The finding of this study revealed that two-third 75% in irrigated and 68.2% in non- irrigated area of respondent’s had early initiation of breast feeding within one hr. after delivery, which was higher than studies conducted in Kingdom of Saudi Arabia (43%)(44) and Nigeria 34.7%(47). The deference might be health facility delivery and skill birth attendant leads to the opportunity of early initiation of breast feeding by health professionals. It might be also health service performance and socio-cultural barriers and the knowledge of the mother when to start breast feeding after delivery. On the other hand, the finding of this study was consistent with EDHS survey analysis in Ethiopia (74.3%)(51) and study conducted in Assella town 70%(56). It could be the focus and commitment of the government for child health and nutrition throughout the country is similar and dramatically increment of skill delivery. This might have the opportunity of initiating breast feeding within 1hr after delivery. More than half of the respondents (63.8%) in irrigated and 57.8% in non- irrigated area were exclusively breast feed for the first six months even without water. It was greater than studies conducted in Somaliland (20.47%)(49), Bishoftu (34.1%)(55) and East Gojam at Motta (50.1%)(57). The discrepancy for this result might be due to socio-economic difference and cultural practice between study subjects in different part of Ethiopia. But lower than studies conducted in Assella town (86.3%)(56). It might be residence, living in urban has an access to health service and media exposure to have information about breast feeding than those living in rural. continued breast feeding to 1yrs and above were (95.6%) in irrigated and 93.4% in non-irrigated area, which is higher than study conducted in Jima (75.6%)(54). The probability of the difference might be, the majority of the participants in this study were housewives which could increase the likelihood of breastfeeding to their child, as it cost less when they have a poor economic status and they spend much of their time at home which increases the likelihood of continuing to breastfeed. Beyond this mothers in urban area might have workload, to turn their works mothers stop breast feeding early and use formula milk instead of breast milk. Urban mothers have better economical assets than those living in rural, based on this fact mothers in urban setting use breast milk substitution by commercially produced formula milk, cow milk and other commercially available foods due to its easily accessible and ability of purchasing.
In this study timely introduction of complementary feeding at 6 months and above was found to be (54.7%) in irrigated and 40.3% in non-irrigated area, which was close to the study conducted in two Agro-ecological zone of Ethiopia (50.5%)(52). On the contrary it was lower than studies conducted in India (72.7%)(42), Addis Ababa (81.1%)(53) and Jima (82.9%)(54). This might be the difference between Indian and Ethiopian socio-economic level, cultural practice, accessibility of child foods items and nutrition action intervention from ministry of health to health professionals, like health extension program implementation in Ethiopia. Another reason might be in deferent part of Ethiopia awareness level, economical status, health service accessibility and performance have its own influence on IYCF practice. Like ways minimum dietary diversity was (58.3%) in irrigated and 25.9% in non-irrigated area, it was greater than studies done at Northern India (29.6%)(43) and in Kenya (32-40%)(48), in Shashemene16.1%(23), in two Agro-ecological zone of Ethiopia (22.2%) (53), EDHS 2016 survey analysis (14.9%) (52) and Assella town (26.6%)(56). This fact might be the study including irrigated area, enabling variety of food groups to be easily accessible and improve or growth of household economic status to feed diversified foods. Another reason might be, optimization of health extension program and community based neonatal care implementation was supported by Path finder from study area. Due to these facts the minimum dietary diversity becomes increased. Minimum meal frequency were (72.8%)in irrigated and 44.1% in non-irrigated area. Minimum acceptable diet was (44.9%) in irrigated and 24% in non-irrigated, which was lower than as compared to studies conducted in India (45.8) (42) and Addis Ababa (65.1%)(53). The minimum acceptable diet was greater than in India (19.5%)(42) and two Agro-ecological Zone of Ethiopia (12%)(52). This discrepancy might be due irrigation scheme, socio-economic and cultural practice between country and study setting.
The overall prevalence of infant and young child feeding practice in this study was 72.2% (95%CI: 67.5%, 76.1%) in irrigated and 52.5%(95%CI: 47.8%, 57.4%) in non-irrigated area and out of the total was 62.5%, (95%CI: 59.1, 65.8%). The finding of this study is greater than the studies conducted Shashemene(32%)(23), North Achefer 43.4%(38) and South Wollo Zone (45.5%)(58). The deference might be due to the study setting including irrigated area, which enhances diversified foods and economical assets of the household. In addition to this it might be the level of health service and, time gap between study period and socio-economic and the support of non-governmental organizations makes the difference between study area.
