Inequality, abuse of women and duration of breastfeeding, Colombia, 2010: Ecological study
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Daza, M., Herrán, O. F., & Del Castillo , S. E. (2022). Inequality, abuse of women and duration of breastfeeding, Colombia, 2010: Ecological study. Salud UIS, 54. https://doi.org/10.18273/saluduis.54.e:22017

Abstract

Introduction: Breastfeeding decreases morbidity, mortality and promotes health in the mother and child. The lower morbidity in relative terms in breastfed versus non-breastfed infants reduces healthcare costs. In Colombia, the duration of breastfeeding is far from desirable times and continues to decline.

Objectives: The objectives were (a) to determine economic inequality based on monetary poverty at the ecological level in the duration of exclusive breastfeeding (EBF) and total breastfeeding (BF) and (b) to establish the social determinants of EBF and BF using the territory as a unit of analysis.

Method: An ecological study was conducted based on data collected regarding the median duration of exclusive breastfeeding and total breastfeeding. The information was provided by 9,389 mothers with children less than 36 months who responded to the National Survey of the Nutritional Situation of 2010 in Colombia. The data were summarized in 24 departments or geodemographic units that represent the Colombian territory (n=24). Fourteen variables representing the economic, social, human and structural development levels in the territory were related by linear regression to explain the duration of EBF and BF.

Results: EBF lasted 1.18 months (95% CI: 1.00 to 1.36), and BF lasted 14.79 months (95% CI: 13.50 to 16.08). Economic inequality was low, and the Gini coefficient was 0.35 for EBF and 0.10 for BF. The EBF duration is affected by the gender empowerment measure (GEM) (β=-1.94, p=0.006) and medical coverage (%) (β=-0.02, p=0.060). The BF duration is explained by the Monetary poverty (β=0.12, p=0.007) GEM (β=-9.94, p=0.033) and Female abuse rate x 100,000 (β=0.01, p=0.005).

Conclusions: The impact of social and human development is greater than the economic aspect as a determinant of EBF and BF duration in Colombia. Exclusive and total breastfeeding are phenomena explained differently. 

https://doi.org/10.18273/saluduis.54.e:22017
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References

Binns C, Lee M, Low WY. The long-term public health benefits of breastfeeding. Asia Pac J Public Health. 2016; 28(1): 7-14. doi: https://doi.org/10.1177/1010539515624964

Collazo CR, Hérnadez-Rodríguez Y, Andrade-Campoverde D. Breastfeeding, metabolic programming and its relationship with chronic diseases. Salu Uninorte. 2018; 34(1): 126-143. doi: http://dx.doi.org/10.14482/sun.34.1.8923

Colchero MA, Contreras-Loya D, Lopez-Gatell H, Gonzalez de Cosio T. The costs of inadequate breastfeeding of infants in Mexico. Am J Clin Nutr. 2015;101(3): 579-586. doi: https://doi.org/10.3945/ajcn.114.092775

Balogun OO, O’Sullivan EJ, McFadden A, Ota E, Gavine A, Garner CD, et al. Interventions for promoting the initiation of breastfeeding. Cochrane Database Syst Rev. 2016;11: CD001688. doi: https://doi.org/10.1002/14651858.CD001688.pub3

Smith LA, Geller NL, Kellams AL, Colson ER, Rybin DV, Heeren T, et al. Infant sleep location and breastfeeding practices in the United States, 2011–2014. Acad Pediatr. 2016; 16(6): 540-549. doi: https://doi.org/10.1016/j.acap.2016.01.021

Dunn RL, Kalich KA, Fedrizzi R, Phillips S. Barriers and contributors to breastfeeding in WIC mothers: A social ecological perspective. Breastfeed Med. 2015; 10(10): 493-501. doi: https://doi.org/10.1089/bfm.2015.0084

Ahluwalia IB, Morrow B, D’Angelo D, Li R. Maternity care practices and breastfeeding experiences of women in different racial and ethnic groups: Pregnancy risk assessment and monitoring system (PRAMS). Matern Child Health J. 2012; 16(8): 1672-1678. doi: https://doi.org/10.1007/s10995-011-0871-0

Bueno-Gutierrez D, Chantry C. Life does not make it easy to breast-feed: Using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico. Breastfeed Med. 2015; 10(2): 124-131. doi: https://doi.org/10.1089/bfm.2014.0109

Bai DL, Fong DYT, Tarrant M. Factors associated with breastfeeding duration and exclusivity in mothers returning to paid employment postpartum. Matern Child Health J. 2015; 19(5): 990-999. doi: https://doi.org/10.1007/s10995-014-1596-7

Amir LH, Donath SM. Socioeconomic status and rates of breastfeeding in Australia: Evidence from three recent national health surveys. Med J Aust. 2008; 189(5): 254-256.

