Exercise-Based and Associated Factors Breastfeeding on HIV-Infected Mothers for Children Age 1-﻿24 Months in Central Zone, Tigray, North Ethiopia, 2019.

doi:10.21203/rs.3.rs-16522/v1

Background: Breastfeeding exposed to HIV is a major factor in the spread of HIV, but breastfeeding alone poses a significant risk to the baby's health because breastfeeding can reduce the impact of many infections and support some chronic diseases. Therefore, this study was aimed to assess exercise-based and associated factors breastfeeding on HIV-infected mothers for children age 1-24 months in the central zone, Tigray, north Ethiopia.

Methods: A Facility-based Cross-Sectional study was conducted from March to April 2019. A systematic random sampling method was used to select study participants. Information was collected using a structured, pre-tested questionnaire. The data is coded, cleaned, copied and entered EPI-info 7 and finally export to SPSS version 22.00 for analysis. Association between independent and dependent variables was first analyzed using binary logistic regression analyses. An alternative bivariate logistic regression analyzes of less than 0.2 were entered in multivariable logistic regression analysis. The statistical association between variance dependent and independent variables was measured using an OR, AOR, 95% CI, and a p-value less than 0.05.

Result: 239 HIV-positive mothers participated in this study. Approximately 204(85.4) are favorable attitude in the practice of exclusive breastfeeding. The majority of mothers 206 (86.7%) experienced good breastfeeding. Mothers with Information while exclusive breastfeeding (AOR, 2.57, 95%CI: 1.03- 6.4) and age at first birth (AOR: .247, 95%: (.106- .578) had a significant collaboration on exclusive breastfeeding practice among HIV-infected mothers. Several ANC visits have had a significant collaboration on exclusive breastfeeding practice among HIV-infected mothers (AOR; 3.726 95%CI; 1 .055-13.154).

Conclusion: The study found that HIV positive mothers attending health care facilities had a favorable attitude but practiced on EBF is still low. Therefore, train health professionals especially health extension workers to raise awareness education, enhance information, regarding EBF and strength counseling in ANC service is better to improve the HIV positive mother level of attitude and practice to EBF.

Sexual & Reproductive Medicine

practice

attitude

Exclusive breastfeeding

HIV positive Mothers

Breastfeeding exposed to HIV is a major factor in the spread of HIV, but breastfeeding alone poses a significant risk to the baby's health because breastfeeding can reduce the impact of many infections and support some chronic diseases and breastfeeding. Diet exercise is generally the best baby diet choice for all women(1).

Globally, over 10 million children under five die each year and 40% of diseases under the age of two are associated with inappropriate breastfeeding, 34% of which occur in South Asia and 41% in sub-Saharan Africa (2).In addition to breastfeeding, 300,000 HIV infections occur annually, while at the same time the United Nation Children Emergency Fund (UNICEF) is not responsible for the deaths of 1.5 million children in one year, and the biggest burden of this infection, Sub-Saharan Africa (3).

In the first year of the world, two-thirds of all deaths in the world often follow appropriate nutritional practices, especially due to unspecified breastfeeding activities(4). In the developing world, including Ethiopia, 3000-4000 infants per day die from diarrhea and respiratory infections associated with high levels of disease(5).

In Ethiopia, 321,000 children under five years of age die from malnutrition, with 57% of death each being primarily prevented by breastfeedings, such as diarrhea and pneumonia. (6).

About 40% of the world population, 47% in Africa, and 58% in Ethiopia, according to Ethiopian demographic and health survey (EDHS) 2016, have increased the number of children under 0-6 months. (7, 8).

Study show’s in India 30.6% (9) southern Ethiopia, Mekelle and central zone Tigray show that attitude towards exclusive breastfeeding about 56.7%, 81.6% and 82.6% of HIV mothers had favorable attitudes towards EBF (10-12).

