Skip to main content
Top
Published in: International Breastfeeding Journal 1/2016

Open Access 01-12-2016 | Research

Have policy responses in Nigeria resulted in improvements in infant and young child feeding practices in Nigeria?

Authors: Felix A. Ogbo, Andrew Page, John Idoko, Fernanda Claudio, Kingsley E. Agho

Published in: International Breastfeeding Journal | Issue 1/2016

Login to get access

Abstract

Background

Nigeria initiated a range of programs and policies (from 1992 to 2005) to improve infant and young child feeding (IYCF) practices. However, the prevalence of children fed in accordance with IYCF recommendations in Nigeria remains low. This paper presents time trends in IYCF practices in Nigeria for the period (1999–2013), and considers trends in the context of key national policy responses and initiatives.

Methods

Prevalence and percentage change (including 95% confidence intervals) of IYCF indicators were investigated over the period 1999–2013 based on a total of 88,152 maternal responses from the Nigeria Demographic and Health Surveys, (n = 8,199 in 1999; n = 7,620 in 2003; n = 33,385 in 2008 and n = 38,948 in 2013).

Results

Early or timely initiation of breastfeeding decreased significantly by 4.3% (95% Confidence Interval [CI]: −8.1, −0.5; p = 0.0280 for the period (1999–2013); while exclusive breastfeeding remained unchanged 1.6% (95% CI: −2.7, 5.9; p = 0.478). From 2003 to 2013, minimum meal frequency increased significantly by 13.8% (95% CI: 9.9, 17.8; p < 0.001), but minimum dietary diversity and minimum acceptable decreased significantly by 9.7% (95% CI: −9.2, −6.3; p < 0.001) and 3.5% (95% CI: −5.7, −1.3; p = 0.002), respectively. Predominant breastfeeding increased significantly by 13.1% (p < 0.001), and children ever breastfed declined by 16.4% (p < 0.001) over time.

