Regional prevalence and socioeconomic inequalities in infant care practices: evidence from 2018 Nigeria Demographic and Health Survey

Regional prevalence and socioeconomic inequalities in infant care practices: evidence from 2018 Nigeria Demographic and Health Survey | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Help Center Sign In Submit a Preprint Cite Share Download PDF Research Regional prevalence and socioeconomic inequalities in infant care practices: evidence from 2018 Nigeria Demographic and Health Survey Michael Ekholuenetale, Amit Arora, Amadou Barrow This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-44307/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background : The effects of breastfeeding practices on children’s health are undoubtedly of great interest worldwide. However, there is inequalities in the coverage of exclusive breastfeeding (EBF), early initiation of breastfeeding (EIBF) and mother and newborn skin-to-skin contact (SSC) in many resource-constrained settings. The aim of this study was to explore regional prevalence and examine the socioeconomic inequalities in EBF, EIBF and SSC in Nigeria. Methods : Data on 2,936 infants under six months old were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS) to determine EBF. In addition, data from 21,569 children were analyzed for EIBF and SSC. Concentration index (CI) and concentration curve were used to measure socioeconomic inequalities in EBF, EIBF and SSC. Results : The prevalence of EBF, EIBF and SSC were 31.8%, 44.2% and 12.1% respectively. Furthermore, Ogun State had the highest prevalence of EBF (71.4%); while Bayelsa State had the highest prevalence of SSC (67.8%) and EIBF (96.2%) respectively. Urban dwellers had higher prevalence of EBF, SSC and EIBF across household wealth quintile and by levels of mothers’ education in contrast to their rural counterparts. We quantified the degree of wealth-related and mothers education inequalities in EBF, SSC and EIBF. There were pro-rich EBF (CI = 0.118; p< 0.001), EIBF (CI = 0.103; p=0.002) and SSC (CI = 0.152; p< 0.001) respectively. Also, EBF (CI = 0.157; p< 0.001), EIBF (CI = 0.091; p< 0.001) and SSC (CI = 0.156; p< 0.001) were significantly more concentrated among mothers with higher educational attainment. The test for differences between urban versus rural was significant in EBF, SSC and EIBF by mothers educational attainment. But this was only significant in EIBF by household wealth respectively. Conclusion : Socioeconomic status determined breastfeeding practices and SSC in Nigeria. Breastfeeding practices interventions should target all mothers, especially those of low socioeconomic status and to ensure improvements in baby friendly initiatives. Health Policy Maternal & Fetal Medicine Pediatrics Breastfeeding complementary feeding neonatal mortality kangaroo care inequality Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Background Optimal breastfeeding practices have an age-long recognition for health benefits [1,2]. The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) for newborn within 1 hour after birth [3]. In addition, that infants be exclusively breastfed for the first six months of their life [4]. Exclusive breastfeeding (EBF) is defined as the practice where an infant receives only breast milk for the first six months, with no other liquids (not even water) or solid foods, except oral rehydration solutions, drops and syrups [3,5]. EIBF is also associated with mother and newborn skin-to-skin contact (SSC), which reduces the risk of hypothermia [6] and strengthens maternal bonding with children [7]. The findings from a previous educational intervention study, led to the development of a guideline that allowed EIBF and SSC be included in newborn care national policy [8]. In recent years, efforts have been made to improve infant and child feeding practices, including International Code of Marketing of Breast-milk Substitutes [9], Global Strategy for Infant and Young Child Feeding (IYCF) [3] and baby friendly hospital initiative (BFHI) [10]. In recent years, WHO provided a set of indicators to evaluate child feeding and determine the progress of breastfeeding advancement efforts. Since then, there has been major attention in infant and child feeding structure and in the knowledge about what comprises ideal breastfeeding practices [4]. WHO defined SSC as when the newborn is placed prone on the mother’s abdomen or chest in direct ventral-to-ventral SSC. Immediate SSC is done immediately after delivery, less than 10 minutes after birth. Early SSC is defined as beginning any time from delivery to 23 hours after birth and should be uninterrupted for at least 60 minutes [11]. SSC improves the newborn maintenance of blood glucose levels, temperature regulation and metabolic adaptation. At birth, the newborn has a reduced capacity to generate heat, resulting from a decline in temperature. It is against this backdrop that maintenance of temperature is required for newborn at delivery. During SSC, there is a transfer of heat from the mother to her child, wherewith the mother’s body temperature activates the child’s sensory nerves, which in turn results in the child’s relaxation, reduces the tone of the sympathetic nerves, dilation of skin vessels and increase in its temperature [12]. Approximately 37% of children under 6 months old are exclusively breastfed in resource-constrained settings; while an estimated 823 000 annual deaths in under 5 children occurs [13]. Sub-optimal breastfeeding has been reported to be responsible for 1.4 million childhood deaths with about 10% of total disease burden among under 5 children [14]. Optimal breastfeeding practices are crucial in improving the health of children, and associated with reduction in the risk of childhood morbidity and mortality [3,15]. EIBF can reduce neonatal mortality. Albeit, the prevalence of EIBF is only about 50% in many resource-constrained settings [16]. The guideline for breastfeeding practices include the initiation of breastfeeding for all newborns within the first hour of life, while EBF is practiced for infants less than 6 months [4,17]. Interestingly, SSC between mother and newborn plays a mediating role in EIBF [6]. High prevalence of hypothermia is recorded in settings with large number of newborn death, where hypothermia has become an issue of major concern to improve newborn survival [18]. In addition, thermal care is crucial as newborns are commonly susceptible to hypothermia without prejudice to tropical climates. Newborns have thin skin, a large body surface area, little insulating fat and easily overwhelmed thermoregulatory mechanisms [19]. In the absence of thermal protection, newborns are unable to maintain body temperature, while preterm babies become most-at-risk of the adverse effects [20]. Several estimates of hypothermia in African settings are limited to hospital studies and ranged between 44- 85 % [21]. Besides the benefits to the newborn, SSC has been linked with many benefits for mothers. For instance, secretion of oxytocin in mothers who receive SSC strengthens uterine contractions, which in turn aids the placenta to separate and the duration of the third stage of labour is shortened [22]. As a simple and cost-effective mechanism, mother and newborn SSC is recommended to improve post-delivery care and potentially save the lives of newborns and mothers [23]. Though WHO recommends SSC, separation of mothers and newborns exists in many health facilities where newborns are often placed under warmers or in cots [24]. Evidence-based studies have reported that EBF and EIBF are associated with large gains and improve childhood survival, as well as support the recommendations to start breastfeeding immediately after childbirth [25,26]. In spite of the numerous advantages identified regarding optimal breastfeeding practices [27], the rates of EBF and EIBF in several resource-constrained settings remains worrisome. There are staggering reports of EBF uptake in Nigeria, as only a coverage of 16.4% was reported in a previous study [5], while another study reported EBF prevalence of 14% and EIBF prevalence of 38% [28], also the prevalence of newborns who were breastfed within 1 hour of birth was 34.7 % [29]. Moreover, only 10% of newborns in Nigeria received SSC [30]. These reports are worrisome and a major call to improve infants health care. Breastfeeding practices and SSC benefit newborns in many ways, by providing warmth and nutrients to facilitate growth and enhance the immunity of babies [6,31]. Understanding the patterns of breastfeeding practices is essential to prioritize filling the knowledge gaps for childhood survival [32]. Nonetheless, there is disparities in the coverage of infant care practices across geographical regions, household wealth status and parental educational levels. Studies have reported that women with higher family incomes, those who had higher education levels or whose partners had higher education or executive occupations were more likely to have optimal breastfeeding practices than their counterparts [28,33,34]. Women with no formal education or low household wealth index have worsening breastfeeding indicators, when compared to women with primary and secondary or higher education [35,36]. Similarly, a previous study revealed disparities in EIBF across geographical regions in Nigeria, as North-Central region had the highest EIBF rates [37]. To the best of our knowledge, there is no study in Nigeria that has examined regional prevalence or wealth-related and education inequalities in EBF, EIBF and SSC using socioeconomic analytical tools. In light of the above, we examine regional prevalence and socioeconomic inequalities in breastfeeding practices and SSC in Nigeria. Methods Data source We analyzed a cross-sectional nationally representative data extracted from Nigeria Demographic and Health Survey (NDHS) 2018. MEASURE DHS provided technical input in the process of data collection and supported by the National Population Commission (NPC) [38]. Data on 2,936 children under six months old was extracted for analysis. In addition, data on 21,569 children was analyzed for EIBF and SSC. NDHS is a vital source of data on EBF, EIBF and SSC especially as it consists of a nationally representative sample of households. Demographic and Health Survey (DHS) data was collected through a stratified multistage cluster sampling technique. The procedure for stratification approach divides the population into groups by geographical region and commonly crossed by place of residence - urban-rural. A multi-level stratification approach is used to divide the population into first-level strata and to subdivide the first-level strata into second-level strata, and so on. A two-level stratification in DHS is region and urban/rural