Study in Botswana 20%(13), southwestern Nigeria 61%(14), Burkina Faso52.5% (15), Kenya40.6%(16), Southern Ethiopia 82.8%(17), in Bahir Dar75.2% (18), Gondar 89.5%(19) and west oromia72%(20) and central zone, Tigray about 90% (21) shows that mothers who are HIV positive breastfed were practiced exclusively breastfeeding for the first 6 months respectively.

Recent study identified that predictor for attitude and practice exclusives breastfeeding among mothers living with HIV/AIDS were mother's occupation, residence, knowledge on EBF practice, ANC service, counseling on EBF practice during ANC visit, insufficient breast milk, husband imposition, mother’s illness and both mother’s and infant’s illness, income, maternal choice of maternal-infant feeding practice and cultural (10-21) Therefore, this study was aimed at assessing attitude, practice and determinant factors affecting exclusives breastfeeding among mothers living with HIV/AIDS have children age 0-24 months in central zone Tigray.

A facility-based cross-sectional study was conducted from March to April 2019, at Central zone Tigray regional state of Ethiopia. The central zone is 1024km from Ethio -capital, Addis Ababa, 240 km from the capital city of Tigray. The central zone was divided into 12weredas, of which 631,972 were female and 613,251 were males. The total number of people living with HIV was 4841, the reproductive-age women who are HIV positive were 2028 and HIV positive mothers who have an infant less than or equal to 24 months were 485. There were 72 health centers (20 of them have ART service), 6 primary hospitals, 3general hospitals, and 1 referral hospital.

All HIV positive mothers with children younger than or equal 24 months were recruited as a study group within the designated public health facility's central zone. All HIV-positive mothers who gave birth within 24months before the study were included, excluded, had no mental illness or had several mental illnesses during data collection.

Considering 82% of exclusive breastfeeding rate for children under six months of age (21), 95% confidence level, 5% tolerable margin of error, 5% unresponsive, a total sample of 239 were considered. to test the consistency of sample size, Epi-info was considered to be the only breastfeeding practice considering the relevant aspect of the observation. It was larger than the EPi-info by comparing a sample size based on a population. Therefore, the largest sample size of 239 was determined.

Considering all public health institutions in the Tigray region of the Central Zone, the sample size visited all public health institution s based on the number of children under or equal the age of 24 months who were HIV positive mother, round up. Participants in the study were selected for each of the 2 HIV-infected mothers of a randomized random sampling method, equal to 24 months.

Attitude and practice Exclusive Brest feeding was considered as the dependent variable. Socio-demographic and Reproductive characteristics, knowledge exclusive breastfeeding, Institutional and source of information related factors were considered as the independent variable.

The attitude of exclusive breastfeeding – Good (Positive) attitude (scores >60%) on the overall attitude question (17).

Good practice of exclusive breastfeeding -mothers answer (score > 60%) on the overall practice question (17).

Keble: A small administrative unite consisting of 20.000 population.

The information was collected using the questionnaire and a structured questionnaire from a variety of similar research (15, 17, 19) if there was a change in the context of the study. Face-to-face breastfeeding alone was tested during a panel discussion with 12 women and one of the women in questionnaire accuracy and translation quality questionnaire. A few questions for language transparency and information were reviewed and the questionnaire was completed for the study. The applicant includes a source of social and demographic, reproductive history, institutional and informational sources.

Five health care professionals and two supervisors were recruited from the health center and trained for one day. Supervisors follow a daily data collection process and communicate with investigators every day to check the consistency of the data.

The data is coded, cleaned, copied and entered EPI-info 7 and finally export to SPSS version 22.00 for analysis. A simple descriptive summary was made. Table, diagrams, descriptions, charts, and graphs were used to produce the result of the analyzed data. After that, you can combine the filters into the corresponding catalogs using a chi-square test variable with small cell size. An alternative bivariate logistic regression analyzes of less than 0.2 were entered in multivariable logistic regression analysis. Appropriate fitness testing done well more than 0.2 predicted variants and a multiple-choice test between Hosmer and Lemeshow test P-value to assess model performance. The statistical association between various independent variables was measured using an OR, AOR, 95% CI, and a p-value less than 0.05.