Conclusion

Despite considerable improvements in national legislation, health system responses and community level development, IYCF practices in Nigeria are still below expected levels. Strengthening community and facility based participation, and broader stand-alone/integrated IYCF policy implementations are needed to improve the current feeding practices of Nigerian mothers.
Appendix
Available only for authorised users
Literature
1.
go back to reference Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.CrossRefPubMed Victora CG, Bahl R, Barros AJ, França GV, Horton S, Krasevec J, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475–90.CrossRefPubMed
2.
go back to reference Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491–504.CrossRefPubMed Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491–504.CrossRefPubMed
3.
go back to reference World Health Organization. WHO collaborative study team on the role of breastfeeding on the prevention of infant mortality effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355(9202):451–5.CrossRef World Health Organization. WHO collaborative study team on the role of breastfeeding on the prevention of infant mortality effect of breastfeeding on infant and child mortality due to infectious diseases in less developed countries: a pooled analysis. Lancet. 2000;355(9202):451–5.CrossRef
4.
go back to reference WHO, UNICEF, USAID, FANTA, AED, UC, et al. Indicators for assessing infant and young child feeding practices I. Geneva: World Health Organization; 2008. WHO, UNICEF, USAID, FANTA, AED, UC, et al. Indicators for assessing infant and young child feeding practices I. Geneva: World Health Organization; 2008.
5.
go back to reference Ogunlesi TA, Dedeke O, Okeniyi J, Oyedeji G. Infant And toddler feeding practices in the Baby Friendly Initiative (BFI) era in Ilesa, Nigeria. The Internet Journal of Nutrition and Wellness 2004, 1(2). Ogunlesi TA, Dedeke O, Okeniyi J, Oyedeji G. Infant And toddler feeding practices in the Baby Friendly Initiative (BFI) era in Ilesa, Nigeria. The Internet Journal of Nutrition and Wellness 2004, 1(2).
6.
go back to reference Federal Ministry of Women Affairs and Youth Development: National Report On Follow-up to the World Summit for Children. In. Abuja, Nigeria: UNICEF; 2000. Federal Ministry of Women Affairs and Youth Development: National Report On Follow-up to the World Summit for Children. In. Abuja, Nigeria: UNICEF; 2000.
7.
go back to reference Federal Ministry of Health. National policy on infant and young child feeding in Nigeria. Abuja: Nutrition Division; 2005. Federal Ministry of Health. National policy on infant and young child feeding in Nigeria. Abuja: Nutrition Division; 2005.
8.
go back to reference Yahya BW, Adebayo BS. Modelling the trend and determinants of breastfeeding initiation in Nigeria. Child Dev Res. 2003;1:1–9. Yahya BW, Adebayo BS. Modelling the trend and determinants of breastfeeding initiation in Nigeria. Child Dev Res. 2003;1:1–9.
9.
go back to reference United Nation Childen’s Education Fund. Infant and young child feeding programming status: results of 2010–2011 assessment of key actions for comprehensive infant and young child feeding programmes in 65 countries. In: Nutrition section. New York: UNICEF; 2012. United Nation Childen’s Education Fund. Infant and young child feeding programming status: results of 2010–2011 assessment of key actions for comprehensive infant and young child feeding programmes in 65 countries. In: Nutrition section. New York: UNICEF; 2012.
10.
go back to reference Ogbo FA, Agho KE, Page A. Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2015;15:259.CrossRefPubMedPubMedCentral Ogbo FA, Agho KE, Page A. Determinants of suboptimal breastfeeding practices in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2015;15:259.CrossRefPubMedPubMedCentral
11.
go back to reference Ogbo FA, Page A, Agho KE, Claudio F. Determinants of trends in breast-feeding indicators in Nigeria, 1999–2013. Public Health Nutr. 2015;18:3287–99.CrossRefPubMed Ogbo FA, Page A, Agho KE, Claudio F. Determinants of trends in breast-feeding indicators in Nigeria, 1999–2013. Public Health Nutr. 2015;18:3287–99.CrossRefPubMed
