Higher educational and economic status are key factors for the timely initiation of breastfeeding in Ethiopia: A review and meta-analysis

Tesfa Dejenie Habtewold*, Shimels Hussien Mohammed, Aklilu Endalamaw, Henok Mulugeta, Getenet Dessie, Derbew Fikadu Berhe, Mulugeta Molla Birhanu, Md Atiqul Islam, Andreas A Teferra, Nigus Gebremedhin Asefa, Sisay Mulugeta Alemu

*Corresponding author for this work

    Research output: Contribution to journalReview articlepeer-review

    3 Citations (Scopus)
    204 Downloads (Pure)


    Aim: To investigate the association between initiation of breastfeeding within 1 hour after birth (TIBF) and maternal educational status, paternal educational status, household income, marital status, media exposure and parity in Ethiopia. Methods: We searched PubMed, EMBASE, Web of Science, SCOPUS, CINAHL and WHO Global health library databases. All studies were conducted in Ethiopia and published from 2000 to 2019 were included. To obtain the pooled odds ratio (OR), data were fitted in random-effects meta-analysis model. Statistical heterogeneity was quantified using Cochran's Q test, τ2 and I2 statistics. This meta-analytic review was reported in compliance with the PRISMA statement. Results: Out of 553 studies retrieved, 25 fulfilled our inclusion criteria. High maternal educational status (P <.001), paternal educational status (P =.001) and household income (P =.002), being married (P =.001) and multiparity (P =.01) were significantly associated with TIBF. There was no significant publication bias. Conclusions: Our meta-analysis showed that TIBF was associated with high educational and economic status, being married and multiparity. This suggests that the meta-analysis detected small associations that many previous studies in Ethiopia have not been able to show. Our findings can be useful for comparisons with other countries.

    Original languageEnglish
    Pages (from-to)2208-2218
    Number of pages11
    JournalActa Paediatrica
    Issue number11
    Early online date1-Apr-2020
    Publication statusPublished - 1-Nov-2020


    • breastmilk
    • breastfeeding
    • breastfeeding initiation
    • systematic review
    • meta-analysis
    • Ethiopia


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