Socio-demographic characteristics of mothers

A total of 239 HIV positive mothers participated in a response rate of 100%. Out of the total participated mothers, 175(73.5%) were with an age range of 25-35 years. The majority of the participants 177(73.8%) were married (Table 1).

Health institutions related factors and source of information

Three fourth of the respondents (75.8%) reported that they had to get information about EBF from health professionals. Among them, 97.9% of these respondents had availability of health care facilities in your area. (Table 2).

Reproductive characteristics of mothers

The majority of the respondent's 74.4% mother's age at marriage was 18-24 years. Among them, 54.2% of mothers their child age from 6 months up to 12 months. From total respondents, about 95.8 % attended ANC follow and about 76.6 % were from 3-4 ANC follow up (Table 3).

Knowledge of EBF among HIV positive mothers

In our study majority respondents, 93.7% heard about exclusive breastfeeding, among this 92.4% knew the importance of exclusive breastfeeding for child health. About knowledge on EBF HIV positive mother, 88.2% of the respondents know HIV seropositive mother can breastfeed, 90.8% know foods or fluids recommended to under 6-month child is only breast milk and about 35.6% know times baby breastfeeding per day were from 8-10 times (Table 4).

The attitude of EBF among HIV positive mothers

In our study more than three fourth respondents, 78.6% believed that breast milk was free from any contamination; among this 86.6% believe that EBF is better than artificial feeding.80.9% of HIV seropositive mothers strongly recommended breastfeeding, and 10% of participants believe that is important to eat food six months ago. Of the total respondent, 83.6% had a positive attitude about EBF for up to six months. (Table 5).

EBF practice among HIV-positive mothers

Most, 214(89.5%) of mothers feed their last baby on the mother's breast. The majority of the participants reported that 194(90.6%) of mothers started breastfeeding immediately within one hour after birth. 102(42.5%) of all breastfeeding was 8-10 times a day. Most mothers reported 74.6% of explicit breastfeeding exercises for your baby up to six months, 20.8% of respondents had 6 to 12 months and 1.3% of mothers over 12 months. It was 86.2% of all positive experiences. (Table 6).

Factors associated with the attitude of EBF among HIV positive mothers

In bivariate analysis, maternal educational status, mothers who had Information on the term of EBF, types of health care facility available, age at first birth and numbers of postnatal care visits were significant association with exclusive breastfeeding attitude among HIV positive mothers. In multivariate analysis, mothers who had information on the term of EBF and age at first birth had significantly associated with an attitude of HIV positive mothers on EBF (AOR: p<0.05). HIV positive mothers who had Information on the term of EBF 2.57 more likely favorable attitude than mothers who had no information on the term of EBF (AOR,2.57,95% CI: 1.03- 6.4). HIV positive mothers whose age at first birth 24 and above were 0.247 times less likely had favorable attitude than HIV positive mothers whose age at first birth were 18-24 years (AOR.247, 95% : (.106- .578).(Table 7)

Factors associated with the practice of EBF among HIV positive mothers

In bivariate analysis, maternal educational level, number of gravidities, number of ANC visits, types of health care facility available and Income had a significant association with exclusive breastfeeding practice among HIV positive mothers and those candidate variables for multivariate logistic regression. In a multivariate analytical number of ANC visit only had a significant association with exclusive breastfeeding practice among HIV positive mothers, mothers were 3-4 numbers of ANC visit had 3 times more likely practice on exclusive breastfeeding than mothers were ANC visits' less than or equal 2 ( AOR; 2.981,95%CI;1.113-7.983). (Table 8).