12.
go back to reference National Population Commission (NPC) [Nigeria]. ICF international. Nigeria demographic and health survey 2013. Abuja, Rockville: NPC and ICF International. National Population Commission and ICF International; 2014. National Population Commission (NPC) [Nigeria]. ICF international. Nigeria demographic and health survey 2013. Abuja, Rockville: NPC and ICF International. National Population Commission and ICF International; 2014.
13.
go back to reference United Nation Children’s Fund - Nigeria. Maternal and child health. 2016. Retrieved March 20 2016 from [http://www.unicef.org/nigeria/children_1926.html]. United Nation Children’s Fund - Nigeria. Maternal and child health. 2016. Retrieved March 20 2016 from [http://​www.​unicef.​org/​nigeria/​children_​1926.​html].
14.
go back to reference National Population Commission (NPC) [Nigeria]. ICF macro. Nigeria demographic and health survey 2008. Abuja: National Population Commission and ICF Macro. National Population Commission and ICF Macro; 2009. National Population Commission (NPC) [Nigeria]. ICF macro. Nigeria demographic and health survey 2008. Abuja: National Population Commission and ICF Macro. National Population Commission and ICF Macro; 2009.
15.
go back to reference National Population Commission (NPC) [Nigeria]. ICF macro. Nigeria demographic and health survey 1999. Calverton: National Population Commission and ICF Macro; 2000. National Population Commission (NPC) [Nigeria]. ICF macro. Nigeria demographic and health survey 1999. Calverton: National Population Commission and ICF Macro; 2000.
16.
go back to reference National Population Commission (NPC) [Nigeria], ICF Macro. Nigeria demographic and health survey 2003. Abuja: National Population Commission and ICF Macro.: National Population Commission and ICF Macro; 2004. National Population Commission (NPC) [Nigeria], ICF Macro. Nigeria demographic and health survey 2003. Abuja: National Population Commission and ICF Macro.: National Population Commission and ICF Macro; 2004.
17.
go back to reference Victor R, Baines SK, Agho KE, Dibley MJ. Determinants of breastfeeding indicators among children less than 24 months of age in Tanzania: a secondary analysis of the 2010 Tanzania demographic and health survey. BMJ Open. 2013;3(1):e001529.CrossRefPubMedPubMedCentral Victor R, Baines SK, Agho KE, Dibley MJ. Determinants of breastfeeding indicators among children less than 24 months of age in Tanzania: a secondary analysis of the 2010 Tanzania demographic and health survey. BMJ Open. 2013;3(1):e001529.CrossRefPubMedPubMedCentral
18.
go back to reference Ogbo FA, Page A, Idoko J, Claudio F, Agho KE. Diarrhoea and suboptimal feeding practices in Nigeria: evidence from the national household surveys. Paediatr Perinat Epidemiol. 2016;30:346–55.CrossRefPubMed Ogbo FA, Page A, Idoko J, Claudio F, Agho KE. Diarrhoea and suboptimal feeding practices in Nigeria: evidence from the national household surveys. Paediatr Perinat Epidemiol. 2016;30:346–55.CrossRefPubMed
19.
20.
go back to reference Senarath U, Agho KE, Akram DS, Godakandage SS, Hazir T, Jayawickrama H, et al. Comparisons of complementary feeding indicators and associated factors in children aged 6–23 months across five south Asian countries. Matern Child Nutr. 2012;8(s1):89–106.CrossRefPubMed Senarath U, Agho KE, Akram DS, Godakandage SS, Hazir T, Jayawickrama H, et al. Comparisons of complementary feeding indicators and associated factors in children aged 6–23 months across five south Asian countries. Matern Child Nutr. 2012;8(s1):89–106.CrossRefPubMed
21.
go back to reference Issaka AI, Agho KE, Page A, Burns P, Stevens GJ, Dibley MJ. Comparisons of complementary feeding indicators among children aged 6–23 months in Anglophone and francophone west African countries. Matern Child Nutr. 2015;11(S1):1–13.CrossRefPubMed Issaka AI, Agho KE, Page A, Burns P, Stevens GJ, Dibley MJ. Comparisons of complementary feeding indicators among children aged 6–23 months in Anglophone and francophone west African countries. Matern Child Nutr. 2015;11(S1):1–13.CrossRefPubMed
22.
