Mapping inequalities in exclusive breastfeeding in low- and middle-income countries, 2000–2018

Natalia V. Bhattacharjee, Lauren E. Schaeffer, Simon I. Hay, Dan Lu, Megan F. Schipp, Alice Lazzar-Atwood, Katie M. Donkers, Gdiom Gebreheat Abady, Foad Abd-Allah, Ahmed Abdelalim, Zeleke Hailemariam Abebo, Ayenew Negesse Abejie, Akine Eshete Abosetugn, Lucas Guimarães Abreu, Michael R.M. Abrigo, Eman Abu-Gharbieh, Abdelrahman I. Abushouk, Aishatu L. Adamu, Isaac Akinkunmi Adedeji, Adeyinka Emmanuel AdegbosinVictor Adekanmbi, Olatunji O. Adetokunboh, Marcela Agudelo-Botero, Budi Aji, Oluwaseun Oladapo Akinyemi, Alehegn Aderaw Alamneh, Fahad Mashhour Alanezi, Turki M. Alanzi, James Albright, Jacqueline Elizabeth Alcalde-Rabanal, Biresaw Wassihun Alemu, Robert Kaba Alhassan, Beriwan Abdulqadir Ali, Saqib Ali, Cyrus Alinia, Vahid Alipour, Arianna Maever L. Amit, Dickson A. Amugsi, Etsay Woldu Anbesu, Robert Ancuceanu, Mina Anjomshoa, Fereshteh Ansari, Carl Abelardo T. Antonio, Davood Anvari, Jalal Arabloo, Amit Arora, Kurnia Dwi Artanti, Mulusew A. Asemahagn, Wondwossen Niguse Asmare, Maha Moh’d Wahbi Atout, Marcel Ausloos, Nefsu Awoke, Beatriz Paulina Ayala Quintanilla, Martin Amogre Ayanore, Yared Asmare Aynalem, Muluken Altaye Ayza, Zelalem Nigussie Azene, B. B. Darshan, Ashish D. Badiye, Atif Amin Baig, Shankar M. Bakkannavar, Maciej Banach, Palash Chandra Banik, Till Winfried Bärnighausen, Huda Basaleem, Mohsen Bayati, Bayisa Abdissa Baye, Neeraj Bedi, Sefealem Assefa Belay, Akshaya Srikanth Bhagavathula, Dinesh Bhandari, Nikha Bhardwaj, Pankaj Bhardwaj, Zulfiqar A. Bhutta, Ali Bijani, Tsegaye Adane Birhan, Binyam Minuye Birihane, Zebenay Workneh Bitew, Somayeh Bohlouli, Mahdi Bohluli, Hunduma Amensisa Bojia, Archith Boloor, Oliver J. Brady, Nicola Luigi Bragazzi, Andre R. Brunoni, Shyam S. Budhathoki, Sharath Burugina Nagaraja, Zahid A. Butt, Rosario Cárdenas, Joao Mauricio Castaldelli-Maia, Franz Castro, Achille Cernigliaro, Jaykaran Charan, Pranab Chatterjee, Souranshu Chatterjee, Vijay Kumar Chattu, Sarika Chaturvedi, Mohiuddin Ahsanul Kabir Chowdhury, Dinh Toi Chu, Michael L. Collison, Aubrey J. Cook, Michael A. Cork, Rosa A.S. Couto, Baye Dagnew, Haijiang Dai, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Aso Mohammad Darwesh, Amira Hamed Darwish, Ahmad Daryani, Jai K. Das, Rajat Das Gupta, Claudio Alberto Dávila-Cervantes, Adrian Charles Davis, Nicole Davis Weaver, Edgar Denova-Gutiérrez, Kebede Deribe, Assefa Desalew, Aniruddha Deshpande, Awrajaw Dessie, Keshab Deuba, Samath Dhamminda Dharmaratne, Meghnath Dhimal, Govinda Prasad Dhungana, Daniel Diaz, Alireza Didarloo, Isaac Oluwafemi Dipeolu, Linh Phuong Doan, Bereket Duko, Andre Rodrigues Duraes, Laura Dwyer-Lindgren, Lucas Earl, Maysaa El Sayed Zaki, Maha El Tantawi, Teshome Bekele Elema, Hala Rashad Elhabashy, Shaimaa I. El-Jaafary, Pawan Sirwan Faris, Andre Faro, Farshad Farzadfar, Valery L. Feigin, Berhanu Elfu Feleke, Tomas Y. Ferede, Florian Fischer, Nataliya A. Foigt, Morenike Oluwatoyin Folayan, Richard Charles Franklin, Mohamed M. Gad, Shilpa Gaidhane, William M. Gardner, Biniyam Sahiledengle Geberemariyam, Birhan Gebresillassie Gebregiorgis, Ketema Bizuwork Gebremedhin, Berhe Gebremichael, Fariborz Ghaffarpasand, Syed Amir Gilani, Themba G. Ginindza, Mustefa Glagn, Mahaveer Golechha, Kebebe Bekele Gonfa, Bárbara Niegia Garcia Goulart, Nachiket Gudi, Davide Guido, Rashid Abdi Guled, Yuming Guo, Samer Hamidi, Demelash Woldeyohannes Handiso, Ahmed I. Hasaballah, Amr