全球经常有报道称婴儿喂养方式欠佳,包括印度尼西亚。该分析研究了一系列行为改变干预措施对Malang和Sidoarjo地区母乳喂养实践的影响,东爪哇省,印度尼西亚。BADUTA研究(在印尼语中是BawahDUaTahun的首字母缩写,或小于2岁的儿童)是使用具有两个平行治疗组的集群随机对照试验进行的影响评估。我们在Malang和Sidoarjo的12个分区进行了家庭调查。我们收集了5175名0-23个月儿童母亲的信息:基线(2015年2月)的2435名母亲和终点(2017年1月至2月)的2740名母亲。这项分析使用了发热和腹泻两项指标和7项母乳喂养指标(早期开始母乳喂养,乳前喂养,6个月以下纯母乳喂养,以母乳喂养为主,继续母乳喂养,适合年龄的母乳喂养和奶瓶喂养)。我们使用多水平logistic回归分析来评估干预效果。实施干预措施2年后,我们观察到干预组6个月以下纯母乳喂养的几率(调整后的优势比[aOR]=1.85;95%置信区间[CI]:1.35-2.53)和适合年龄的母乳喂养(aOR=1.39;95%CI:1.07-1.79)比对照组增加,在终点线调查。我们发现干预组的乳前喂养几率明显低于对照组(aOR=0.52;95%CI:0.41-0.65)。我们的发现证实了整合的好处,多层行为改变干预措施,以促进母乳喂养实践。需要进一步的研究,以制定有效的干预措施,以减少奶瓶的使用,并改善其他母乳喂养指标,而BADUTA干预措施并未改变。
Suboptimal infant young child feeding practices are frequently reported globally, including in Indonesia. This analysis examined the impact of a package of behaviour change interventions on breastfeeding practices in Malang and Sidoarjo Districts, East Java Province, Indonesia. The BADUTA study (which in the Indonesian Language is an acronym for BAwah DUa TAhun, or children aged less than 2 years) was an impact evaluation using a cluster-randomized controlled trial with two parallel treatment arms. We conducted household surveys in 12 subdistricts from Malang and Sidoarjo. We collected information from 5175 mothers of children aged 0-23 months: 2435 mothers at baseline (February 2015) and 2740 mothers at endline (January to February 2017). This analysis used two indicators for fever and diarrhoea and seven breastfeeding indicators (early initiation of breastfeeding, prelacteal feeding, exclusive breastfeeding under 6 months, predominant breastfeeding, continued breastfeeding, age-appropriate breastfeeding and bottle-feeding). We used multilevel logistic regression analysis to assess the effect of the intervention. After 2 years of implementation of interventions, we observed an increased odds of exclusive breastfeeding under 6 months (adjusted odds ratio [aOR] = 1.85; 95% confidence interval [CI]: 1.35-2.53) and age-appropriate breastfeeding (aOR = 1.39; 95% CI: 1.07-1.79) in the intervention group than in the comparison group, at the endline survey. We found significantly lower odds for prelacteal feeding (aOR = 0.52; 95% CI: 0.41-0.65) in the intervention than in the comparison group. Our findings confirmed the benefits of integrated, multilayer behaviour change interventions to promote breastfeeding practices. Further research is required to develop effective interventions to reduce bottle use and improve other breastfeeding indicators that did not change with the BADUTA intervention.