stratification. DHS data is available in the public domain and accessed at; http://dhsprogram.com/data/available-datasets.cfm . The details of DHS data has been report in a previous study [39]. Response rate NDHS 2018 selected a total of 41,668 households for the sample, of which 40,666 were occupied. Of the occupied households, 40,427 were successfully interviewed, yielding a response rate of 99%. In the households interviewed, 42,121 women age 15-49 were identified for individual interviews; interviews were completed with 41,821 women, yielding a response rate of 99% [40]. Selection and measurement of variables Outcome a) Early initiation of breastfeeding: This is a measure of children who were put to breast within 1 hour of delivery. b) Exclusive breastfeeding: This is a measure of infants less than 6 months of age who were fed exclusively with breastmilk. This indicator was based on the diets of infants younger than 6 months during the 24 hour before the survey. c) Skin-to-skin contact was measured dichotomously; “Was child put on mother's chest and bare skin after birth” yes versus no Explanatory factors Women’s educational attainment was measured as; no formal education, primary, secondary and higher. Household wealth quintile was computed by DHS using principal components analysis (PCA) to assign the wealth indicator weights. In their computation, they assigned scores and standardized the wealth indicator variable using household assets including; wall, floor, roof and wall type; whether a household had improved versus unimproved sanitation amenities and water source; whether a household had essential assets such as electricity, radio, television, cooking fuel, refrigerator, furniture amongst others. Furthermore, the factor loadings and z-scores were calculated. For each household, they multiplied the indicator values by the factor loadings and summed to produce the household’s wealth index value. The standardized z-score was disentangled to classify the overall scores to wealth quintiles; poorest, poorer, middle, richer and richest [41]. Household wealth quintiles and mothers’ educational attainment were used as measures of socioeconomic status similar to previous studies [42–44]. Residential status was classified as urban versus rural. Geographical region and states were measured thus; North Central: Benue, Federal Capital Territory, Kogi, Kwara, Nasarawa, Niger, Plateau; North East: Adamawa, Bauchi, Borno, Gombe, Taraba, Yobe; North West: Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto,Zamfara; South East: Abia, Anambra, Ebonyi, Enugu, Imo South South: Akwa-Ibom, Bayelsa, Cross River, Edo, Delta, Rivers; South West: Ekiti, Lagos , Ogun, Ondo, Osun, Oyo. Ethical consideration This study was based on an analysis of population-based data that exist in public domain and available online with all identifier information removed. The authors were granted access to use the data by MEASURE DHS/ICF International. DHS Program is consistent with the standards for ensuring the protection of respondents’ privacy. ICF International ensures that the survey complies with the U.S. Department of Health and Human Services regulations for the respect of human subjects. The DHS project sought and obtained the required ethical approval from the National Health Research Ethics Committee (NHREC) in Nigeria before the surveys were conducted. No further approval was required for this study. More details about data and ethical standards are available at http://goo.gl/ny8T6X . Statistical analysis Stata survey module (‘svy’) was used with adjustment for the sample design. Percentage and Chi-square test were used for summary statistics and bivariate analysis respectively. To determine socioeconomic inequalities in EBF, EIBF and SSC, we used concentration index and present it graphically with the concentration curve. When the concentration index value is positive or the curve lies below the diagonal line (line of equality), it indicates that EBF, EIBF and SSC coverage is greater among high socioeconomic groups. Conversely, when concentration index value is negative or the curve is above the line of equality, it indicates that EBF, EIBF and SSC coverage is higher among low socioeconomic groups. The concentration index was used to decipher socioeconomic inequalities using Erreygers adjustment in line with previous studies [45,46]. Statistical significance was determined at p < 0.05. Stata Version 14 (StataCorp., College Station, TX, USA) was used for data analysis. Results In Figure 1 we presented the prevalence of EBF (31.8%), EIBF (44.2%) and SSC (12.1%) respectively. The results from Table 1 showed that Benue (65.3%), Ondo and Osun (66.7%), Ekiti (69.6%), and Ogun (71.4%) had the leading prevalence of EBF respectively. Furthermore, Oyo (45.4%) and Bayelsa (67.8%) reported the highest prevalence of SSC in Nigeria. In addition, Niger (74.9%), Kogi (78.4%), Ogun (78.6%) and Bayelsa (96.2%) reported the highest prevalence of EIBF respectively. Similar differences were obtained across geographical zones. Table 1. Summary statistics from 36 States + Federal Capital Territory on exclusive breastfeeding, early initiation of breastfeeding and skin-to-skin contact between mother and newborn; NDHS, 2018 State Exclusive breastfeeding Skin-to-skin contact Early initiation of breastfeeding n % n % n % North Central Benue 72 65.3 599 20.2 591 64.3 Federal Capital Territory 71 46.5 519 6.7 529 64.7 Kogi 53 18.9 411 8.0 402 78.4 Kwara 54 51.9 466 5.2 456 61.6 Nasarawa 72 48.6 537 13.0 527 23.5 Niger 120 12.5 786 3.7 754 74.9 Plateau 63 46.0 521 1.7 515 52.4 Total estimate 505 39.0 3839 8.4 3774 60.3 P <0.001* <0.001* <0.001* North East Adamawa 86 16.3 620 32.7 606 20.3 Bauchi 129 24.8 893 15.1 882 14.0 Borno 67 7.5 670 6.4 663 51.3 Gombe 124 30.7 816 22.9 798 20.7 Taraba 104 30.8 709 2.5 698 11.6 Yobe 101 40.6 766 9.1 734 51.8 Total estimate 611 26.5 4474 14.7 4381 27.7 P <0.001* <0.001* <0.001* North West Jigawa 118 9.3 901 37.6 879 11.3 Kaduna 147 19.7 895 6.4 866 34.5 Kano 168 12.5 1247 8.2 1210 40.4 Katsina 146 25.3 929 17.1 914 39.9 Kebbi 96 14.6 824 5.5 794 28.2 Sokoto 104 20.2 703 0.4 672 14.3 Zamfara 128 39.8 804 2.5 790 52.9 Total estimate 907 20.3 6303 11.5 6125 32.5 P <0.001* <0.001* <0.001* South East Abia 55 21.8 386 6.5 387 47.8 Anambra 93 34.4 536 9.0 537 39.3 Ebonyi 93 47.3 609 7.6 603 Enugu 49 24.5 360 2.2 349 47.0 Imo 52 15.4 438 2.7 422 47.4 Total estimate 342 31.6 2329 6.0 2298 43.4 P <0.001* <0.001* <0.001* South South Akwa-Ibom 49 30.6 377 13.8 365 57.3 Bayelsa 45 35.6 373 67.8 366 96.2 Cross River 36 41.7 307 11.7 301 65.1 Edo 45 37.8 306 7.5 297 63.0 Delta 40 25.0 328 8.5 335 44.8 Rivers 48 33.3 423 9.5 435 52.6 Total estimate 263 33.8 2114 20.4 2099 63.0 P <0.001* <0.001* <0.001* South West Ekiti 46 69.6 353 8.8 345 52.2 Lagos 59 59.3 555 8.7 577 57.7 Ogun 42 71.4 364 0.8 359 78.6 Ondo 54 66.7 400 7.3 391 48.1 Osun 39 66.7 371 5.7 366 64.5 Oyo 68 51.5 467 45.4 453 73.3 Total estimate 308 63.0 2510 13.7 2491 62.3 P <0.001* <0.001* <0.001* *Significant at P <0.05; P value was obtained using Chi-square test In Table 2, we presented the percentages of EBF, SSC and EIBF across household wealth quintile and mother’s education. Based on the results, urban dwellers had higher EBF, SSC and EIBF across household wealth quintile and levels of mother’s education, in contrast to their rural counterparts. The concentration index quantified the degree of wealth-related and mother’s education inequalities in EBF, SSC and EIBF. Overall, the study outcomes were significantly more in higher household wealth, in contrast to the lower household wealth groups; EBF (CI = 0.118; p< 0.001), SSC (CI = 0.152; p< 0.001) and EIBF (CI = 0.103; p=0.002) respectively. Furthermore, EBF was significantly more from mothers with higher educational attainment, compared with children from mothers with lower educational attainment (CI = 0.157; p< 0.001), SSC (CI = 0.156; p< 0.001) and EIBF (CI = 0.091; p< 0.001). The test for differences between children from urban versus rural was significant in EBF, SSC and EIBF for maternal educational attainment. But this was only significant for EIBF for household wealth quintile. Table 2. Prevalence and concentration index of exclusive breastfeeding, early initiation of breastfeeding and skin-to-skin contact between mother and newborn in Nigeria Exclusive breastfeeding Skin-to-skin contact Early initiation of breastfeeding Urban Rural Total Urban Rural Total Urban Rural Total Household wealth quintile Poorest (%) 51.1 24.8 26.6 5.2 8.1 7.9 46.7 31.5 32.8 Poorer (%) 28.0 23.7 24.3 9.4 10.7 10.5 45.0 38.2 39.2 Middle (%) 37.4 26.8 30.7 12.5 12.5 12.5 46.5 48.8 47.9 Richer (%) 37.6 41.7 39.3 15.4 13.4 14.6 49.7 53.5 51.2 Richest (%) 47.9 34.8 45.0 18.0 17.4 17.9 55.5 55.0 55.4 Overall (%) 40.4 27.4 31.8 14.5 10.8 12.1 50.3 40.8 44.2 Concentration index 0.061 0.083 0.118 0.125 0.121 0.152 0.042 0.114 0.103 Standard error 0.021 0.021 0.015 0.015 0.013 0.010 0.006 0.006 0.004 P -value α 0.004* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* Rural-urban comparison z-stat 0.73 -0.18 8.55 Difference in concentration index values 0.022 -0.004 0.073 P -value β 0.464 0.855 <0.001* Mother’s education No formal education (%) 30.7 21.3 22.9 11.6 8.2 8.8 43.7 34.3 35.9 Primary (%) 32.0 27.0 28.6 12.3 11.4 11.8 50.2 44.5 46.5 Secondary (%) 45.8 37.2 41.5 14.2 15.6 14.9 51.7 51.7 51.7 Higher (%) 45.8 52.5 48.1 21.7 17.1 20.4 54.9 51.8 54.0 Overall (%) 40.4 27.4 31.8 14.5 10.8 12.1 50.3 40.8 44.2 Concentration index 0.086 0.149 0.157 0.109 0.157 0.156 0.037 0.097 0.091 Standard error 0.021 0.019 0.014 0.015 0.012 0.010 0.006 0.005 0.004 P -value α <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* <0.001* Rural-urban comparison z-stat 2.26 2.46 7.43 Difference in concentration index values 0.063 0.048 0.060 P -value β 0.033* 0.014* <0.001* *Significant at p<0.05; SE standard error; P -value α and P -value β were obtained using Concentration Index for overall inequalities across socioeconomic groups and measuring rural versus urban differences, respectively Figure 2-4 showed the household wealth related inequalities for EBF, SSC and EIBF. The more the curves sags away from the line of equality, the greater the degree of inequality. The inequalities in household wealth level was more among EBF, SSC and EIBF rural children, as the areas between the curve and the line of inequality was maximal. This is consistent with the results obtained in the concentration index model. Figure 5-7 showed mother’s educational attainment inequalities for EBF, SSC and EIBF. The farther the curves draws away from the line of equality, the higher the degree of inequality. The inequalities in mother’s educational attainment varied among children by breastfeeding practices and SSC, as the areas between