Hassan, Khezar Hayat, Mohamed I. Hegazy, Behnam Heidari, Nathaniel J. Henry, Claudiu Herteliu, Hagos Degefa de Hidru, Hung Chak Ho, Chi Linh Hoang, Ramesh Holla, Julia Hon, Mostafa Hosseini, Mehdi Hosseinzadeh, Mowafa Househ, Mohamed Hsairi, Guoqing Hu, Tanvir M. Huda, Bing Fang Hwang, Segun Emmanuel Ibitoye, Olayinka Stephen Ilesanmi, Irena M. Ilic, Milena D. Ilic, Leeberk Raja Inbaraj, Usman Iqbal, Seyed Sina Naghibi Irvani, M. Mofizul Islam, Chidozie C.D. Iwu, Chinwe Juliana Iwu, Animesh Jain, Manthan Dilipkumar Janodia, Tahereh Javaheri, Yetunde O. John-Akinola, Kimberly B. Johnson, Farahnaz Joukar, Jacek Jerzy Jozwiak, Ali Kabir, Leila R. Kalankesh, Rohollah Kalhor, Ashwin Kamath, Naser Kamyari, Other Tanuj Kanchan, Neeti Kapoor, Behzad Karami Matin, Salah Eddin Karimi, Habtamu Kebebe Kasaye, Getinet Kassahun, Nicholas J. Kassebaum, Gbenga A. Kayode, Ali Kazemi Karyani, Peter Njenga Keiyoro, Bayew Kelkay, Nauman Khalid, Md Nuruzzaman Khan, Khaled Khatab, Amir M. Khater, Mona M. Khater, Mahalaqua Nazli Khatib, Yun Jin Kim, Ruth W. Kimokoti, Damaris K. Kinyoki, Adnan Kisa, Sezer Kisa, Soewarta Kosen, Kewal Krishan, Vaman Kulkarni, G. Anil Kumar, Manasi Kumar, Nithin Kumar, Pushpendra Kumar, Om P. Kurmi, Dian Kusuma, Carlo La Vecchia, Sheetal D. Lad, Faris Hasan Lami, Iván Landires, Van Charles Lansingh, Savita Lasrado, Paul H. Lee, Kate E. LeGrand, Ian D. Letourneau, Sonia Lewycka, Bingyu Li, Ming Chieh Li, Shanshan Li, Xuefeng Liu, Rakesh Lodha, Jaifred Christian F. Lopez, Celia Louie, Daiane Borges Machado, Venkatesh Maled, Shokofeh Maleki, Deborah Carvalho Malta, Abdullah A. Mamun, Navid Manafi, Mohammad Ali Mansournia, Chabila Christopher Mapoma, Laurie B. Marczak, Francisco Rogerlândio Martins-Melo, Man Mohan Mehndiratta, Fabiola Mejia-Rodriguez, Tefera Chane Mekonnen, Walter Mendoza, Ritesh G. Menezes, Endalkachew Worku Mengesha, Abera M. Mersha, Ted R. Miller, G. K. Mini, Erkin M. Mirrakhimov, Sanjeev Misra, Masoud Moghadaszadeh, Dara K. Mohammad, Abdollah Mohammadian-Hafshejani, Jemal Abdu Mohammed, Shafiu Mohammed, Ali H. Mokdad, Pablo A. Montero-Zamora, Masoud Moradi, Rahmatollah Moradzadeh, Paula Moraga, Jonathan F. Mosser, Seyyed Meysam Mousavi, Amin Mousavi Khaneghah, Sandra B. Munro, Moses K. Muriithi, Ghulam Mustafa, Saravanan Muthupandian, Ahamarshan Jayaraman Nagarajan, Gurudatta Naik, Mukhammad David Naimzada, Vinay Nangia, Bruno Ramos Nascimento, Vinod C. Nayak, Rawlance Ndejjo, Duduzile Edith Ndwandwe, Ionut Negoi, Georges Nguefack-Tsague, Josephine W. Ngunjiri, Cuong Tat Nguyen, Diep Ngoc Nguyen, Huong Lan Thi Nguyen, Samuel Negash Nigussie, Tadesse T.N. Nigussie, Rajan Nikbakhsh, Chukwudi A. Nnaji, Virginia Nunez-Samudio, Bogdan Oancea, Onome Bright Oghenetega, Andrew T. Olagunju, Bolajoko Olubukunola Olusanya, Jacob Olusegun Olusanya, Muktar Omer Omer, Obinna E. Onwujekwe, Doris V. Ortega-Altamirano, Aaron E. Osgood-Zimmerman, Nikita Otstavnov, Stanislav S. Otstavnov, Mayowa O. Owolabi, P. A. Mahesh, Jagadish Rao Padubidri, Adrian Pana, Anamika Pandey, Seithikurippu R. Pandi-Perumal, Helena Ullyartha Pangaribuan, Shradha S. Parsekar, Deepak Kumar Pasupula, Urvish K. Patel, Ashish Pathak, Mona Pathak, Sanjay M. Pattanshetty, George C. Patton, Kebreab Paulos, Veincent Christian Filipino Pepito, Brandon V. Pickering, Marina Pinheiro, Ellen G. Piwoz, Khem Narayan Pokhrel, Hadi Pourjafar, Sergio I. Prada, Dimas Ria Angga Pribadi, Zahiruddin Quazi Syed, Mohammad Rabiee, Navid Rabiee, Fakher Rahim, Shadi