This study was a case study of cognitive functioning and corresponding breastfeeding status among HIV-infected mothers who participated in PMTCT and ART services in selected health education of the central zone, Tigray, Ethiopia. In this study, two hundred five (85.4) of the HIV infected mother reported the mother had a positive attitude towards the EBF experience. This source study conduct in Botswana 56.3% (13), is higher than a study. This may be the single most effective and effective treatment for children under six months of age. This finding is higher than another study conducted in southern Ethiopia (56.7% ) and central zone Tigray 82.6% respectively. This difference may be due to health services and health education(17,21).

In this study, the mother, who had information about EBF status and age at first birth, had played a significant role in the attitudes toward EBF on the HIV positive mothers. HIV positive mothers who have had information on the term of EBF three times more likely favorable attitude than mothers who had no information on the term of EBF. This may be due to poor information or poor advice on dietary options for children under six months. HIV positive mothers whose age at first birth 24 and above was 24% times less likely had favorable attitude than HIV positive mothers whose age at first birth were 18-24 years. This may be due to poor advice on the risk of HIV transmission to your baby and breastfeeding alone.

In this study, two hundred six (86.2) of HIV positive mothers had good practice towards EBF practice. This finding is higher than the study conducted in India 30.6% (9), Tanzania ilala municipality dares salaam46% (22), Botswana 20% (13), western Nigeria 61% (14) and in Burkina Faso, 52.5%(15) of HIV positive mothers were practice exclusively breastfed to their children. This discrepancy might be due to socio-demographic characteristics and the availability of health services.

In this study, about 85 % of HIV positive mothers initiated breastfeeding within the recommended first hour of birth. this result was higher than the study conducted in Oromia regional 69.3% and Southern Ethiopia shows that 51.5% initiated breastfeeding within the recommended first hour of birth(20,17).

In this study, HIV positive mothers practiced complementary feeding at 6 months of life were 53.3 % .this finding is lower than the study done in Southern Ethiopia that 77.2 % mothers practiced complementary feeding at 6 months of life (17).

This study also found out that 86.7 % of HIV positive mothers were practiced exclusive breastfeeding This finding was higher than from a study done in Bahir Dar 75.2% and

west Oromia 72% practiced exclusive breastfeeding(17, 20). However, this study finding is lower the study done Gondar town 89.5% and Mekelle town, 90 % of HIV positive mothers had practiced exclusive breastfeeding (11, 18). In this finding number of ANC visits had a significant association with exclusive breastfeeding practice among HIV positive mothers, mothers were 3-4 numbers of ANC visits had 37% more likely practice on exclusive breastfeeding than mothers were ANC visits' less than or equal 2. This may be to increasing contact with the health care provider and to provide information on breastfeeding practices, particularly in EBF practice.

The study found that HIV positive mothers attending health care facilities in the central zone, the Tigray region had a favorable attitude but practiced on EBF is still low. Factor such as Information on the term of EBF and age at first birth was associated with attitude toward EBF and the Number of ANC visits was associated with practice on EBF. Therefore, train health professionals especially health extension workers to raise awareness education, enhance information, regarding EBF and strength counseling in ANC service is better to improve the HIV positive mother level of attitude and practice to EBF.

Ethics approval and consent to participant

Ethical clearance was obtained from the Institutional Review Committee (IRC), College of Medicine and Health Sciences, University of Aksum. Permission letter was received from those administrative bodies of the Central Tigray Health Department and each health facility's verbal and written consent was obtained from all participants after they informed on the purpose of the study.

Consent for publication

Not applicable

Availability of data and materials

All relevant data are within the manuscript and its Supporting Information files.

Computing interest

The authors declare that they have no competing interests.

Funding

"The authors received no specific funding for this work”.

Authors’ contributions

HM and TG designed the study, performed the statistical analysis, drafted the paper, data analysis and read and approved the final paper.

