Date of Award

Spring 5-13-2016

Degree Type

Thesis

Degree Name

Master of Public Health (MPH)

Department

Public Health

First Advisor

Jenelle Shanley Chatham, Ph.D

Second Advisor

Shannon Self-Brown

Third Advisor

Whitney Louise Rostad, Ph.D

Abstract

Examining Exclusive Breastfeeding Practice in Indonesia, and its Association to Maternal Socio-demographic Determinants, to Inform Intervention Efforts Aimed at Reducing Infant Mortality

Introduction Exclusive breastfeeding, the gold standard of infant feeding practices, has been identified as the single most effective strategy to improve child survival. However, this recommendation is not highly practiced in Indonesia, while Indonesia’s infant and under five mortality is still high. Interventions to promote, protect, and support breastfeeding practice are critical public health needs in Indonesia.

Aim The current study examined socio-demographic factors associated with exclusive breastfeeding practice in Indonesia: whether maternal age, level of education, occupation status, wealth index, and region of residence, as well as breastfeeding initiation are associated with exclusive breastfeeding practice in Indonesia for mothers having infants up to age five months.

Methods This study analyzed 1695 women having infant aged 0-5 month old data from the 2012 Indonesia Demographic Health Survey. Chi-square test was used for preliminary analysis and logistic regression analyses were used to primary analysis by using SAS 9.4 program.

Results Exclusive breastfeeding practice in Indonesia was low (36.1%). Mothers aged 30-39 years old were more likely to exclusively breastfeed compare to mothers under 20 years old (OR=1.56, 95% CI 1.04-2.35). Mothers with high education level had higher odds to exclusively breastfeed compare to low education mothers. Unemployed mother were more likely to exclusively breastfeed than working mothers (OR=1.65, 95% CI 1.28-2.13). Mothers coming from richer wealth index were less likely to exclusively breastfeed compare to mothers having poorest wealth index (OR= 0.49, 95% CI 95% 0.34-0.72). Those who initiated breastfeeding early had increased odds to exclusively breastfeed than mothers who delayed breastfeeding initiation (OR=1.47 95% CI 1.19-1.83). Finally, mothers who lived in Eastern Indonesia were more likely to exclusively breastfeed compare to mothers who lived in Sumatera and Kalimantan (OR=1.82, 95% CI 1.30-2.55).

Conclusion This study found characteristics of Indonesian mothers who were more likely to exclusively breastfeed compared to the reference group: aged 30-39 years old, high education level, unemployed, richer wealth index, and those who live in Eastern Indonesia; as well as, mother who initiate breastfeeding early. Having tailored strategies and interventions to targeted at-risk populations may increase the likelihood of exclusive breastfeeding practices, and ultimately, decreasing infant mortality rates in Indonesia.

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