Predictors of exclusive breastfeeding and maternal access to mobile phones in urban settings in Hawassa City, Sidama Region, Ethiopia

Abstract

Introduction: exclusive breastfeeding (EBF) rates in Ethiopia remain below national targets. In urban areas, the prevalence of EBF is comparatively low, and the underlying determinants influencing breastfeeding practices in these settings have not been sufficiently explored. This study aimed to assess the prevalence and predictors of exclusive breastfeeding practice and maternal access to mobile phones. Methods: community-based cross-sectional study was conducted with a sample of 772 mothers and their infants aged 0-5 months. Trained data collectors administered a pre-tested and validated questionnaire developed by the Food and Agriculture Organization of the United Nations (FAO). Data were analyzed using a multiple logistic regression model to identify predictors of exclusive breastfeeding practice. Results: the prevalence of exclusive breastfeeding was 54.4% (95% CI 50.8, 58.0). Regarding maternal knowledge, 96% (95% CI 94.7, 97.4) of women have adequate knowledge, and 59.6% (95% CI 55.9, 63.1) have a favorable attitude towards exclusive breastfeeding. Access to mobile phones among women was 100%, and 84.1% of women were willing to receive breastfeeding SMS text messages. Mothers with adequate knowledge were 3.27 times more likely to practice exclusive breastfeeding (AOR = 3.27; 95% CI: 1.38, 7.75). Women with vocational education were 2.62 times and secondary education were 3.20 times more likely to practice exclusive breastfeeding (AOR = 2.62; 95% CI: 1.37, 5.00), and (AOR = 3.20; 95% CI: 1.53, 6.67) respectively than no education and university graduates. Exclusive breastfeeding was 2.11 times more common among women with supportive husbands than those without (AOR = 2.11; 95% CI: 1.41, 3.16). Conclusion: more than half of the women practiced exclusive breastfeeding, and the majority demonstrated good knowledge and a positive attitude toward it. However, the overall prevalence of exclusive breastfeeding remains inadequate. Maternal knowledge, age, educational level, occupation, and husband's support were key predictors of exclusive breastfeeding. A significant proportion of lactating mothers own mobile phones and are familiar with sending, receiving, and reading SMS messages. Therefore, a more extensive and comprehensive approach to exclusive breastfeeding counseling should be implemented to improve rates among urban populations.