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Abstract

Despite the fact that exclusive breastfeeding brings a lot of benefits for infants and mothers, breastfeeding rates in Indonesia remain low, at 42% of all infants aged 0-5 months in 2012. This study aims to apply the positive deviance concept to explore the factors determining the success of exclusive breastfeeding among mothers in a high-risk group in Indonesia. The study used the cross-sectional, DHS 2017 data of 1.178 mothers with 0-5 months old infants in Indonesia. Chi-square and multiple logistic regression tests with 95% confidence intervals are used in identifying the factors associated with exclusive breastfeeding. Maternal working status is shown to be the most significant risk factor in preventing mothers to breastfeed exclusively. Furthermore, the data suggest that, out of 376 working mothers, 45,5% can be identified as positive deviants – those succeeding in implementing exclusive breastfeeding. The study finds ante-natal care (ANC) visits, post-natal care (PNC) visits, and economic status displayed significant association with exclusive breastfeeding among working mothers. In the sample, ANC visit is the dominant factor associated with exclusive breastfeeding (OR: 1,831; 95% CI: 1,075-3,118). Completion of ANC and PNC visits should be taken to consideration in improving exclusive breastfeeding rate among working mothers in Indonesia.

References

  1. WHO. Breastfeeding. WHO [Internet]. 2018 [cited 2020 Jan 18]; Available from: www.who.int/nutrition/topics/exc lusive_breastfeeding/en/
  2. Walters DD, Phan LTH, Mathisen R. The cost of not breastfeeding: global results from a new tool. Health Policy Plan. 2019;34(6):407–17.
  3. Development Initiatives. Global Nutrition Report 2017: Nourishing the SDGs. Bristol, UK: Development Initiative. 2017.
  4. UNICEF. From the First Hour of Life: Key Findings 2016. 2016. 5. Dwinanda N, Syarif BH, Sjarif DR. Factors affecting exclusive breastfeeding in term infants. Paediatr Indones. 2018;58(1):25– 35.
  5. Mogre V, Dery M, Gaa PK. Knowledge, attitudes and determinants of exclusive breastfeeding practice among Ghanaian rural lactating mothers. Int Breastfeed J [Internet]. 2016;11(12):1–8. Available from: http://dx.doi.org/10.1186/s13006-016-0071-z
  6. Alemayehu T, Haidar J, Habte D. Determinants of exclusive breastfeeding practices in Ethiopia. Ethiop J Heal Dev. 2009;23(1).
  7. Tariku A, Alemu K, Gizaw Z, Muchie KF, Derso T, Abebe SM, et al. Mothers’ education and ANC visit improved exclusive breastfeeding in Dabat health and Demographic surveillance system site, northwest Ethiopia. PLoS One. 2017;12(6):1–13.
  8. Mundagowa PT, Chadambuka EM, Chimberengwa PT, Mukora-Mutseyekwa F. Determinants of exclusive breastfeeding among mothers of infants aged 6 to 12 months in Gwanda District, Zimbabwe. Int Breastfeed J. 2019;14(1):1–8.
  9. Mawaddah S. Hubungan Inisiasi Menyusu Dini Dengan Pemberian Asi Ekslusif Pada Bayi. J Info Kesehat. 2018;16(2):214–25.
  10. Biks GA, Tariku A, Tessema GA. Effects of antenatal care and institutional delivery on exclusive breastfeeding practice in northwest Ethiopia: A nested case-control study. Int Breastfeed J [Internet]. 2015;10(1):1–6. Available from: http://dx.doi.org/10.1186/s13006- 015-0055-4
  11. Hossain M, Islam A, Kamarul T, Hossain G. Exclusive breastfeeding practice during first six months of an infant’s life in Bangladesh: A country based cross-sectional study. BMC Pediatr. 2018;18(1):1–9.
  12. Aiga H, Nguyen VD, Nguyen CD, Nguyen TTT, Nguyen LTP. Knowledge, attitude and practices: Assessing maternal and child health care handbook intervention in Vietnam. BMC Public Health [Internet]. 2016;16(1):1–10. Available from: http://dx.doi.org/10.1186/s12889- 016-2788-4
  13. Hunegnaw MT, Gezie LD, Teferra AS. Exclusive breastfeeding and associated factors among mothers in Gozamin district, northwest Ethiopia: a community based cross-sectional study. Int Breastfeed J. 2017;12(30):1–8.
  14. Ma P, Magnus JH. Exploring the concept of positive deviance related to breastfeeding initiation in black and white WIC enrolled first time mothers. Matern Child Health J. 2012;16(8):1583–93.
  15. Srivastava A, Gwande K, Bhattacharya S, Singh VK. Impact of positive deviance approach on breastfeeding practices among tribal pregnant women: A before-after intervention study. CHRISMED J Heal Res. 2019;6:222–8.
  16. Walker LO, Sterling BS, Hoke MM, Dearden KA. Applying the concept of positive deviance to public health data: A tool for reducing health disparities. Public Health Nurs. 2007;24(6):571–6.
  17. Riordan J. Breastfeeding and Human Lactation. 3rd ed. Massachusetts: Jones and Bartlett; 2005.
  18. Brown JE. Nutrition Through the Life Cycle. 6th ed. USA: Thomson Wadsword; 2016.
  19. Sari Y. Lack of exclusive breastfeeding among working mothers in Indonesia. Kesmas Natl Public Heal J. 2016;11(2):61–8.
  20. Kementerian Kesehatan RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 97 Tahun 2014. 2014.
  21. Su LL, Chong YS, Chan YH, Chan YS, Fok D, Tun KT, et al. Antenatal education and postnatal support strategies for improving rates of exclusive breast feeding: Randomised controlled trial. Br Med J. 2007;335(7620):596–9.
  22. Mawa R. Socio-Economic Status and Exclusive Breastfeeding Among Infants in a Ugandan Cross-Sectional Study. J Food Nutr Sci. 2019;7(1):16.
  23. Banu B, Khanom K. Effects of Education Level of Father and Mother on Perceptions of Breastfeeding. J Enam Med Coll. 2012;2(2):67–73.
  24. Guo S, Fu X, Scherpbier RW, Wang Y, Zhou H, Wang X, et al. Breastfeeding rates in central and western China in 2010: implications for child and population health. Bull World Health Organ. 2013;91(5):322– 31.
  25. Syamiyah N, Helda H. Dukungan Tenaga Kesehatan dalam Meningkatkan Pemberian ASI Eksklusif Ibu di Posyandu Wilayah Puskesmas Kecamatan Mampang Prapatan Jakarta. J Penelit dan Pengemb Pelayanan Kesehat. 2018;2(1):29–37.
  26. Setegn T, Belachew T, Gerbaba M, Deribe K, Deribew A, Biadgilign S. Factors associated with exclusive breastfeeding practices among mothers in Goba district, south east Ethiopia: a cross-sectional study. Int Breastfeed J. 2012;7(17):1–8.
  27. Tahiru R, Agbozo F, Garti H, Abubakari A. Exclusive Breastfeeding and Associated Factors among Mothers with Twins in the Tamale Metropolis. Int J Pediatr. 2020;2020:1–9.
  28. Sholikah BM. Hubungan Penolong Persalinan, Inisiasi Menyusu Dini dan Dukungan Petugas Kesehatan dengan Perilaku Ibu Dalam Pemberian ASI Eksklusif. J Keperawatan Muhammadiyah. 2018;3(2):6–12.