the curve and the line of inequality was maximal. This clearly showed EBF, SSC and EIBF were higher among those with improved educational attainment. Discussion The findings from this study bring to limelight the practices to reduce high newborn or infant mortality, such as EBF, EIBF and SSC which are still under-utilized and remained a worrisome issue in Nigeria. Despite the known benefits of EBF, the findings of this study showed that only about one-third of women (31.8%) and less than half of them (44.2%) practiced EBF and EIBF respectively. However, these showed some improvement over results of previous studies. For example, using 2003 data, an average EBF of about 16.4% was reported in Nigeria [5], but in another study using 2008 data, EBF was 14% and EIBF was about 38.0% [28]. In the results from 2013 data, the proportion of infants who initiated breastfeeding early was 34.7 % [29]. These levels including the findings of this study are far less than the program target of 90% of women to exclusively breastfeed their infants in the first 6 months of life, a practice that is associated with 10% reduction of under 5 deaths [47]. The low coverage among educated women may be attributed to current economic challenges in Nigeria, where mothers may be forced to return to full time work very quickly after childbirth which can result to sub-optimal breastfeeding practices [48]. The impact of SSC in providing an appropriate and affordable yet high quality alternative to technology is well known. Moreover, it can easily be implemented, even in primary health care centres in many resource-constrained settings and has the potential to save newborns’ and mothers’ lives amongst other benefits [6]. Unfortunately, only approximately one-tenth of women (12.1%) reportedly practiced it in Nigeria as found in this study. This finding is similar to a previous report of 10% SSC coverage in Nigeria [30]. In the Gambia, 35.7% national prevalence of SSC was reported [49]. In Tanzania, SSC was rarely practiced (less than 1%) [50]. In Uganda and Mali, only 2% of mother and newborn SSC was reported respectively [51,52]. In Ethiopia, approximately 9% and 13% immediate mother and newborn SSC after delivery were reported [53,54]. In Ghana, the coverage of mother and newborn SSC was only about 10% [55]. These results showed that SSC coverage in sub-Saharan Africa countries is very low. In a previous study in various African sites including Nigeria, on the beliefs and practices related to neonatal thermal care, a lack of opportunities for SSC, beliefs that the vernix caseosa was related to poor maternal behaviours to practice SSC were reported as major barriers. Based on the findings, early bathing of newborn was a very common practice especially in Nigerian sites due to a deep-rooted belief that delay to bath the newborn would result in body odour. Worst still, when asked about keeping the baby warm, respondents across study sites rarely mentioned the recommended thermal care practices (SSC), suggesting that these were not perceived as salient [56]. Such norms can clearly be responsible for poor coverage of SSC in the general population. Clearly, higher socioeconomic status would help to improve EBF, EIBF and SSC by way of enhancing accessibility to health information which could positively influence health care seeking behaviour [57]. In this study, we found that women who had formal education or high household wealth level had higher utilization of EBF, EIBF and SSC. The findings are similar to the report of a previous study which found maternal education to significantly improve SSC and EIBF [8,35,36]. A simple and cost effective educational intervention achieved the inclusion of SSC and EIBF as part of standard care due to the observed significant impact in maternal health care continuum [8]. Mothers from socioeconomically privileged class would have higher coverage of EBF in contrast to their counterparts in lower socioeconomic class. This is in line with a previous study which found a connection between household wealth, maternal education and infant breastfeeding, as only about one-tenth of mothers who practiced EBF came from poor households and without formal education, in contrast to their well-off and educated counterparts with over one-quarter coverage of EBF [5,31,58–60]. Therefore, our evidence of a positive association between maternal education and improvement in EBF is well founded. Women of higher socioeconomic status would find better access or act more positively to health promotion messages due to the availability of resources. The improvement in breastfeeding practices among educated mothers, indicates the substantial impact of mother’s education on infant well-being, health and development. This is consistent with the findings from previous studies whereby elementary education became the basic threshold needed to gain health information, as well as provided women, specifically the disadvantaged, with self-confidence and the autonomy required to act appropriately. Conversely, women with no formal education are known to have poor knowledge and attitude about proper breastfeeding practices. In spite of the role of education in child welfare, frequent contacts with a health care provider would enhance information about proper breastfeeding practices [61]. Therefore, stakeholders in public health are oblige to design interventions or policies to aid mothers of low socioeconomic class for example, those with poor or no formal educational background to access health facility for information (for example, during antenatal visit) to improve proper breastfeeding practices in Nigeria. Strength And Limitation We used large sample data to reach plausible conclusions on infant breastfeeding practices and SSC. Furthermore, this study has become the foremost to examine socioeconomic inequalities in EBF, EIBF and SSC using vital socioeconomic tools. The results from this study fill the knowledge gap for socioeconomic inequalities in EBF, EIBF and SSC. Nonetheless, there is potential recall bias that could lead to overestimation or underestimation of the outcome variables. Conclusion There was low coverage of EBF, EIBF and SSC in Nigeria. Moreover, these practices were influenced by mother’s educational attainment and their household wealth quintiles. Notably, educated women and the well-off had better coverage of EBF, EIBF and SSC. Based on these findings, we suggest that postnatal care interventions immediately after childbirth, such as SSC and EIBF as well as EBF should be taught and encouraged by health care professionals especially during antenatal care contacts, at delivery and postpartum stay period. Lack of formal education and poverty would increase the chance of home delivery, which could result in women missing out in skilled maternal and child health care practices. Therefore, women without formal education, the underprivileged as well as those from hard-to-reach communities should be well considered during health care programme design, planning and implementation. Providing the opportunity for community involvement in baby friendly initiatives would lead to higher coverage in skilled care practices, given the large number of Nigerian women who opt for home deliveries and traditional care due to poverty or ignorance and would rarely visit health facilities for counseling on proper child ware fare. Abbreviations BFHI: Baby Friendly Hospital Initiative; CI: Concentration Index; EBF: Exclusive Breastfeeding; EIBF: Early Initiation of Breastfeeding; ICF: Inner City Fund; IYCF: Infant and Young Child Feeding; NDHS: Nigeria Demographic and Health Survey; NHREC: National Health Research Ethics Committee; NPC: National Population Commission; PCA: Principal Components Analysis; SE: Standard Error; SSC: mother and newborn skin-to-skin contact; WHO: World Health Organization. Declarations Ethics approval and consent to participate This study is a secondary data analysis of the NDHS, which is publicly available, approval was sought from MEASURE DHS/ICF International and permission was granted for this use. The original DHS data were collected in conformity with international and national ethical guidelines. Written consent was obtained from mothers/caregivers and data were recorded anonymously at the time of data collection during the NDHS 2018. More details regarding DHS data and ethical standards are available at: http://dhsprogram.com/data/available-datasets.cfm Consent for publication Not applicable Availability of data and materials Data for this study were sourced from Demographic and Health surveys (DHS) and available here: http://dhsprogram.com/data/available-datasets.cfm . Competing interests The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Funding information This research received no grant from any funding agency in the public, commercial or not-for-profit sectors. Author contributions ME and AA contributed to the conceptualisation and manuscript preparation, the study design, review of literature and wrote the results. ME, AA and AB conducted data analysis, discussed the findings and critically reviewed the manuscript for its intellectual content. All authors read and approved the final manuscript. Acknowledgements The authors appreciate the MEASURE DHS project for the approval and access to the original data. References World Health Organization. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. 2009. Available: http://www.ncbi.nlm.nih.gov/books/NBK148965/ Belfort MB, Rifas-Shiman SL, Kleinman KP, Guthrie LB, Bellinger DC, Taveras EM, et al. Infant feeding and childhood cognition at ages 3 and 7 years: effects of breastfeeding duration and exclusivity. JAMA Pediatr. 2013;167: 836–844. doi:10.1001/jamapediatrics.2013.455 World Health Organization. Global Strategy for Infant and Young Child Feeding; World Health Organization: Geneva, Switzerland, 2003; Available online: https://apps.who.int/iris/bitstream/handle/10665/42590/ 9241562218.pdf?sequence=1 (Accessed: 9 January 2021). World Health Organization (WHO). 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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. doi:10.1186/s12889-015-1595-7 Berde AS, Yalcin SS. Determinants of early initiation of breastfeeding in Nigeria: a population-based study using the 2013 demograhic and health survey data. BMC Pregnancy Childbirth. 2016;16: 32. doi:10.1186/s12884-016-0818-y Singh K, Khan SM, Carvajal–Aguirre L, Brodish P, Amouzou A, Moran A. The importance of skin–to–skin contact for early initiation of breastfeeding in Nigeria and Bangladesh. J Glob Health. 2017;7. doi:10.7189/jogh.07.020505 Bui QT-T, Lee H-Y, Le AT-K, Van Dung D, Vu LT-H. Trends and determinants for early initiation of and exclusive breastfeeding under six months in Vietnam: results from the Multiple Indicator Cluster Surveys, 2000–2011. Glob Health Action. 