Acknowledgments

We are highly indebted to all participants of the study, supervisors of data collection and data collectors for their worthy efforts and participation in this study.

Authors’ details

Hamelmal Mekonen (MPH-RH): Department of Reproductive Health, College of Health Sciences, Adigrat University, Adigrat, Ethiopia. Email:[email protected]

Teferi Gebru Gebremeskel (MPH-RH): Department of Reproductive Health, College of Health Sciences, Aksum University, Aksum, Ethiopia. Email: [email protected]

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Table 1: Socio-demographic characteristics of HIV positive mothers on EBF in a public health facility central zone, Tigray, Ethiopia, 2019.

Variables

Response

Frequency

percent

Maternal age

From 15-24 year

From 25-35 year

Above 35 year

Total

6

175

58

239

2.5

73.5

24.2

100

Ethnicity

Tigray

Amhara

Oromo

230

8

1

96.2

3.3

0.4

Religion

Orthodox

Protestant

Muslim

217

2

20

90.8

0.8

8.4

Residence

urban

rural

205

34

85.5

14.2

Education states of mothers

Illiterate

Literate

Total

95

144

239

39.7

60.3

100

mothers occupation

Nonemployee

Employed

Total

119

120

239

49.8

50.2

100

marital status

Married

never married

Divorced

Widowed

177

21

34

8

73.8

8.8

14.2

3.3

husband’s educational level

Illiterate

Literate

Total

72

116

188

30.1

48.5

78.7

husband’s occupation

Nonemployee

Employed

Total

80

108

188

33.5

45.2

78.7

average monthly income of your family

Lessthan1000birr

From 1000-1500

Above1500

39

54

146

16.3

22.6

61.1

Table2: Health Institutions related factors and source of information on EBF among HIV positive mothers in public health facility central zone, Tigray, Ethiopia 2019.

Variables

Response

Frequency

percent

heard of any those EBF

Yes

No

194

45

81.2

18.2

Sources of information about EBF?

Health professionals

Media

Reading books

Family/ Friend

Magazines

182

28

2

3

1

75.8

11.7

0.8

1.3

0.4

type of media use

Television

Radio

Newspaper

Magazine

156

50

2

10

65

20.8

0.8

4.2

Availability of health care facility in your area

Yes

No

234

5

97.9

2.1

Type of health facilities in your area

Health post

health center

hospital

private clinic

19

105

116

7.9

43.8

48.3

The distance of health facilities from your home on foot.

Less than 30 minute

30 minute to one hour

One hour to two hour

More than two hour

129

93

14

4

53.8

38.8

5.8

1.7

Cost of care influence your services

yes

no

31

208

13

87

Healthcare staffs have a good approach for you where you have utilized healthcare services

Yes

No

226

13

94.6

5.4

Table 3 Reproductive characteristics of HIV positive mothers on EBF in public health facility central zone, Tigray, Ethiopia 2019.

Variables

Response

Frequency

percent

age at marriage

From18-24 years

Greater than 24 year

221

18

92.5

7.5

age at first birth

From18-24 years

Greater than 24 year

191

48

79.9

20.1

Age of the child in the month

Less than 6 month

6-12 month

Greater than 12 month

38

130

72

15.8

54.2

30

Sex of the child

male

female

127

113

52.9

47.1

Gravidity

Primi gravida

multigravida

grand multigravida

141

77

21

59

32.2

8.8

Parity

Primi Para

multi Para

grand multi Para

188

42

9

78.7

17.6

3.8

ANC service pregnancy

Yes

No

229

10

95.8

4.2

Numbers of ANC follow up

1-2

3-4

Above 4

32

184

23

13.4

76.6

10

given HE on BF during the ANC

Yes

No

214

25

89.2

10.2

Place of birth to this child

HC

Hospital

Home

58

179

3

24.2

74.6

1.3

PNC service

Yes

No

192

47

80.4

19.6

Numbers of PNC

One visit

2-3 visit

>3 visit

204

28

7

85.4

11.4

2.9

HE on BF during PNC

HC

Hospital

Home

53

142

1

22.1

59.2

0.4

Table 4: Knowledge of HIV positive mothers on EBF in public health facility central zone, Tigray, Ethiopia 2019