Bahasa Abstract

Meskipun manfaat dari ASI eksklusif sudah tidak diragukan lagi, cakupan pemberian ASI eksklusif di Indonesia masih rendah, yaitu hanya 42% pada tahun 2012. Penelitian ini berusaha menggunakan konsep positive deviance untuk menelusuri faktor determinan keberhasilan pemberian ASI eksklusif pada kelompok ibu yang memiliki risiko tinggi untuk tidak ASI eksklusif. Penelitian dengan metode cross-sectional ini menganalisis data sekunder dari 1.178 ibu dengan bayi usia 0-5 bulan di Indonesia pada SDKI tahun 2017. Analisis dengan uji chi-square dan regresi logistik ganda dengan confidence interval 95% dilakukan untuk menganalisis faktor yang berhubungan signifikan dengan pemberian ASI eksklusif. Status ibu bekerja ditemukan sebagai faktor dominan yang berhubungan dengan terhambatnya pemberian ASI eksklusif. Di antara 376 ibu yang bekerja, 45,5% nya diidentifikasi sebagai pelaku positive deviance, yaitu mereka yang berhasil memberikan ASI eksklusif. Pada analisis multivariat, ditemukan kunjungan ANC, kunjungan PNC, dan status ekonomi sebagai faktor yang berhubungan secara signifikan dengan pemberian ASI eksklusif di antara ibu bekerja. Kunjungan ANC merupakan faktor dominan yang berhubungan dengan ASI eksklusif dengan OR 1,831 (95% CI: 1,075-3,118). Perilaku melakukan kunjungan ANC dan PNC, termasuk mendapatkan edukasi dan konseling terkait menyusui dari petugas kesehatan saat kunjungan tersebut dapat mendukung pemberian ASI eksklusif di antara ibu bekerja di Indonesia.

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