2016;9. doi:10.3402/gha.v9.29433 Debes AK, Kohli A, Walker N, Edmond K, Mullany LC. Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review. BMC Public Health. 2013;13: S19. doi:10.1186/1471-2458-13-S3-S19 Heck KE, Braveman P, Cubbin C, Chávez GF, Kiely JL. Socioeconomic Status and Breastfeeding Initiation Among California Mothers. Public Health Rep. 2006;121: 51–59. Wu W, Wu JC-L, Chiang T. Variation in the association between socioeconomic status and breastfeeding practices by immigration status in Taiwan: a population based birth cohort study. BMC Pregnancy Childbirth. 2015;15: 298. doi:10.1186/s12884-015-0732-8 Neves PAR, Barros AJD, Gatica-Domínguez G, Vaz JS, Baker P, Lutter CK. Maternal education and equity in breastfeeding: trends and patterns in 81 low- and middle-income countries between 2000 and 2019. Int J Equity Health. 2021;20: 20. doi:10.1186/s12939-020-01357-3 Ogbo FA, Page A, Agho KE, Claudio F. Determinants of trends in breast-feeding indicators in Nigeria, 1999–2013. Public Health Nutr. 2015;18: 3287–3299. doi:10.1017/S136898001500052X Adewuyi EO, Zhao Y, Khanal V, Auta A, Bulndi LB. Rural-urban differences on the rates and factors associated with early initiation of breastfeeding in Nigeria: further analysis of the Nigeria demographic and health survey, 2013. Int Breastfeed J. 2017;12: 51. doi:10.1186/s13006-017-0141-x NPC/Nigeria. Report of Nigeria’s National Population Commission on the 2006 Census. Popul Dev Rev. 2007;33: 206–210. Corsi DJ, Neuman M, Finlay JE, Subramanian S. Demographic and health surveys: a profile. Int J Epidemiol. 2012;41: 1602–1613. doi:10.1093/ije/dys184 National Population Commission (NPC) [Nigeria] and ICF. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF. Available: https://www.dhsprogram.com/pubs/pdf/FR359/FR359.pdf Rutstein SO, Staveteig S. Making the Demographic and Health Surveys Wealth Index Comparable. 2014; DHS Methodological Reports No. 9. Rockville, Maryland, USA: ICF International. Szklarska A, Jankowska EA. Independent effects of social position and parity on body mass index among Polish adult women. J Biosoc Sci. 2003;35: 575–583. Walters S, Suhrcke M. Socioeconomic inequalities in health and health care access in central and eastern Europe and the CIS. 2005; 50. Bado AR, Sathiya Susuman A. Women’s Education and Health Inequalities in Under-Five Mortality in Selected Sub-Saharan African Countries, 1990–2015. Carpenter DO, editor. PLOS ONE. 2016;11: e0159186. doi:10.1371/journal.pone.0159186 Uthman OA. Using extended concentration and achievement indices to study socioeconomic inequality in chronic childhood malnutrition: the case of Nigeria. Int J Equity Health. 2009;8: 22. doi:10.1186/1475-9276-8-22 Erreygers G. Correcting the Concentration Index. J Health Econ. 2009;28: 504–515. doi:10.1016/j.jhealeco.2008.02.003 Jones et al. How many child deaths can we prevent this year? - The Lancet. 2003 [cited 5 Mar 2020]. Available: https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(03)13811-1.pdf Salami L. Factors influencing breastfeeding practices in Edo state, Nigeria. Afr J Food Agric Nutr Dev. 2011;6. doi:10.4314/ajfand.v6i2.71755 Ekholuenetale M, Onikan A, Ekholuenetale CE. Prevalence and determinants of mother and newborn skin-to-skin contact in The Gambia: a secondary data analysis. J Egypt Public Health Assoc. 2020;95: 18. doi:10.1186/s42506-020-00050-1 Penfold S, Hill Z, Mrisho M, Manzi F, Tanner M, Mshinda H, et al. A Large Cross-Sectional Community-Based Study of Newborn Care Practices in Southern Tanzania. PLoS ONE. 2010;5. doi:10.1371/journal.pone.0015593 Waiswa P, Peterson S, Tomson G, Pariyo GW. Poor newborn care practices - a population based survey in eastern Uganda. BMC Pregnancy Childbirth. 2010;10: 9. doi:10.1186/1471-2393-10-9 Save the Children. Newborn Care in Mali: Results of a Baseline Survey. 2008; 6. Callaghan‐Koru JA, Estifanos AS, Sheferaw ED, Graft‐Johnson J de, Rosado C, Patton‐Molitors R, et al. Practice of skin‐to‐skin contact, exclusive breastfeeding and other newborn care interventions in Ethiopia following promotion by facility and community health workers: results from a prospective outcome evaluation. Acta Paediatr. 2016;105: e568–e576. doi:10.1111/apa.13597 Callaghan-Koru JA, Seifu A, Tholandi M, de Graft-Johnson J, Daniel E, Rawlins B, et al. Newborn care practices at home and in health facilities in 4 regions of Ethiopia. BMC Pediatr. 2013;13: 198. doi:10.1186/1471-2431-13-198 Hill Z, Tawiah‐Agyemang C, Manu A, Okyere E, Kirkwood BR. Keeping newborns warm: beliefs, practices and potential for behaviour change in rural Ghana. Trop Med Int Health. 2010;15: 1118–1124. doi:10.1111/j.1365-3156.2010.02593.x Adejuyigbe EA, Bee MH, Amare Y, Omotara BA, Iganus RB, Manzi F, et al. “Why not bathe the baby today?”: A qualitative study of thermal care beliefs and practices in four African sites. BMC Pediatr. 2015;15: 156. doi:10.1186/s12887-015-0470-0 Dutta MJ. Health information processing from television: the role of health orientation. Health Commun. 2007;21: 1–9. doi:10.1080/10410230701283256 Woldeamanuel BT. Trends and factors associated to early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: evidence from the Ethiopia Demographic and Health Survey 2016. Int Breastfeed J. 2020;15: 3. doi:10.1186/s13006-019-0248-3 Rahman MdA, Khan MdN, Akter S, Rahman A, Alam MdM, Khan MdA, et al. Determinants of exclusive breastfeeding practice in Bangladesh: Evidence from nationally representative survey data. Joe W, editor. PLOS ONE. 2020;15: e0236080. doi:10.1371/journal.pone.0236080 Mgongo M, Mosha MV, Uriyo JG, Msuya SE, Stray-Pedersen B. Prevalence and predictors of exclusive breastfeeding among women in Kilimanjaro region, Northern Tanzania: a population based cross-sectional study. Int Breastfeed J. 2013;8: 12. doi:10.1186/1746-4358-8-12 Ukegbu AU, Ukegbu PO, Onyeonoro UU, Ubajaka CF. Determinants of breastfeeding patterns among mothers in Anambra State, Nigeria. South Afr J Child Health. 2011;5: 112–116. Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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11:33:21","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.3.rs-44307/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-44307/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":5247528,"identity":"31aa33db-ea54-4725-9596-a0120c2c8fe8","added_by":"auto","created_at":"2021-01-25 22:04:44","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":11120,"visible":true,"origin":"","legend":"Prevalence of EBF, SSC and EIBF in Nigeria","description":"","filename":"Fig1.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/7bc0fa87e43b94d797dbe776.png"},{"id":5247522,"identity":"f43bd72e-864d-4453-964f-76d633faa576","added_by":"auto","created_at":"2021-01-25 22:04:41","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19742,"visible":true,"origin":"","legend":"a) Urban-rural difference for exclusive breastfeeding by household wealth level\nb) Exclusive breastfeeding by household wealth level","description":"","filename":"Fig2.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/3ff951d667fa400b714f667f.png"},{"id":5244010,"identity":"53b55fcf-1872-4957-af9f-03c097128de1","added_by":"auto","created_at":"2021-01-25 21:57:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":18522,"visible":true,"origin":"","legend":"a) Urban-rural difference for skin-to-skin contact by household wealth level\nb) Skin-to-skin contact by household wealth level","description":"","filename":"Fig3.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/42963389939dda5b604d5532.png"},{"id":5248271,"identity":"f006da0c-f54c-4482-8496-dd4a68d939ea","added_by":"auto","created_at":"2021-01-25 22:06:26","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":48022,"visible":true,"origin":"","legend":"a) Urban-rural difference for early initiation of breastfeeding by household wealth level\nb) Early initiation of breastfeeding by household wealth level","description":"","filename":"Fig4.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/8a0f24aae6df47c8fb11d5d5.png"},{"id":5246992,"identity":"7cd846b7-8176-496e-a30c-a59235ee85f2","added_by":"auto","created_at":"2021-01-25 22:03:29","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":15844,"visible":true,"origin":"","legend":"a) Urban-rural difference for exclusive breastfeeding by educational level\nb) Exclusive breastfeeding by educational level","description":"","filename":"Fig5.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/c6f17a5574cb4284f7d07e6e.png"},{"id":5246397,"identity":"3dbe72df-9e07-4c0e-a020-9397cb763ba1","added_by":"auto","created_at":"2021-01-25 22:02:08","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":15385,"visible":true,"origin":"","legend":"a) Urban-rural difference for skin-to-skin contact by educational level\nb) Skin-to-skin contact by educational level","description":"","filename":"Fig6.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/a43c012bf8a3c419c9d03102.png"},{"id":5246475,"identity":"8f23973a-0142-4f47-91c2-5dce71adaad9","added_by":"auto","created_at":"2021-01-25 22:02:21","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":47194,"visible":true,"origin":"","legend":"a) Urban-rural difference for early initiation of breastfeeding by educational level\nb) Early initiation of breastfeeding by educational level\n","description":"","filename":"Fig7.png","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/9ef569dddd45508c52a68fa0.png"},{"id":13652630,"identity":"46beb2ea-2b16-4f8b-9785-1ee2f96b067a","added_by":"auto","created_at":"2021-09-17 09:50:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":621949,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-44307/v2/c7656aea-fa5f-4d8c-8b7c-6e1c0436d3f3.pdf"}],"financialInterests":"","formattedTitle":"Regional prevalence and socioeconomic inequalities in infant care practices: evidence from 2018 Nigeria Demographic and Health Survey","fulltext":[{"header":"Background","content":"\u003cp\u003eOptimal breastfeeding practices have an age-long recognition for health benefits\u0026nbsp;[1,2]. The World Health Organization (WHO) recommends early initiation of breastfeeding (EIBF) for newborn within 1 hour after birth\u0026nbsp;[3]. In addition, that infants be exclusively breastfed for the first six months of their life\u0026nbsp;[4]. Exclusive breastfeeding (EBF) is defined as the practice where an infant receives only breast milk for the first six months, with no other liquids (not even water) or solid foods, except oral rehydration solutions, drops and syrups\u0026nbsp;[3,5]. EIBF is also associated with mother and newborn skin-to-skin contact (SSC), which reduces the risk of hypothermia\u0026nbsp;[6]\u0026nbsp;and strengthens maternal bonding with children\u0026nbsp;[7].