Variables

Response

Frequency

percent

Ever heard the term EBF

Yes

no

224

15

93.7

6.3

infant feeding per day

As needed

From 8-10

Above10

Less than 8

103

85

11

40

42.9

35.6

4.8

16.9

The right time to give breast milk to the child after birth

After giving some better

Within one hour

After one hour

After 24 hours

8

205

23

3

3.3

85.6

9.8

1.3

breastfeeding important for child health

Yes

No

221

18

92.4

7.6

Importance of breastfeeding

Prevent diarrhea

Minimize cost

Sterile

Growth and development

Increases bonding

96

18

14

89

4

40

7.5

5.8

37.1

1.7

Duration of newborns be fed breast milk only

Less than 6 month

6-12 month

Above 12 month

169

49

18

70.4

20.4

7.5

Age of complementary feeding be initiated

At 6month

Less than 6 month

6-12 month

Above 12 month

137

34

95

7

57.3

14.2

39.6

2.9

Duration of breastfeeding be continued

Less than 6 month

6-12 month

Above 12 month

15

45

179

6.3

18.5

75.2

Foods or fluids recommended to under 6-month child

Only breast milk

Breast milk and /or water or sugar

formula

Others

217

11

10

1

90.5

4.7

4.3

0.5

pre-lacteal feeding needed for an infant before starting breast milk

Yes

No

I do not know

14

189

36

5.8

78.8

15.4

Is BM alone is enough for an infant< 6 month of life

Yes

No

I do not know

216

11

12

90.1

4.6

5.3

EBF for the first 6 months used to prevent diarrhea and Respiratory disease for the infant

Yes

No

I do not know

199

7

33

82.9

2.9

14.2

HIV seropositive mother breastfeed

Yes

No

211

28

88.2

11.8

HIV positive mother knowledge of EBF

Good Knowledge

Poor Knowledge

211

28

88.4

11.6

Table 5: Attitude of HIV positive mothers on EBF in public health facility central zone, Tigray, Ethiopia 2019

Variables

Response

Frequency

percent

Breast milk is free from any contamination.

strong Agree

Agree

Disagree

strong disagree Not sure

75

113

41

1

9

31.3

47.4

17.1

0.4

3.8

Giving breast milk for a baby immediately within an hour after birth is important

strong Agree

Agree

Disagree

strong disagree

77

151

4

7

32.5

62.9

1.7

2.9

EBF is better than artificial feeding

strong Agree

Agree

Disagree strong disagree

Not sure

62

152

12

3

10

25.8

63.7

5

1.2

4.1

Discarding colostrums is important before giving breast milk to a newborn

strong Agree

Agree

Disagree

strong disagree Not sure

4

36

139

28

32

1.7

15

58.3

11.7

13.3

Giving a child of three months only breast milk may not be sufficient and a child needs water and other fluids to prevent thirst

strong Agree

Agree

Disagree

strong disagree Not sure

2

13

182

25

17

0.8

5.4

75.9

10.4

7.5

Starting complementary foods to a child before six months is important

strong Agree

Agree

Disagree

strong disagree Not sure

4

20

195

12

8

1.7

8.3

81.7

5

3.3

Only breastfeeding is enough for the baby for up to six months.

strong Agree

Agree

Disagree

strong disagree Not sure

62

141

25

1

10

25.8

58.8

10.4

0.4

4.6

Breast milk contains all the nutrients necessary for the infant for up to 6 months.

strong Agree

Agree

Disagree

strong disagree Not sure

52

155

13

3

16

21.7

64.6

5.4

1.3

7

Breast milk provides the infant with the immunity to disease.