go back to reference Ghana Statistical Service, Ghana Health Service, Measure DHS, ICF Macro. Ghana demogrphic and healh survey 2008. Calverton: Ghana Statistical Service, Ghana Health Service, Measure DHS, ICF Macro; 2009. Ghana Statistical Service, Ghana Health Service, Measure DHS, ICF Macro. Ghana demogrphic and healh survey 2008. Calverton: Ghana Statistical Service, Ghana Health Service, Measure DHS, ICF Macro; 2009.
23.
go back to reference Dibley MJ, Senarath U, Agho KE. Infant and young child feeding indicators across nine east and southeast Asian countries: an analysis of national survey data 2000–2005. Public Health Nutr. 2010;13(9):1296–303.CrossRefPubMed Dibley MJ, Senarath U, Agho KE. Infant and young child feeding indicators across nine east and southeast Asian countries: an analysis of national survey data 2000–2005. Public Health Nutr. 2010;13(9):1296–303.CrossRefPubMed
24.
go back to reference Magnowski D. Nigerian economy overtakes south Africa’s on rebased GDP. In: Bloomberg. Abuja: Bloomberg; 2014. Magnowski D. Nigerian economy overtakes south Africa’s on rebased GDP. In: Bloomberg. Abuja: Bloomberg; 2014.
25.
go back to reference Doherty T, Sanders D, Jackson D, Swanevelder S, Lombard C, Zembe W, et al. Early cessation of breastfeeding amongst women in South Africa: An area needing urgent attention to improve child health. BMC Pediatrics 2012, 12(105). Doherty T, Sanders D, Jackson D, Swanevelder S, Lombard C, Zembe W, et al. Early cessation of breastfeeding amongst women in South Africa: An area needing urgent attention to improve child health. BMC Pediatrics 2012, 12(105).
26.
go back to reference Piwoz EG, Huffman SL. The impact of marketing of breast-milk substitutes on WHO-recommended breastfeeding practices. Food Nutr Bull. 2015;36(4):373–86.CrossRefPubMed Piwoz EG, Huffman SL. The impact of marketing of breast-milk substitutes on WHO-recommended breastfeeding practices. Food Nutr Bull. 2015;36(4):373–86.CrossRefPubMed
27.
28.
go back to reference Federal Ministry of Health - Nigeria. The World Breastfeeding Trends Initiative (WBTi) - Nigeria. In: Ngozi N, Nte A, editors. Abuja: Federal Ministry of Health; 2015. Federal Ministry of Health - Nigeria. The World Breastfeeding Trends Initiative (WBTi) - Nigeria. In: Ngozi N, Nte A, editors. Abuja: Federal Ministry of Health; 2015.
29.
go back to reference Mihrshahi S, Kabir I, Roy S, Agho KE, Senarath U, Dibley MJ. Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004. Food Nutr Bull. 2010;31(2):295–313. Mihrshahi S, Kabir I, Roy S, Agho KE, Senarath U, Dibley MJ. Determinants of infant and young child feeding practices in Bangladesh: secondary data analysis of Demographic and Health Survey 2004. Food Nutr Bull. 2010;31(2):295–313.
30.
go back to reference Montagu D, Yamey G, Visconti A, Harding A, Yoong J. Where do poor women in developing countries give birth? a multi-country analysis of demographic and health survey data. PLoS One. 2011;6(2):e17155.CrossRefPubMedPubMedCentral Montagu D, Yamey G, Visconti A, Harding A, Yoong J. Where do poor women in developing countries give birth? a multi-country analysis of demographic and health survey data. PLoS One. 2011;6(2):e17155.CrossRefPubMedPubMedCentral
31.
go back to reference Institute for Health Metrics and Evaluation (IHME). Financing global health 2015: development assistance steady on the path to new global goals. Seattle: Institute for Health Metrics and Evaluation (IHME); 2016. Institute for Health Metrics and Evaluation (IHME). Financing global health 2015: development assistance steady on the path to new global goals. Seattle: Institute for Health Metrics and Evaluation (IHME); 2016.
32.
go back to reference Takang E, Serumaga B, Okoh C, Obaje E. Nigeria: nationwide forecast and funding Gap analysis; maternal, newborn, and child health commodities. Arlington: USAID | Deliver project, Task Order 4; 2012. Takang E, Serumaga B, Okoh C, Obaje E. Nigeria: nationwide forecast and funding Gap analysis; maternal, newborn, and child health commodities. Arlington: USAID | Deliver project, Task Order 4; 2012.
33.