Rahimzadeh, Azizur Rahman, Mohammad Hifz Ur Rahman, Amir Masoud Rahmani, Rajesh Kumar Rai, Chhabi Lal Ranabhat, Sowmya J. Rao, Prateek Rastogi, Priya Rathi, David Laith Rawaf, Salman Rawaf, Reza Rawassizadeh, Rahul Rawat, Ramu Rawat, Lemma Demissie Regassa, Maria Albertina Santiago Rego, Robert C. Reiner, Bhageerathy Reshmi, Aziz Rezapour, Ana Isabel Ribeiro, Jennifer Rickard, Leonardo Roever, Susan Fred Rumisha, Godfrey M. Rwegerera, Rajesh Sagar, S. Mohammad Sajadi, Marwa Rashad Salem, Abdallah M. Samy, Milena M. Santric-Milicevic, Sivan Yegnanarayana Iyer Saraswathy, Abdur Razzaque Sarker, Benn Sartorius, Brijesh Sathian, Deepak Saxena, Alyssa N. Sbarra, Debarka Sengupta, Subramanian Senthilkumaran, Feng Sha, Omid Shafaat, Amira A. Shaheen, Masood Ali Shaikh, Ali S. Shalash, Mohammed Shannawaz, Aziz Sheikh, B. Suresh Kumar Shetty, Ranjitha S. Shetty, Kenji Shibuya, Wondimeneh Shibabaw Shiferaw, Jae Il Shin, Diego Augusto Santos Silva, Narinder Pal Singh, Pushpendra Singh, Surya Singh, Yitagesu Sintayehu, Valentin Yurievich Skryabin, Anna Aleksandrovna Skryabina, Amin Soheili, Shahin Soltani, Muluken Bekele Sorrie, Emma Elizabeth Spurlock, Krista M. Steuben, Agus Sudaryanto, Mu’awiyyah Babale Sufiyan, Scott J. Swartz, Eyayou Girma Tadesse, Animut Tagele Tamiru, Leili Tapak, Md Ismail Tareque, Ingan Ukur Tarigan, Getayeneh Antehunegn Tesema, Fisaha Haile Tesfay, Abinet Teshome, Zemenu Tadesse Tessema, Kavumpurathu Raman Thankappan, Rekha Thapar, Nihal Thomas, Roman Topor-Madry, Marcos Roberto Tovani-Palone, Eugenio Traini, Bach Xuan Tran, Phuong N. Truong, Berhan Tsegaye B.T. Tsegaye, Irfan Ullah, Chukwuma David Umeokonkwo, Bhaskaran Unnikrishnan, Era Upadhyay, Benjamin S.Chudi Uzochukwu, John David VanderHeide, Francesco S. Violante, Bay Vo, Yohannes Dibaba Wado, Yasir Waheed, Richard G. Wamai, Fang Wang, Yafeng Wang, Yuan Pang Wang, Nuwan Darshana Wickramasinghe, Kirsten E. Wiens, Charles Shey Wiysonge, Lauren Woyczynski, Ai Min Wu, Chenkai Wu, Tomohide Yamada, Sanni Yaya, Alex Yeshaneh, Yigizie Yeshaw, Yordanos Gizachew Yeshitila, Mekdes Tigistu Yilma, Paul Yip, Naohiro Yonemoto, Tewodros Yosef, Mustafa Z. Younis, Abdilahi Yousuf Yousuf, Chuanhua Yu, Yong Yu, Deniz Yuce, Shamsa Zafar, Syed Saoud Zaidi, Leila Zaki, Josefina Zakzuk, Maryam Zamanian, Heather J. Zar, Mikhail Sergeevich Zastrozhin, Anasthasia Zastrozhina, Desalege Amare Zelellw, Yunquan Zhang, Zhi Jiang Zhang, Xiu Ju George Zhao, Sanjay Zodpey, Yves Miel H. Zuniga, Simon I. Hay

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Exclusive breastfeeding (EBF)—giving infants only breast-milk for the first 6 months of life—is a component of optimal breastfeeding practices effective in preventing child morbidity and mortality. EBF practices are known to vary by population and comparable subnational estimates of prevalence and progress across low- and middle-income countries (LMICs) are required for planning policy and interventions. Here we present a geospatial analysis of EBF prevalence estimates from 2000 to 2018 across 94 LMICs mapped to policy-relevant administrative units (for example, districts), quantify subnational inequalities and their changes over time, and estimate probabilities of meeting the World Health Organization’s Global Nutrition Target (WHO GNT) of ≥70% EBF prevalence by 2030. While six LMICs are projected to meet the WHO GNT of ≥70% EBF prevalence at a national scale, only three are predicted to meet the target in all their district-level units by 2030.