Diez-Roux AV. Investigating neighborhood and area effects on health. Am J Public Health. 2001; 91(11): 1783–1789.

Wiese D, Stroup AM, Maiti A, Harris G, Lynch SM, Vucetic V et al. Measuring Neighborhood Landscapes: Associations between a neighborhood’s landscape characteristics and colon cancer survival. Int J Environ Res Public Health. 2021; 18(9): 4728. doi: https://doi.org/10.3390/ijerph18094728

Herrán OF, Patiño GA, DelCastillo SE. Desigualdad y nutrición: Encuesta de la situación nutricional en Colombia, 2010. Rev Bras Saude Mater Infant. 2015; 15(4): 401-412. doi: https://doi.org/10.1590/S1519-38292015000400004

Ministerio de la Protección Social., Instituto Colombiano de Bienestar Familiar, & Instituto Nacional de Salud. Encuesta nacional de la situación nutricional en Colombia 2010. Ensin, 2011; 1–512. https://www.icbf.gov.co/bienestar/nutricion/encuesta-nacional-situacion-nutricional

Instituto de Medicina Legal y Ciencias Forences. Obsertorio de Violencia Contra la Mujer, Colombia. https://www.medicinalegal.gov.co/observatorio-deviolencia-contra-la-mujer

Sierra-Gómez CT. Violencia contra la mujer en Colombia: Reflexiones sobre los mecanismos para su protección. https://repository.ucatolica.edu.co/bitstream/10983/20582/1/Articulo%20Tatiana%20Sierra%20PDF.pdf

Martin-de-Las-Heras S, Velasco C, Luna-Del-Castillo JD, Khan KS. Breastfeeding avoidance following psychological intimate partner violence during pregnancy: a cohort study and multivariate analysis. BJOG. 2019; 126(6): 778-783. doi: https://doi.org/10.1111/1471-0528.15592

DANE (Departamento Administrativo Nacional de Estadística). Pobreza y desigualdad – 2011. 2011; https://www.dane.gov.co/index.php/estadisticaspor-tema/pobreza-y-condiciones-de-vida/pobreza-y-desigualdad/pobreza-y-desigualdad-2011#pobreza-monetaria-por-departamentos-2011

Morgenstern H. Ecologic studies in epidemiology: Concepts, principles, and methods. Annu Rev Public Health. 1995; 16: 61-61. https://www.annualreviews.org/doi/pdf/10.1146/annurev.pu.16.050195.000425

DANE (Departamento Administrativo Nacional de Estadística). Proyecciones de población, Colombia 2005-2020. 2005; https://www.dane.gov.co/index.php/estadisticas-por-tema/demografia-y-poblacion/proyecciones-de-poblacion

DANE (Departamento Administrativo Nacional de Estadística). Nacimientos 2010. Colombia, 2010; https://www.dane.gov.co/index.php/estadisticaspor-tema/salud/nacimientos-y-defunciones/nacimientos/nacimientos-2010

DANE (Departamento Administrativo Nacional de Estadística). Cifras departamentales de pobreza monetaria y desigualdad, 2012. https://www.dane.gov.co/index.php/estadisticas-por-tema/pobrezay-condiciones-de-vida/pobreza-y-desigualdad/pobreza-y-desigualdad-2012

Mancero X. Revisión de algunos indicadores para medir la desigualdad. In Sexto taller regional sobre indicadores sobre el desarrollo social. Buenos Aires: CEPAL, 2000. LC/R.2046 – 2000. pp. 375-386