\u0026nbsp;The findings from a previous educational intervention study, led to the development of a guideline that allowed EIBF and SSC be included in newborn care national policy\u0026nbsp;[8]. In recent years, efforts have been made to improve infant and child feeding practices, including International Code of Marketing of Breast-milk Substitutes\u0026nbsp;[9],\u0026nbsp;Global Strategy for Infant and Young Child Feeding (IYCF)\u0026nbsp;[3]\u0026nbsp;and baby friendly hospital initiative (BFHI)\u0026nbsp;[10].\u0026nbsp;In recent years, WHO provided a set of indicators to evaluate child feeding and determine the progress of breastfeeding advancement efforts. Since then, there has been major attention in infant and child feeding structure and in the knowledge about what comprises ideal breastfeeding practices\u0026nbsp;[4].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWHO defined SSC as when the newborn is placed prone on the mother\u0026rsquo;s abdomen or chest in direct ventral-to-ventral SSC. Immediate SSC is done immediately after delivery, less than 10 minutes after birth. Early SSC is defined as beginning any time from delivery to 23 hours after birth and should be uninterrupted for at least 60 minutes\u0026nbsp;[11]. SSC improves the newborn maintenance of blood glucose levels, temperature regulation and metabolic adaptation. At birth, the newborn has a reduced capacity to generate heat, resulting from a decline in temperature. It is against this backdrop that maintenance of temperature is required for newborn at delivery. During SSC, there is a transfer of heat from the mother to her child, wherewith the mother\u0026rsquo;s body temperature activates the child\u0026rsquo;s sensory nerves, which in turn results in the child\u0026rsquo;s relaxation, reduces the tone of the sympathetic nerves, dilation of skin vessels and increase in its temperature\u0026nbsp;[12].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eApproximately 37% of children under 6 months old are exclusively breastfed in resource-constrained settings; while an estimated 823 000 annual deaths in under 5 children occurs\u0026nbsp;[13]. Sub-optimal breastfeeding has been reported to be responsible for 1.4 million childhood deaths with about 10% of total disease burden among under 5 children\u0026nbsp;[14]. Optimal breastfeeding practices are crucial in improving the health of children, and associated with reduction in the risk of childhood morbidity and mortality\u0026nbsp;[3,15]. EIBF can reduce neonatal mortality. Albeit, the prevalence of EIBF is only about 50% in many resource-constrained settings\u0026nbsp;[16]. The guideline for breastfeeding practices include the initiation of breastfeeding for all newborns within the first hour of life, while EBF is practiced for infants less than 6 months\u0026nbsp;[4,17]. Interestingly, SSC between mother and newborn plays a mediating role in EIBF\u0026nbsp;[6].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHigh prevalence of hypothermia is recorded in settings with large number of newborn death, where hypothermia has become an issue of major concern to improve newborn survival\u0026nbsp;[18]. In addition,\u0026nbsp;thermal care is crucial as newborns are commonly susceptible to hypothermia without prejudice to tropical climates. Newborns have thin skin, a large body surface area, little insulating fat and easily overwhelmed thermoregulatory mechanisms\u0026nbsp;[19]. In the absence of thermal protection, newborns are unable to maintain body temperature, while preterm babies become most-at-risk of the adverse effects\u0026nbsp;[20]. Several estimates of hypothermia in African settings are limited to hospital studies and ranged between 44- 85 %\u0026nbsp;[21].\u0026nbsp;Besides the benefits to the newborn, SSC has been linked with many benefits for mothers. For instance, secretion of oxytocin in mothers who receive SSC strengthens uterine contractions, which in turn aids the placenta to separate and the duration of the third stage of labour is shortened\u0026nbsp;[22]. As a simple and cost-effective mechanism, mother and newborn SSC is recommended to improve post-delivery care and potentially save the lives of newborns and mothers\u0026nbsp;[23]. Though WHO recommends SSC, separation of mothers and newborns exists in many health facilities where newborns are often placed under warmers or in cots\u0026nbsp;[24].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEvidence-based studies have reported that EBF and EIBF are associated with large gains and improve childhood survival, as well as support the recommendations to start breastfeeding immediately after childbirth\u0026nbsp;[25,26]. In spite of the numerous advantages identified regarding optimal breastfeeding practices\u0026nbsp;[27], the rates of EBF and EIBF in several resource-constrained settings remains worrisome. There are staggering reports of EBF uptake in Nigeria, as only a coverage of 16.4% was reported in a previous study\u0026nbsp;[5], while another study reported EBF prevalence of 14% and EIBF prevalence of 38%\u0026nbsp;[28], also the prevalence of newborns who were breastfed within 1 hour of birth was 34.7 %\u0026nbsp;[29]. Moreover, only 10% of newborns in Nigeria received SSC\u0026nbsp;[30]. These reports are worrisome and a major call to improve infants health care.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBreastfeeding practices and SSC benefit newborns in many ways, by providing warmth and nutrients to facilitate growth and enhance the immunity of babies [6,31]. Understanding the patterns of breastfeeding practices is essential to prioritize filling the knowledge gaps for childhood survival [32]. Nonetheless, there is disparities in the coverage of infant care practices across geographical regions, household wealth status and parental educational levels. Studies have reported that women with higher family incomes, those who had higher education levels or whose partners had higher education or executive occupations were more likely to have optimal breastfeeding practices than their counterparts [28,33,34]. Women with no formal education or low household wealth index have worsening breastfeeding indicators, when compared to women with primary and secondary or higher education [35,36]. Similarly, a previous study revealed disparities in EIBF across geographical regions in Nigeria, as North-Central region had the highest EIBF rates [37]. To the best of our knowledge, there is no study in Nigeria that has examined regional prevalence or wealth-related and education inequalities in EBF, EIBF and SSC using socioeconomic analytical tools. In light of the above, we examine regional prevalence and socioeconomic inequalities in breastfeeding practices and SSC in Nigeria.\u0026nbsp;\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eData source\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe analyzed a cross-sectional nationally representative data extracted from Nigeria Demographic and Health Survey (NDHS) 2018. MEASURE DHS provided technical input in the process of data collection and supported by the National Population Commission (NPC)\u0026nbsp;[38].\u0026nbsp;Data on 2,936 children under six months old was extracted for analysis. In addition, data on 21,569 children was analyzed for EIBF and SSC. NDHS is a vital source of data on EBF, EIBF and SSC especially as it consists of a nationally representative sample of households. Demographic and Health Survey (DHS) data was collected through a stratified multistage cluster sampling technique. The procedure for\u0026nbsp;stratification approach divides the population into groups by geographical region and commonly crossed by place of residence - urban-rural. A multi-level stratification approach is used to divide the population into first-level strata and to subdivide the first-level strata into second-level strata, and so on. A two-level stratification in DHS is region and urban/rural stratification. DHS data is available in the public domain and accessed at;\u0026nbsp;\u003ca href=\"http://dhsprogram.com/data/available-datasets.cfm\"\u003ehttp://dhsprogram.com/data/available-datasets.cfm\u003c/a\u003e. The details of DHS data has been report in a previous study\u0026nbsp;[39].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResponse rate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNDHS 2018 selected a total of 41,668 households for the sample, of which 40,666 were occupied. Of the occupied households, 40,427 were successfully interviewed, yielding a response rate of 99%. In the households interviewed, 42,121 women age 15-49 were identified for individual interviews; interviews were completed with 41,821 women, yielding a response rate of 99%\u0026nbsp;[40].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSelection and measurement of variables\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ea) Early initiation of breastfeeding: This is a measure of children who were put to breast within 1 hour of delivery.\u003c/p\u003e\n\u003cp\u003eb) Exclusive breastfeeding: This is a measure of infants less than 6 months of age who were fed exclusively with breastmilk. This indicator was based on the diets of infants younger than 6 months during the 24 hour before the survey.\u003c/p\u003e\n\u003cp\u003ec) Skin-to-skin contact was measured dichotomously; \u003cem\u003e\u0026ldquo;Was child put on mother\u0026apos;s chest and bare skin after birth\u0026rdquo;\u003c/em\u003e yes versus no\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eExplanatory factors\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWomen\u0026rsquo;s educational attainment was measured as; no formal education, primary, secondary and higher.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHousehold wealth quintile was computed by DHS using principal components analysis (PCA) to assign the wealth indicator weights. In their computation, they assigned scores and standardized the wealth indicator variable using household assets including; wall, floor, roof and wall type; whether a household had improved versus unimproved sanitation amenities and water source; whether a household had essential assets such as electricity, radio, television, cooking fuel, refrigerator, furniture amongst others. Furthermore, the factor loadings and z-scores were calculated. For each household, they multiplied the indicator values by the factor loadings and summed to produce the household\u0026rsquo;s wealth index value. The standardized z-score was disentangled to classify the overall scores to wealth quintiles; poorest, poorer, middle, richer and richest\u0026nbsp;[41]. Household wealth quintiles and mothers\u0026rsquo; educational attainment were used as measures of socioeconomic status similar to previous studies\u0026nbsp;[42\u0026ndash;44].