Original languageEnglish (US)
Pages (from-to)1027-1045
Number of pages19
JournalNature Human Behaviour
Volume5
Issue number8
DOIs
StatePublished - Jun 3 2021

Bibliographical note

KAUST Repository Item: Exported on 2021-12-21
Acknowledgements: This work was primarily supported by grant no. OPP1132415 from the Bill & Melinda Gates Foundation. Co-authors used by the Bill & Melinda Gates Foundation (E.G.P. and R.R.3) provided feedback on initial maps and drafts of this manuscript. L.G.A. has received support from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES), Código de Financiamento 001 and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (grant nos. 404710/2018-2 and 310797/2019-5). O.O.Adetokunboh acknowledges the National Research Foundation, Department of Science and Innovation and South African Centre for Epidemiological Modelling and Analysis. M.Ausloos, A.Pana and C.H. are partially supported by a grant from the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project no. PN-III-P4-ID-PCCF-2016-0084. P.C.B. would like to acknowledge the support of F. Alam and A. Hussain. T.W.B. was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. K.Deribe is supported by the Wellcome Trust (grant no. 201900/Z/16/Z) as part of his international intermediate fellowship. C.H. and A.Pana are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNDS-UEFISCDI, project no. PN-III-P2-2.1-SOL-2020-2-0351. B.Hwang is partially supported by China Medical University (CMU109-MF-63), Taichung, Taiwan. M.Khan acknowledges Jatiya Kabi Kazi Nazrul Islam University for their support. A.M.K. acknowledges the other collaborators and the corresponding author. Y.K. was supported by the Research Management Centre, Xiamen University Malaysia (grant no. XMUMRF/2020-C6/ ITM/0004). K.Krishan is supported by a DST PURSE grant and UGC Centre of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. M.Kumar would like to acknowledge FIC/NIH K43 TW010716-03. I.L. is a member of the Sistema Nacional de Investigación (SNI), which is supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panamá. M.L. was supported by China Medical University, Taiwan (CMU109-N-22 and CMU109-MF-118). W.M. is currently a programme analyst in Population and Development at the United Nations Population Fund (UNFPA) Country Office in Peru, which does not necessarily endorses this study. D.E.N. acknowledges Cochrane South Africa, South African Medical Research Council. G.C.P. is supported by an NHMRC research fellowship. P.Rathi acknowledges support from Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India. Ramu Rawat acknowledges the support of the GBD Secretariat for supporting the reviewing and collaboration of this paper. B.R. acknowledges support from Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal. A.Ribeiro was supported by National Funds through FCT, under the programme of ‘Stimulus of Scientific Employment—Individual Support’ within the contract no. CEECIND/02386/2018. S.Sajadi acknowledges colleagues at Global Burden of Diseases and Local Burden of Disease. A.M.S. acknowledges the support from the Egyptian Fulbright Mission Program. F.S. was supported by the Shenzhen Science and Technology Program (grant no. KQTD20190929172835662). A.Sheikh is supported by Health Data Research UK. B.K.S. acknowledges Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal for all the academic support. B.U. acknowledges support from Manipal Academy of Higher Education, Manipal. C.S.W. is supported by the South African Medical Research Council. Y.Z. was supported by Science and Technology Research Project of Hubei Provincial Department of Education (grant no. Q20201104) and Outstanding Young and Middle-aged Technology Innovation Team Project of Hubei Provincial Department of Education (grant no. T2020003). The funders of the study had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication. All maps presented in this study are generated by the authors and no permissions are required to publish them.

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