In this study the prevalence of IYCF practice had statistically significant variation among 0-23months of age children. The possible explanation for this significance variation might be due difference of household wealth index status in irrigated and non-irrigated area. It may be happening due to irrigation scheme, since irrigation increases productivity in addition to non-rainfall season. Beside to this economically improved community has increased health seeking behavior and uptake of health services, so mother’s in irrigated area had most likely child health service than mothers’ in non-irrigated area to enhances IYCF practice. The other reason for the difference might be mothers in irrigated area can easily accesses variety of food items due to opportunity of production by irrigation or purchasing than non-irrigated area. This an advantage to enhances timely introduction of complementary feeding, increases minimum dietary diversity, minimum mealy frequency and minimum acceptable diet results to improving IYCF practice in irrigated area than in non-irrigated area. Another issue for the difference might be mothers in irrigated may have frequent health facility visit, which enables to gaining IYCF related information’s at health facility and better media accesses. This may intern increases mother’s knowledge and attitude towards IYCF practice, which has better infant and young child feeding practice again(6).
A significant association was observed between mothers’ participation on household decision making and good IYCF practice in both irrigated and non-irrigated area. The prevalence of IYCF practice was significantly higher among those who had women’s decision making as compared to those who do not women’s decision making. The possible explanation might be mothers who have participating on household decision making can get free time to feed their child and can purchase easily foods which is not available in the household. In addition to this, mothers who had participation on household decision making has freedom to visit health facilities for child health service with IYCF education. These opportunities are used as input to achieve or to have good IYCF practice. This finding was supported with the previous studies conducted in south Ethiopia(71).
ANC follow up has significantly associated with infant and young child feeding practice. It could be due to, mothers who had ANC follow up has a chance to gain health worker counselling and education about IYCF practice and participating cooking demonstration during ANC follow up. Pregnant and lactating mothers conference has key messages about IYCF practice during their ANC follow up. The same result was observed from the previous study conducted in Assella(56),and Gondar town(64).
In this study PNC follow up was associated with infant and young child feeding practice among 0-23months of age children. Mothers who had PNC follow up are receiving information to breast feeding, complementary feeding and diversified foods within cooking demonstration. Beside to this, health professionals may show practical demonstrations and role models for breast feeding and complementary feeding. Furthermore, it might be the strength of health extension worker implementation to maternal health service packages including postnatal service. This finding is supported by previous studies conducted in Assella(56), Shashemene(23).
knowledge and attitude were significantly associated to infant and young child feeding practice. Mothers who were knowledgeable and mothers who had positive attitude were more likely practice infant and young child feeding practice. This might be those mothers having information and understanding about the issue of IYCF components can have a better chance of good IYCF practice. The same is true mothers who has positive inclination toward IYCF have a chance to increase IYCF practice. This result is supported by the previous studies conducted in Saudi Arabia(44), Uganda(45), in North west Ethiopia(71) and in Kenya(48). (71).
An association was observed between wealth index and good infant and young child feeding practice among 0-23monthes of age children in irrigated area. Mothers who are rich has good infant and young child feeding practice than mothers who were poor. This finding is true, because irrigation by itself has an advantage for economic growth, this reality makes to have better nutrition. This result is evidenced by the previous study conducted in Wollo Zone, EDHS, 2016 analysis, Gondar town north Achefer district (38, 58, 64, 66).
In irrigated area skill birth attendant has a significant association to good infant and young child feeding practice. Mothers who hand skilled birth attendance has good IYCF practice than those who had traditional birth attendant. This fact might be in irrigated area four and above ANC follow up were higher than in non-irrigated area. This frequent health facility visits enables adherence with maternal health services and health professionals leading to enhance skill delivery. During skill birth attendance facilitating early initiation of breast feeding, counseling about IYCF practice, informing the bad effects of pre-lacteal feeding and all child health services by skill birth attendant. The above justification is coincide with the previous study conducted in Shashemenie, Assela Town, Hawassa (23, 56, 64–66).
Between multiple delivery and infant and young child feeding has significant association in non-irrigated area. Mothers who had single delivery has better infant and young child feed than mothers who had multiple delivery. It is clear that, economic cost to purchase formula milk, burden of work, to have child health service like immunization, feeding and giving care for single child is easier.