strong Agree

Agree

Disagree

strong disagree Not sure

67

151

8

1

12

27.6

63

3.3

0.4

5.7

Mixed feeding is always necessary for infants

strong Agree

Agree

Disagree

strong disagree Not sure

8

26

157

32

16

3.3

10.8

65.5

13.3

7.1

Dealing with breastfeeding is always time-consuming.

strong Agree

Agree

Disagree

strong disagree Not sure

3

34

181

19

2

1.3

14.2

75.8

7.9

0.8

Breastfeeding affects the health of the mother negatively.

strong Agree

Agree

Disagree

strong disagree Not sure

5

20

171

31

7

2.1

8.3

73.8

12.9

2.9

HIV seropositive mother recommend breastfeeding

strong Agree

Agree

Disagree

strong disagree Not sure

58

135

32

3

11

24.5

56.3

13.3

1.3

4.6

Favorable Attitude

Unfavorable Attitude

204

35

85.4

14.6

Table 6: Practice of HIV positive mothers on EBF in public health facility central zone, Tigray, Ethiopia 2019.

Variables

Response

Frequency

percent

Breastfeed your last-child

Yes

No

214

25

89.5

10.5

Initiation of breastfeeding for your last child after delivery

Immediately within 1 hour

Between 2 and 24 hrs

After 24 hr

194

17

3

90.6

8

1.4

Mothers colostrum feed

Yes

No

224

15

93.5

6.5

Giving anything within 3days

Other than breast milk feeding

Yes

No

24

215

10.1

89.9

what was given

Cow and breast milk

Breast milk only

Formula

7

2

15

2.9

0.8

6.3

Reasons for pre-lacteal feeding

Milk did not come in ye

I was ill

Baby was ill

9

12

3

6.4

5

1.25

Dose Still breastfeeding

Yes

No

200

39

83.7

16.3

Frequency of breastfeeding

Less than 8 times

8-10 times

Frequent and on-demand

Greater than 10 times

38

102

81

18

16.2

42.5

33.8

7.5

Exclusive breastfeeding practice to your child

0-6 months

6-12 months

Above 12 months

Not yet started

162

50

3

24

67.5

20.8

1.3

10.4

Type of complimentary food started

Fluid

Simi fluid

family food

Not yet started

Other

47

91

52

6

44

19.6

37.9

21.7

2.5

18.3

Starting age of complementary feeding

At 6 months

After 5 months

2-4 months

After 6 month

Underage

Not yet started

128

7

27

68

8

1

53.6

2.9

11.3

28.5

3.3

.4

Who supports you during breastfeeding?

Husband

Another family member

No one

88

78

73

36.7

32.7

30.6

Good practice

Poor practice

206

33

86.2

13.8

Table 7: Factors associated attitude of HIV positive mothers on EBF in a public health facility in the central zone, Tigray, Ethiopia 2019.

Variables

Knowledge

COR (95%CI)

AOR(95 %CI)

Good

Poor

Residence

Rural

Urban

27(12.9)

183(87.1

7(25)

21(75)

1

2.259(.877 -5.819)

1

2.96(.948-9.29)

Maternal educational level

illiterate

literate

80(38.1)

130(61.9)

15(51.7)

14(48.7

1

1.74 (0.736- 3.586)

1

1.37(.564- 3.34)

Monthly income

>=1500birr

1000-1500birr

< 1000bir

126(60

51(24.3)

33(15.7)

19(67.9)

3(10.7)

6(21.4)

1

2.56(.72- 9.041)

0.829(.307- 2.242

1

5.57(1.176-26.38)*

1.48(.439-4.48)

Age at first birth

18-24

24 and above

172(81.9)

38(18.1)

18(64.3)

10(35.7))

1

.398(.170-.930)

1

.339(.133-.863)*

Numbers of postnatal visit

1 visit

2-3 visit

Above 3 visit

180(85.2)

