Abstract

Background: In Ethiopia, study findings regarding the prevalence of EBF have been inconsistent and highly variable. Antenatal care and institutional delivery are the most important factors contributing to the practice EBF however; their effect has not been investigated yet. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of EBF and its association with antenatal care and institutional delivery in Ethiopia.

Methods: In this systematic review and meta-analysis, international databases, including PubMed, Google Scholar, Science Direct and the Cochrane Library were systematically searched. Two authors independently extracted all necessary data using a standardized data extraction format.STATA Version 13 statistical software was used to do the meta-analysis. The Cochrane Q test statistics and I² test were used to assess the heterogeneity of the included studies. A random effectsmeta-analysis model was computed to estimate the pooled prevalence of EBF. Moreover, the association of ANC and institutional delivery with EBF was determined.

Results: The findings from 32 studies reported that the pooled prevalence of EBF in Ethiopia was 59.3% (95% CI: 53.8, 64.8%). The subgroup analysis of this study also indicated that the highest prevalence was observed in Afar region (65.6%), followed by SNNP (63.8%), and then by Oromia (61.8%). Additionally, mothers who attended ANC visit were 2.1 times more likely to practice EBF as compared to their counterparts (OR: 2.1, 95%CI: 1.5, 2.8). Moreover, mothers who gave birth at health institution were 2.2 times more likely to practice EBF as compared to mothers who gave birth at home (OR: 2.2, 95%CI: 1.3, 3.5).

Conclusion:In this meta-analysis, EBF practice in Ethiopia was significantly low as compared to the global recommendation level of exclusive breastfeeding.Mothers who attended ANC visits and who gave birth at health institutions were significantly associated with the better EBF practice.

Keywords: Prevalence, exclusive breastfeeding, meta-analysis, systematic review, Ethiopia