DANE (Departamento Administrativo Nacional de Estadística). Cuentas departamentales - Colombia producto interno bruto (PIB) comportamiento 2000-2012. 2014; https://www.dane.gov.co/files/investigaciones/pib/departamentales/B_2005/Bol_dptal_2011def_2012pre.pdf

UNPD. Informe Nacional de Desarrollo Humano. Colombia rural razones para la esperanza, 2011. http://hdr.undp.org/sites/default/files/nhdr_colombia_2011_es_low.pdf

DANE (Departamento Administrativo Nacional de Estadística). Gran encuesta integrada de hogares -GEIH- históricos, 2011. https://www.dane.gov.co/index.php/estadisticas-por-tema/mercado-laboral/empleo-y-desempleo/geih-historicos

Lorena V, Bernal V, Mancera NL. Comportamiento de la violencia intrafamiliar, Colombia, 2012. Bogotá, DC: Instituto de Medicina Legal, Colombia.

Minsalud. Situación de salud en Colombia 2012. https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/VS/ED/PSP/Indicadoresbasicos-en-salud-2012.pdf

Consellería de Sanidade, Xunta de Galicia, España, Organización Panamericana de la Salud, Universidad CES. Epidat: Programa para análisis epidemiológico de datos, 2016. http://www.sergas.es/Saude-publica/EPIDAT

StataCorp. (2015). Stata statistical software: Release 14.1 College Station, TX: StataCorp LP.

Banco Mundial. https://datos.bancomundial.org/indicador/SI.POV.GINI?locations=CA

Asociación Española de Pediatría: Comité de Lactancia Materna. Lactancia materna en cifras: Tasa de inicio y duración de la lactancia materna en España y otros paises. Madrid, 2016. https://www.aeped.es/sites/default/files/documentos/201602-lactancia-materna-cifras.pdf

Huang R, Yang M. Paid maternity leave and breastfeeding practice before and after California’s implementation of the nation’s first paid family leave program. Eco Hum Biol. 2015;16: 45-59. doi: https://doi.org/10.1016/j.ehb.2013.12.009

Mirkovic KR, Perrine CG, Scanlon KS. Paid maternity leave and breastfeeding outcomes. Birth. 2016: 43(3): 233-239. doi: https://doi.org/10.1111/birt.12230

Madden S, Curtis B. The case for creating a model insurance policy: Payer coverage of breastfeeding counseling services, pumps, and supplies. Breastfeed Med. 2013; 8(5): 450-452. doi: https://doi.org/10.1089/bfm.2013.0078

Bettinelli ME. Breastfeeding policies and breastfeeding support programs in the mother’s workplace. J Matern Fetal Neonatal Med. 2012; 25(Sup4): 73-74. https://doi.org/10.3109/14767058.2012.715033

Moraes CL, de Oliveira ASD, Reichenheim ME, Lobato G. Severe physical violence between intimate partners during pregnancy: A risk factor for early cessation of exclusive breast-feeding. Public Health Nutr. 2011; 14(12): 2148-2155. doi: https://doi.org/10.1017/S1368980011000802

Sørbø MF, Lukasse M, Brantsæter A, Grimstad H. Past and recent abuse is associated with early cessation of breast feeding: Results from a large prospective cohort in Norway. BMJ Open. 2015;5(12): 9240. doi: https://doi.org/10.1136/bmjopen-2015-009240

Rose G. Estratégias da medicina preventiva. Porto Alegre: Artmed; 2010. 192 p.

Norman AH, Estratégias da medicina preventiva de Geoffrey Rose. Rev Bras Med Fam Comunidade. 2015; 10(34): 1-3. doi: https://doi.org/10.5712/rbmfc10(34)1092

Idrovo J. Three criteria for ecological falacy. Environ Health Perspect. 2011;119(8): a332. doi: https://doi.org/10.1289/ehp.1103768

Blanco-Becerra LC, Pinzón-Flórez CE, Idrovo AJ. Estudios ecológicos en salud ambiental: más allá de la epidemiología. Biomédica. 2015; 35(Supl.2): 191-206. doi: https://doi.org/10.7705/biomedica. v35i0.2819

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Copyright (c) 2022 Marcela Daza, Oscar Fernando Herrán, Sara E. Del Castillo

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