Geospatial variation of bottle feeding practice among children aged 0-23 months in East Africa: Geographically weighted regression analysis
Andualem Addisu Birlie, Angwach Abrham Asnake, Bizunesh Fantahun Kase, Etsay Woldu Anbesu, Abdulkerim Hassen Moloro, Tesfaye Deribe Bedada, Alemayehu Kasu Gebrehana, Hiwot Altaye AsebeIntroduction
Bottle-feeding a baby aged 0-23 months is the act of giving any liquid or semi-solid food from a bottle with a nipple. Bottle feeding can increase their risk of excessive weight gain, malnutrition, iron deficiency, and reduced birth spacing. However, no study has been conducted on geographically weighted regression (GWR) analysis and the factors associated with bottle-feeding practice.
Objective
To assess the geospatial variation and determinants of bottle-feeding practice among children aged 0-23 months in East Africa using GWR.
Methods
A total sample of 28,562 children aged 0-23 months were included in the study. Excel 2019, STATA version 17, ArcGIS version 10.7.1, and SaTScan version 10.1 were used to analyze children’s bottle-feeding practice. Spatial autocorrelation, hotspot analysis, interpolation, and spatial scan analysis were performed. Ordinary least squares analysis and geographically weighted regression analysis were employed to assess the association between bottle feeding practice and explanatory variables.
Results
The magnitude of bottle feeding practice among children aged 0-23 months in East Africa was 13%. Rwanda, Central and Eastern Tanzania, Central and some coastal regions of Madagascar, Southern Kenya, and both Southern and Eastern Mozambique were found to have high hotspots of bottle-feeding practice among children aged 0-23 months The primary clusters were 244, and statistically significant clusters were observed in Madagascar and centered at -20.6258N, 46.6889E, 214.8715 km with an LLR of 155.9459, RR: 2.138.
Conclusion
This study led to the conclusion that the spatial distribution of child bottle-feeding practice was clustered, and hotspot areas were identified in East Africa. Thus, this study aims to reduce the burden of child bottle-feeding practice in hotspot areas in East African countries. The local authorities and policymakers should focus on providing parental counseling, especially in the regions that are identified as high risk for child bottle-feeding practices.