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResidential status was classified as urban versus rural.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGeographical region and states were measured thus; \u003cstrong\u003eNorth Central:\u003c/strong\u003e Benue, Federal Capital Territory, Kogi, Kwara, Nasarawa, Niger, Plateau; \u003cstrong\u003eNorth East:\u003c/strong\u003e Adamawa, Bauchi, Borno, Gombe, Taraba, Yobe; \u003cstrong\u003eNorth West:\u003c/strong\u003e Jigawa, Kaduna, Kano, Katsina, Kebbi, Sokoto,Zamfara; \u003cstrong\u003eSouth East:\u003c/strong\u003e Abia, Anambra, Ebonyi, Enugu, Imo \u003cstrong\u003eSouth South:\u003c/strong\u003e Akwa-Ibom, Bayelsa, Cross River, Edo, Delta, Rivers; \u003cstrong\u003eSouth West:\u003c/strong\u003e Ekiti, Lagos , Ogun, Ondo, Osun, Oyo.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was based on an analysis of population-based data that exist in public domain and available online with all identifier information removed. The authors were granted access to use the data by MEASURE DHS/ICF International. DHS Program is consistent with the standards for ensuring the protection of respondents\u0026rsquo; privacy. ICF International ensures that the survey complies with the U.S. Department of Health and Human Services regulations for the respect of human subjects. The DHS project sought and obtained the required ethical approval from the National Health Research Ethics Committee (NHREC) in Nigeria before the surveys were conducted. No further approval was required for this study. More details about data and ethical standards are available at\u0026nbsp;\u003ca href=\"http://goo.gl/ny8T6X\"\u003ehttp://goo.gl/ny8T6X\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStata survey module (\u0026lsquo;svy\u0026rsquo;) was used with adjustment for the sample design. Percentage and Chi-square test were used for summary statistics and bivariate analysis respectively. To determine socioeconomic inequalities in EBF, EIBF and SSC, we used concentration index and present it graphically with the concentration curve. When the concentration index value is positive or the curve lies below the diagonal line (line of equality), it indicates that EBF, EIBF and SSC coverage is greater among high socioeconomic groups. Conversely, when concentration index value is negative or the curve is above the line of equality, it indicates that EBF, EIBF and SSC coverage is higher among low socioeconomic groups. The concentration index was used to decipher socioeconomic inequalities using Erreygers adjustment in line with previous studies [45,46]. Statistical significance was determined at p \u0026lt; 0.05. Stata Version 14 (StataCorp., College Station, TX, USA) was used for data analysis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn Figure 1 we presented the prevalence of EBF (31.8%), EIBF (44.2%) and SSC (12.1%) respectively.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe results from Table 1 showed that Benue (65.3%), Ondo and Osun (66.7%), Ekiti (69.6%), and Ogun (71.4%) had the leading prevalence of EBF respectively. Furthermore, Oyo (45.4%) and Bayelsa (67.8%) reported the highest prevalence of SSC in Nigeria. In addition, Niger (74.9%), Kogi (78.4%), Ogun (78.6%) and Bayelsa (96.2%) reported the highest prevalence of EIBF respectively. Similar differences were obtained across geographical zones.\u0026nbsp;\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:107%;font-family:\"Times New Roman\",serif;'\u003eTable 1.\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-size:16px;line-height:107%;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Summary statistics from 36 States + Federal Capital Territory on exclusive breastfeeding, early initiation of breastfeeding and skin-to-skin contact between mother and newborn; NDHS, 2018\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 68.65pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eState\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 134.2pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eExclusive breastfeeding\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 130.15pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eSkin-to-skin contact\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 134.5pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eEarly initiation of breastfeeding\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 39.35pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003en\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003e%\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003en\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003e%\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003en\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003e%\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eNorth Central\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eBenue\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e72\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e65.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e599\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e20.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e591\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e64.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eFederal Capital Territory\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e71\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n 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style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eTaraba\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e104\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e30.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e709\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e2.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New 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style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e101\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e40.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New 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style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e51.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eTotal estimate\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e611\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e26.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e4474\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e14.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e4381\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New 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none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eNorth West\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp 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style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e435\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e52.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan 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top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan 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Roman\",serif;'\u003e73.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eTotal estimate\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e308\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e63.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e2510\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e13.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e2491\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e62.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 68.65pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eP\u003c/span\u003e\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39.35pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 94.85pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31.15pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 99pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0.5in;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98.5pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;line-height:107%;font-family:\"Times New Roman\",serif;'\u003e*Significant at \u003cem\u003eP\u003c/em\u003e\u0026lt;0.05; \u003cem\u003eP\u003c/em\u003e value was obtained using Chi-square test\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eIn Table 2, we presented the percentages of EBF, SSC and EIBF across household wealth quintile and mother\u0026rsquo;s education. Based on the results, urban dwellers had higher EBF, SSC and EIBF across household wealth quintile and levels of mother\u0026rsquo;s education, in contrast to their rural counterparts. The concentration index quantified the degree of wealth-related and mother\u0026rsquo;s education inequalities in EBF, SSC and EIBF. Overall, the study outcomes were significantly more in higher household wealth, in contrast to the lower household wealth groups; EBF (CI = 0.118; p\u0026lt; 0.001), SSC (CI = 0.152; p\u0026lt; 0.001) and EIBF (CI = 0.103; p=0.002) respectively. Furthermore, EBF was significantly more from mothers with higher educational attainment, compared with children from mothers with lower educational attainment (CI = 0.157; p\u0026lt; 0.001), SSC (CI = 0.156; p\u0026lt; 0.001) and EIBF (CI = 0.091; p\u0026lt; 0.001). The test for differences between children from urban versus rural was significant in EBF, SSC and EIBF for maternal educational attainment. But this was only significant for EIBF for household wealth quintile.\u003c/p\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;line-height:107%;font-family:\"Times New Roman\",serif;'\u003eTable 2.