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

T.D. Habtewold*, S.H. Mohammed, A. Endalamaw, H. Mulugeta, G. Dessie, D.F. Berhe, M.M. Birhanu, M.A. Islam, A.A. Teferra, N.G. Asefa, S.M. Alemu

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


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, τ 2 and I 2 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
Publication statusPublished - 1 Nov 2020


  • breastfeeding
  • breastfeeding initiation
  • breastmilk
  • children
  • ethiopia
  • meta-analysis
  • mothers
  • rural communities
  • systematic review
  • Ethiopia

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