go back to reference Dieleman JL, Templin T, Sadat N, Reidy P, Chapin A, Foreman K, et al. National spending on health by source for 184 countries between 2013 and 2040. Lancet. 2016;387:2521–35.CrossRefPubMed Dieleman JL, Templin T, Sadat N, Reidy P, Chapin A, Foreman K, et al. National spending on health by source for 184 countries between 2013 and 2040. Lancet. 2016;387:2521–35.CrossRefPubMed
34.
go back to reference Fund UNC’s. Nigeria launches initiative to save one million lives by 2015. Nigeria UNICEF: Abuja; 2012. Fund UNC’s. Nigeria launches initiative to save one million lives by 2015. Nigeria UNICEF: Abuja; 2012.
35.
go back to reference The World Bank. Nigeria: world bank approves US$500 million to improve maternal and child health, achieve the ‘saving One million Lives’ goal. Washington: The World Bank; 2015. The World Bank. Nigeria: world bank approves US$500 million to improve maternal and child health, achieve the ‘saving One million Lives’ goal. Washington: The World Bank; 2015.
39.
go back to reference Agunbiade OM, Ogunleye OV. Constraints to exclusive breastfeeding practice among breastfeeding mothers in southwest Nigeria: implications for scaling up. Int Breastfeed J. 2012;7:5.CrossRefPubMedPubMedCentral Agunbiade OM, Ogunleye OV. Constraints to exclusive breastfeeding practice among breastfeeding mothers in southwest Nigeria: implications for scaling up. Int Breastfeed J. 2012;7:5.CrossRefPubMedPubMedCentral
40.
go back to reference Davies-Adetugbo AA. Sociocultural factors and the promotion of exclusive breastfeeding in rural Yoruba communities of osun state, Nigeria. Soc Sci Med. 1997;45(1):113–25.CrossRefPubMed Davies-Adetugbo AA. Sociocultural factors and the promotion of exclusive breastfeeding in rural Yoruba communities of osun state, Nigeria. Soc Sci Med. 1997;45(1):113–25.CrossRefPubMed
41.
go back to reference Burleigh M. A country so corrupt it would be better to burn our aid money. In: Daily mail Australia. Australia: Daily Mail Australia; 2013. Burleigh M. A country so corrupt it would be better to burn our aid money. In: Daily mail Australia. Australia: Daily Mail Australia; 2013.
44.
go back to reference Federal Republic of Nigeria - Subsidy Reinvestment and Empowerment Programme (SURE-P). Subsidy reinvestment and empowerment programme (SURE-P)- maternal and child health project. In: Online: the presidency - federal republic of Nigeria, vol. 2016. 2016. Federal Republic of Nigeria - Subsidy Reinvestment and Empowerment Programme (SURE-P). Subsidy reinvestment and empowerment programme (SURE-P)- maternal and child health project. In: Online: the presidency - federal republic of Nigeria, vol. 2016. 2016.
45.
go back to reference World Health Organization. Global nutrition targets 2025: policy brief series (WHO/NMH/NHD/14.2). Geneva: World Health Organisation; 2014. World Health Organization. Global nutrition targets 2025: policy brief series (WHO/NMH/NHD/14.2). Geneva: World Health Organisation; 2014.
46.
go back to reference World Health Organization. Essential nutrition actions: improving maternal, newborn, infant and young child health and nutrition. Geneva: World Health Organisation; 2013. World Health Organization. Essential nutrition actions: improving maternal, newborn, infant and young child health and nutrition. Geneva: World Health Organisation; 2013.
47.
go back to reference Agbo HA, Envuladu EA, Adams HS, Inalegwu E, Okoh E, Agba A, et al. Barriers and facilitators to the practice of exclusive breast feeding among working class mothers: a study of female resident doctors in tertiary health institutions in plateau state. J Med Res. 2013;2(1):112–6. Agbo HA, Envuladu EA, Adams HS, Inalegwu E, Okoh E, Agba A, et al. Barriers and facilitators to the practice of exclusive breast feeding among working class mothers: a study of female resident doctors in tertiary health institutions in plateau state. J Med Res. 2013;2(1):112–6.
48.
go back to reference Grassley J, Eschiti V. Grandmother breastfeeding support: what do mothers need and want? Birth. 2008;35(4):329–35.CrossRefPubMed Grassley J, Eschiti V. Grandmother breastfeeding support: what do mothers need and want? Birth. 2008;35(4):329–35.CrossRefPubMed
49.