\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-size:16px;line-height:107%;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;Prevalence and concentration index of exclusive breastfeeding, early initiation of breastfeeding and skin-to-skin contact between mother and newborn in Nigeria\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 67.5pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 193.3pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eExclusive breastfeeding\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 193.35pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eSkin-to-skin contact\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 193.35pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eEarly initiation of breastfeeding\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 64.4pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eUrban\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eRural\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: 1pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eUrban\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eRural\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eUrban\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eRural\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eTotal\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eHousehold wealth quintile\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New 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5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.083\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.118\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan 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style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.006\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.006\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e-value\u003csup\u003e\u0026alpha;\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.004*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eRural-urban comparison\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003ez-stat\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.73\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e-0.18\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e8.55\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eDifference in concentration index values\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.022\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e-0.004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.073\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e-value\u003csup\u003e\u0026beta;\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.464\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.855\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eMother\u0026rsquo;s education\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eNo formal education (%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e30.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e21.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e22.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e11.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e8.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e8.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e43.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e34.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e35.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003ePrimary (%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e32.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e27.0\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e28.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e12.3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e11.4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e11.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e50.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e44.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e46.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eSecondary (%)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e45.8\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e37.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e41.5\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e14.2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e15.6\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e14.9\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e51.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e51.7\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New 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5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.149\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.157\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan 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style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.006\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.005\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.004\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e-value\u003csup\u003e\u0026alpha;\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cstrong\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eRural-urban comparison\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.4pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003ez-stat\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e2.26\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e2.46\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e7.43\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003eDifference in concentration index values\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.85pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.063\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.048\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.060\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border: none;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 67.5pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cem\u003e\u003cspan style='font-size:13px;font-family: \"Times New Roman\",serif;'\u003eP\u003c/span\u003e\u003c/em\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e-value\u003csup\u003e\u0026beta;\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.85pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.033*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e0.014*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 128.9pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;text-align:center;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;0.001*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 64.45pt;border-top: none;border-right: none;border-left: none;border-image: initial;border-bottom: 1pt solid windowtext;padding: 0in 5.4pt;vertical-align: top;\"\u003e\n \u003cp style='margin-top:0in;margin-right:0in;margin-bottom:0in;margin-left:0in;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style='margin-top:0in;margin-right:0in;margin-bottom:8.0pt;margin-left:0in;line-height:107%;font-size:15px;font-family:\"Calibri\",sans-serif;'\u003e\u003cspan style='font-size:13px;line-height:107%;font-family:\"Times New Roman\",serif;'\u003e*Significant at p\u0026lt;0.05; SE standard error; \u003cem\u003eP\u003c/em\u003e-value\u003csup\u003e\u0026alpha;\u003c/sup\u003e and \u003cem\u003eP\u003c/em\u003e-value\u003csup\u003e\u0026beta;\u003c/sup\u003e were obtained using Concentration Index for overall inequalities across socioeconomic groups and measuring rural versus urban differences, respectively\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003eFigure 2-4 showed the household wealth related inequalities for EBF, SSC and EIBF. The more the curves sags away from the line of equality, the greater the degree of inequality. The inequalities in household wealth level was more among EBF, SSC and EIBF rural children, as the areas between the curve and the line of inequality was maximal. This is consistent with the results obtained in the concentration index model.\u003c/p\u003e\n\u003cp\u003eFigure 5-7 showed mother\u0026rsquo;s educational attainment inequalities for EBF, SSC and EIBF. The farther the curves draws away from the line of equality, the higher the degree of inequality. The inequalities in mother\u0026rsquo;s educational attainment varied among children by breastfeeding practices and SSC, as the areas between the curve and the line of inequality was maximal. This clearly showed EBF, SSC and EIBF were higher among those with improved educational attainment. \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe findings from this study bring to limelight the practices to reduce high newborn or infant mortality, such as EBF, EIBF and SSC which are still under-utilized and remained a worrisome issue in Nigeria. Despite the known benefits of EBF, the findings of this study showed that only about one-third of women (31.8%) and less than half of them (44.2%) practiced EBF and EIBF respectively. However, these showed some improvement over results of previous studies. For example, using 2003 data, an average EBF of about 16.4% was reported in Nigeria\u0026nbsp;[5], but in another study using 2008 data, EBF was 14% and EIBF was about 38.0%\u0026nbsp;[28]. In the results from 2013 data, the proportion of infants who initiated breastfeeding early was 34.7 %\u0026nbsp;[29]. These levels including the findings of this study are far less than the program target of 90% of women to exclusively breastfeed their infants in the first 6 months of life, a practice that is associated with 10% reduction of under 5 deaths\u0026nbsp;[47]. The low coverage among educated women may be attributed to current economic challenges in Nigeria, where mothers may be forced to return to full time work very quickly after childbirth which can result to sub-optimal breastfeeding practices\u0026nbsp;[48].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe impact of SSC in providing an appropriate and affordable yet high quality alternative to technology is well known. Moreover, it can easily be implemented, even in primary health care centres in many resource-constrained settings and has the potential to save newborns\u0026rsquo; and mothers\u0026rsquo; lives amongst other benefits\u0026nbsp;[6]. Unfortunately, only approximately one-tenth of women (12.1%) reportedly practiced it in Nigeria as found in this study. This finding is similar to a previous report of 10% SSC coverage in Nigeria\u0026nbsp;[30]. In the Gambia, 35.7% national prevalence of SSC was reported\u0026nbsp;[49].\u0026nbsp;In Tanzania, SSC was rarely practiced (less than 1%)\u0026nbsp;[50].\u0026nbsp;In Uganda and Mali, only 2% of mother and newborn SSC was reported respectively\u0026nbsp;[51,52]. In Ethiopia, approximately 9% and 13% immediate mother and newborn SSC after delivery were reported\u0026nbsp;[53,54]. In Ghana, the coverage of mother and newborn SSC was only about 10%\u0026nbsp;[55]. These results showed that SSC coverage in sub-Saharan Africa countries is very low.\u003c/p\u003e\n\u003cp\u003eIn a previous study in various African sites including Nigeria, on the beliefs and practices related to neonatal thermal care, a lack of opportunities for SSC, beliefs that the \u003cem\u003evernix caseosa\u003c/em\u003e was related to poor maternal behaviours to practice SSC were reported as major barriers. Based on the findings, early bathing of newborn was a very common practice especially in Nigerian sites due to a deep-rooted belief that delay to bath the newborn would result in body odour. Worst still, when asked about keeping the baby warm, respondents across study sites rarely mentioned the recommended thermal care practices (SSC), suggesting that these were not perceived as salient\u0026nbsp;[56]. Such norms can clearly be responsible for poor coverage of SSC in the general population.