0.05, using SPSS version 25. The study found that 19 (4.4%) infants aged 0-6 months in Rwanda were non-exclusively breastfed. Infants from rural areas (AOR = 0.162, 95% CI: 0.035-0.758) and infants whose fathers had a secondary education level (AOR = 0.088, 95% CI: 0.008-0.973) were less likely to be non-exclusively breastfed compared to infants from urban areas and those whose fathers had a higher education level, respectively. Moreover, male infants were 4.35 times more likely to be non-exclusively breastfed compared to female infants (AOR = 4.354, 95% CI: 1.109-17.100). In conclusion, although the overall prevalence of NEBF in Rwanda is low, it is concentrated among infants living in urban areas, infants whose fathers have higher education, and male infants. Targeted interventions to promote exclusive breastfeeding should focus on urban households and highly educated parents, and address the sex disparity in infant feeding practices.