go back to reference Qureshi AM, Oche OM, Sadiq UA, Kabiru S. Using community volunteers to promote exclusive breastfeeding in sokoto state, Nigeria. Pan Afr Med J. 2011;10:8.CrossRefPubMedPubMedCentral Qureshi AM, Oche OM, Sadiq UA, Kabiru S. Using community volunteers to promote exclusive breastfeeding in sokoto state, Nigeria. Pan Afr Med J. 2011;10:8.CrossRefPubMedPubMedCentral
50.
go back to reference Quinn VJ, Guyon AB, Schubert JW, Stone-Jiménez M, Hainsworth MD, Martin LH. Improving breastfeeding practices on a broad scale at the community level: success stories from africa and Latin america. J Hum Lact. 2005;21(3):345–54.CrossRefPubMed Quinn VJ, Guyon AB, Schubert JW, Stone-Jiménez M, Hainsworth MD, Martin LH. Improving breastfeeding practices on a broad scale at the community level: success stories from africa and Latin america. J Hum Lact. 2005;21(3):345–54.CrossRefPubMed
51.
go back to reference Braun MLG, Giugliani ER, Soares MEM, Giugliani C, de Oliveira AP, Danelon CMM. Evaluation of the impact of the baby-friendly hospital initiative on rates of breastfeeding. Am J Public Health. 2003;93(8):1277–9.CrossRefPubMedPubMedCentral Braun MLG, Giugliani ER, Soares MEM, Giugliani C, de Oliveira AP, Danelon CMM. Evaluation of the impact of the baby-friendly hospital initiative on rates of breastfeeding. Am J Public Health. 2003;93(8):1277–9.CrossRefPubMedPubMedCentral
52.
go back to reference Ojofeitimi EO, Esimai OA, Owolabi OO, Olaobaju OF, Olanuga TO. Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in ILE-IFE, Nigeria. Nutr Health. 2000;14(2):119–25.CrossRefPubMed Ojofeitimi EO, Esimai OA, Owolabi OO, Olaobaju OF, Olanuga TO. Breast feeding practices in urban and rural health centres: impact of baby friendly hospital initiative in ILE-IFE, Nigeria. Nutr Health. 2000;14(2):119–25.CrossRefPubMed
53.
go back to reference Venancio SI, Saldiva SRDM, Escuder MML, Giugliani ERJ. The baby-friendly hospital initiative shows positive effects on breastfeeding indicators in brazil. J Epidemiol Community Health. 2011;66(10):914–8.CrossRefPubMed Venancio SI, Saldiva SRDM, Escuder MML, Giugliani ERJ. The baby-friendly hospital initiative shows positive effects on breastfeeding indicators in brazil. J Epidemiol Community Health. 2011;66(10):914–8.CrossRefPubMed
54.
go back to reference Abrahams SW, Labbok MH. Exploring the impact of the baby-friendly hospital initiative on trends in exclusive breastfeeding. Int Breastfeed J. 2009;4:1.CrossRef Abrahams SW, Labbok MH. Exploring the impact of the baby-friendly hospital initiative on trends in exclusive breastfeeding. Int Breastfeed J. 2009;4:1.CrossRef
55.
go back to reference Hazir T, Akram DS, Nisar Y, Kazmi N, Agho K, Abbasi S, et al. Determinants of suboptimal breast-feeding practices in Pakistan. Public Health Nutr. 2013;16(04):659–72.CrossRefPubMed Hazir T, Akram DS, Nisar Y, Kazmi N, Agho K, Abbasi S, et al. Determinants of suboptimal breast-feeding practices in Pakistan. Public Health Nutr. 2013;16(04):659–72.CrossRefPubMed
56.
go back to reference Rosenberg KD, Stull JD, Adler MR, Kasehagen LJ, Crivelli-Kovach A: Impact of hospital policies on breastfeeding outcomes. Breastfeed Med. 2008;3(2):110–16. Rosenberg KD, Stull JD, Adler MR, Kasehagen LJ, Crivelli-Kovach A: Impact of hospital policies on breastfeeding outcomes. Breastfeed Med. 2008;3(2):110–16.
57.
go back to reference Madeley J. Sustainable development goals. Appropr Technol. 2015;42(4):32. Madeley J. Sustainable development goals. Appropr Technol. 2015;42(4):32.
58.
go back to reference Isaac A. Military regimes and nation building in Nigeria, 1966–1999. African J Hist Cult. 2013;5(7):138–42. Isaac A. Military regimes and nation building in Nigeria, 1966–1999. African J Hist Cult. 2013;5(7):138–42.
Metadata
Title
Have policy responses in Nigeria resulted in improvements in infant and young child feeding practices in Nigeria?
Authors
Felix A. Ogbo
Andrew Page
John Idoko
Fernanda Claudio
Kingsley E. Agho
Publication date
01-12-2016
Publisher
BioMed Central
Published in
International Breastfeeding Journal / Issue 1/2016
Electronic ISSN: 1746-4358
DOI
https://doi.org/10.1186/s13006-017-0101-5

Other articles of this Issue 1/2016

International Breastfeeding Journal 1/2016 Go to the issue