26(12.4)

5(2.4)

25(89.3)

1(3.6)

2(7.1)

1

3.63(.472-27.9)

.349(.064-1.89)

1

5.2(.559-49.4)

.312(.046-2.11)

Types of health care facility available

Health post

Health center

Hospital

14(6.7)

93(44.3)

104(49

5(17.9)

10(35.7)

13(46.4)

1

3.32 (.98-11.15)

2.8(0.87- 9.14

1

2.77(.712-10.7)

1.84(.485-6.9)

Note: *-significant results, 1-reference category **p-value<0.001, *p-value≤0.05

Table 8: Factors associated practice of HIV positive mothers on EBF in a public health facility in the central zone, Tigray, Ethiopia 2019.

Variables

practice

COR (95%CI)

AOR(95 %CI)

Poor practice %

Good practise %

Maternal educational statues

Illiterate

Literate

38(39.6)

58(60.4)

38(26.4)

105(73.6)

1

1.828(1.052-3.174)

1

1.351(.626-2.916)

Income

<1000

1000-1500

>1500

22(22.9)

23(24)

51(53.1)

17(11.8)

31(21.5)

96(66.7

1.744(.759-4.006)

2.436(1.88-4.996)

1

.625(.235-1.66)

1.322(.530-3.294)

1

Types of health care facility

Health post

Health center

Hospital

5(5.2)

44(45.8)

47(49

14(9.7)

61(42.4)

69(47.8

1

.495(0.166-1.476)

.524(0.177-1.554)

1

.499(.141-1.766)

.427(.12-1.527)

No of gravidity

Primi gravid

Multi gravid

Grandmultigravia

71(74)

20(20.8)

5(5.2)

117(81.9)

22(15.3)

4(2.8)

1

..0667(.290-1.056)

.4854(0.161-2.068)

1

.619(.289-1.328)

1.055(.246-4.519)

No of ANC visit

1-2

3-4

>4

71(74)

20(20.8)

5(5.2)

21(14.6)

111(77.1)

12(8.3)

1

2.176(.971-4.8981)

2.543(.895-7.239)

1

2.981(1.113-7.983)*

3.726(1.055-13.154)

Note: *-significant results, 1-reference category **p-value<0.001, *p-value≤0.05

Exercise-Based and Associated Factors Breastfeeding on HIV-Infected Mothers for Children Age 1-24 Months in Central Zone, Tigray, North Ethiopia, 2019.

Status:

Version 1

Abstract

Background

Methods

Results

Socio-demographic characteristics of mothers

Reproductive characteristics of mothers

Knowledge of EBF among HIV positive mothers

The attitude of EBF among HIV positive mothers

EBF practice among HIV-positive mothers

Factors associated with the attitude of EBF among HIV positive mothers

Factors associated with the practice of EBF among HIV positive mothers

Discussions

Conclusion

Declarations

Ethics approval and consent to participant

Consent for publication

Acknowledgments

References

Tables

Status:

Version 1

Exercise-Based and Associated Factors Breastfeeding on HIV-Infected Mothers for Children Age 1-﻿24 Months in Central Zone, Tigray, North Ethiopia, 2019.

Status:

Version 1

Abstract

Background

Methods

Results

Socio-demographic characteristics of mothers

Reproductive characteristics of mothers

Knowledge of EBF among HIV positive mothers

The attitude of EBF among HIV positive mothers

EBF practice among HIV-positive mothers

Factors associated with the attitude of EBF among HIV positive mothers

Factors associated with the practice of EBF among HIV positive mothers

Discussions

Conclusion

Declarations

Ethics approval and consent to participant

Consent for publication

Acknowledgments

References

Tables

Status:

Version 1

Exercise-Based and Associated Factors Breastfeeding on HIV-Infected Mothers for Children Age 1-24 Months in Central Zone, Tigray, North Ethiopia, 2019.