背景:本研究旨在使用人口与健康调查(DHS)数据调查母乳喂养患病率指标的测量,专注于早期启动,纯母乳喂养,世界卫生组织(世卫组织)和联合国儿童基金会(儿童基金会)报告的持续母乳喂养指标,以及其定义的微小变化引起的差异。
方法:分析了来自78个国家的260份国土安全部样本,以重新计算世卫组织和联合国儿童基金会报告的常规指标:早期开始母乳喂养(EIB),6个月以下纯母乳喂养(EBF),和持续母乳喂养1至2年(CBF12和CBF24)。此外,对相同指标的替代估计,稍微改变了他们的定义,进行了计算以测试它们的稳健性。
结果:世界卫生组织和联合国儿童基金会的早期启动指标(EIB)主要记录了在出生后“立即”开始母乳喂养的病例,省略那些在0或1小时内启动的。这种差异导致某些地区的水平大大低估,尤其是南亚,和趋势。此外,纯母乳喂养(EBF)指标之间存在相当大的差异,原因是定义中包含或不包含白开水,不同地区的差异很大,尤其是在西非和中非。然而,持续母乳喂养指标显示出不同定义的一致性,证明它们对于国际比较和时间趋势估计是稳健的。
结论:这项研究强调了了解如何使用DHS数据定义和计算母乳喂养指标的重要性。研究人员在使用世卫组织和儿童基金会的早期开始和纯母乳喂养指标时应谨慎,因为它们的定义狭窄,可能会低估患病率。持续的母乳喂养指标,另一方面,较少受到定义微小变化的影响,并为跨国比较和趋势分析提供可靠的衡量标准。这些发现强调了在全球健康评估中需要对母乳喂养指标进行标准化、稳健的定义和透明的报告。
BACKGROUND: This study aims to investigate the
measurement of breastfeeding prevalence indicators using Demographic and Health Surveys (DHS) data, focusing on early initiation, exclusive breastfeeding, and continued breastfeeding indicators as reported by the World Health Organization (WHO) and the United Nations Children\'s Fund (UNICEF) and on the discrepancies arising from small changes in their definition.
METHODS: Two hundred sixty DHS samples from 78 countries were analyzed to re-calculate usual indicators reported by WHO and UNICEF: early initiation of breastfeeding (EIB), exclusive breastfeeding under 6 months (EBF), and continued breastfeeding between 1 and 2 years (CBF12 and CBF24). Additionally, alternative estimates of the same indicators, slightly changing their definition, were calculated to test their robustness.
RESULTS: The WHO and UNICEF indicators for early initiation (EIB) primarily capture cases where breastfeeding is initiated \"immediately\" after birth, omitting those initiated within 0 or 1 hour. This discrepancy leads to substantial underestimation of levels in some regions, particularly South Asia, and in trends. Furthermore, sizable discrepancies between exclusive breastfeeding (EBF) indicators arise from the inclusion or exclusion of plain water in the definition, with significant variations across regions, especially in West and Middle Africa. However, continued breastfeeding indicators showed consistency across definitions, proving them robust for international comparisons and time trend estimations.
CONCLUSIONS: This study highlights the importance of understanding how breastfeeding indicators are defined and calculated using DHS data. Researchers should be cautious when using WHO and UNICEF indicators for early initiation and exclusive breastfeeding, as they may underestimate prevalence due to their narrow definition. Continued breastfeeding indicators, on the other hand, are less affected by small changes in definitions and provide reliable measures for cross-country comparisons and trend analyses. These findings underscore the need for standardized robust definitions and transparent reporting of breastfeeding indicators in global health assessments.