\u003c/p\u003e\n\u003cp\u003eClearly, higher socioeconomic status would help to improve EBF, EIBF and SSC by way of enhancing accessibility to health information which could positively influence health care seeking behaviour\u0026nbsp;[57]. In this study, we found that women who had formal education or high household wealth level had higher utilization of EBF, EIBF and SSC. The findings are similar to the report of a previous study which found maternal education to significantly improve SSC and EIBF\u0026nbsp;[8,35,36]. A simple and cost effective educational intervention achieved the inclusion of SSC and EIBF as part of standard care due to the observed significant impact in maternal health care continuum\u0026nbsp;[8]. Mothers from socioeconomically privileged class would have higher coverage of EBF in contrast to their counterparts in lower socioeconomic class. This is in line with a previous study which found a connection between household wealth, maternal education and infant breastfeeding, as only about one-tenth of mothers who practiced EBF came from poor households and without formal education, in contrast to their well-off and educated counterparts with over one-quarter coverage of EBF\u0026nbsp;[5,31,58\u0026ndash;60]. Therefore, our evidence of a positive association between maternal education and improvement in EBF is well founded. Women of higher socioeconomic status would find better access or act more positively to health promotion messages due to the availability of resources.\u003c/p\u003e\n\u003cp\u003eThe improvement in breastfeeding practices among educated mothers, indicates the substantial impact of mother\u0026rsquo;s education on infant well-being, health and development. This is consistent with the findings from previous studies whereby elementary education became the basic threshold needed to gain health information, as well as provided women, specifically the disadvantaged, with self-confidence and the autonomy required to act appropriately. Conversely, women with no formal education are known to have poor knowledge and attitude about proper breastfeeding practices. In spite of the role of education in child welfare, frequent contacts with a health care provider would enhance information about proper breastfeeding practices\u0026nbsp;[61]. Therefore, stakeholders in public health are oblige to design interventions or policies to aid mothers of low socioeconomic class for example, those with poor or no formal educational background to access health facility for information (for example, during antenatal visit) to improve proper breastfeeding practices in Nigeria.\u0026nbsp;\u003c/p\u003e\n"},{"header":"Strength And Limitation","content":"\u003cp\u003eWe used large sample data to reach plausible conclusions on infant breastfeeding practices and SSC. Furthermore, this study has become the foremost to examine socioeconomic inequalities in EBF, EIBF and SSC using vital socioeconomic tools. The results from this study fill the knowledge gap for socioeconomic inequalities in EBF, EIBF and SSC. Nonetheless, there is potential recall bias that could lead to overestimation or underestimation of the outcome variables.\u0026nbsp;\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThere was low coverage of EBF, EIBF and SSC in Nigeria. Moreover, these practices were influenced by mother\u0026rsquo;s educational attainment and their household wealth quintiles. Notably, educated women and the well-off had better coverage of EBF, EIBF and SSC. Based on these findings, we suggest that postnatal care interventions immediately after childbirth, such as SSC and EIBF as well as EBF should be taught and encouraged by health care professionals especially during antenatal care contacts, at delivery and postpartum stay period. Lack of formal education and poverty would increase the chance of home delivery, which could result in women missing out in skilled maternal and child health care practices. Therefore, women without formal education, the underprivileged as well as those from hard-to-reach communities should be well considered during health care programme design, planning and implementation. Providing the opportunity for community involvement in baby friendly initiatives would lead to higher coverage in skilled care practices, given the large number of Nigerian women who opt for home deliveries and traditional care due to poverty or ignorance and would rarely visit health facilities for counseling on proper child ware fare.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eBFHI: Baby Friendly Hospital Initiative; CI: Concentration Index; EBF: Exclusive Breastfeeding; EIBF: Early Initiation of Breastfeeding; ICF: Inner City Fund; IYCF: Infant and Young Child Feeding; NDHS: Nigeria Demographic and Health Survey; NHREC: National Health Research Ethics Committee; NPC: National Population Commission; PCA: Principal Components Analysis; SE: Standard Error; SSC: mother and newborn skin-to-skin contact; WHO: World Health Organization.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is a secondary data analysis of the NDHS, which is publicly available, approval was sought from MEASURE DHS/ICF International and permission was granted for this use. The original DHS data were collected in conformity with international and national ethical guidelines. Written consent was obtained from mothers/caregivers and data were recorded anonymously at the time of data collection during the NDHS 2018. More details regarding DHS data and ethical standards are available at:\u0026nbsp;\u003ca href=\"http://dhsprogram.com/data/available-datasets.cfm\"\u003ehttp://dhsprogram.com/data/available-datasets.cfm\u003c/a\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData for this study were sourced from Demographic and Health surveys (DHS) and available here:\u0026nbsp;\u003ca href=\"http://dhsprogram.com/data/available-datasets.cfm\"\u003ehttp://dhsprogram.com/data/available-datasets.cfm\u003c/a\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no grant from any funding agency in the public, commercial or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eME and AA contributed to the conceptualisation and manuscript preparation, the study design, review of literature and wrote the results. ME, AA and AB conducted data analysis, discussed the findings and critically reviewed the manuscript for its intellectual content. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors appreciate the MEASURE DHS project for the approval and access to the original data.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWorld Health Organization. Infant and young child feeding: model chapter for textbooks for medical students and allied health professionals. 2009. Available: http://www.ncbi.nlm.nih.gov/books/NBK148965/\u003c/li\u003e\n\u003cli\u003eBelfort MB, Rifas-Shiman SL, Kleinman KP, Guthrie LB, Bellinger DC, Taveras EM, et al. Infant feeding and childhood cognition at ages 3 and 7 years: effects of breastfeeding duration and exclusivity. JAMA Pediatr. 2013;167: 836\u0026ndash;844. doi:10.1001/jamapediatrics.2013.455\u003c/li\u003e\n\u003cli\u003eWorld Health Organization. Global Strategy for Infant and Young Child Feeding; World Health Organization: Geneva, Switzerland, 2003; Available online: https://apps.who.int/iris/bitstream/handle/10665/42590/ 9241562218.pdf?sequence=1 (Accessed: 9 January 2021).\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Indicators for assessing infant and young child feeding practices: conclusions of a consensus meeting held 6-8 November 2007 in Washington D.C., USA. Washington, D.C.: World Health Organization (WHO); 2008.\u003c/li\u003e\n\u003cli\u003eAgho KE, Dibley MJ, Odiase JI, Ogbonmwan SM. Determinants of exclusive breastfeeding in Nigeria. BMC Pregnancy Childbirth. 2011;11: 2. doi:10.1186/1471-2393-11-2\u003c/li\u003e\n\u003cli\u003eSafari K, Saeed AA, Hasan SS, Moghaddam-Banaem L. 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Delayed breastfeeding initiation and infant survival: A systematic review and meta-analysis. Simeoni U, editor. PLOS ONE. 2017;12: e0180722. doi:10.1371/journal.pone.0180722\u003c/li\u003e\n\u003cli\u003eEdmond KM. Delayed Breastfeeding Initiation Increases Risk of Neonatal Mortality. PEDIATRICS. 2006;117: e380\u0026ndash;e386. doi:10.1542/peds.2005-1496\u003c/li\u003e\n\u003cli\u003eLeung AKC, Sauve RS. Breast is best for babies. J Natl Med Assoc. 2005;97: 1010\u0026ndash;1019.\u003c/li\u003e\n\u003cli\u003eOgbo 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. doi:10.1186/s12889-015-1595-7\u003c/li\u003e\n\u003cli\u003eBerde AS, Yalcin SS. Determinants of early initiation of breastfeeding in Nigeria: a population-based study using the 2013 demograhic and health survey data. 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Trop Med Int Health. 2010;15: 1118\u0026ndash;1124. doi:10.1111/j.1365-3156.2010.02593.x\u003c/li\u003e\n\u003cli\u003eAdejuyigbe EA, Bee MH, Amare Y, Omotara BA, Iganus RB, Manzi F, et al. \u0026ldquo;Why not bathe the baby today?\u0026rdquo;: A qualitative study of thermal care beliefs and practices in four African sites. BMC Pediatr. 2015;15: 156. doi:10.1186/s12887-015-0470-0\u003c/li\u003e\n\u003cli\u003eDutta MJ. Health information processing from television: the role of health orientation. Health Commun. 2007;21: 1\u0026ndash;9. doi:10.1080/10410230701283256\u003c/li\u003e\n\u003cli\u003eWoldeamanuel BT. Trends and factors associated to early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: evidence from the Ethiopia Demographic and Health Survey 2016. Int Breastfeed J. 2020;15: 3. doi:10.1186/s13006-019-0248-3\u003c/li\u003e\n\u003cli\u003eRahman MdA, Khan MdN, Akter S, Rahman A, Alam MdM, Khan MdA, et al. Determinants of exclusive breastfeeding practice in Bangladesh: Evidence from nationally representative survey data. Joe W, editor. PLOS ONE. 2020;15: e0236080. doi:10.1371/journal.pone.0236080\u003c/li\u003e\n\u003cli\u003eMgongo M, Mosha MV, Uriyo JG, Msuya SE, Stray-Pedersen B. Prevalence and predictors of exclusive breastfeeding among women in Kilimanjaro region, Northern Tanzania: a population based cross-sectional study. Int Breastfeed J. 2013;8: 12. doi:10.1186/1746-4358-8-12\u003c/li\u003e\n\u003cli\u003eUkegbu AU, Ukegbu PO, Onyeonoro UU, Ubajaka CF. Determinants of breastfeeding patterns among mothers in Anambra State, Nigeria. South Afr J Child Health. 2011;5: 112\u0026ndash;116.\u003c/li\u003e\n\u003c/ol\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Breastfeeding, complementary feeding, neonatal mortality, kangaroo care, inequality ","lastPublishedDoi":"10.21203/rs.3.rs-44307/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-44307/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: The effects of breastfeeding practices on children’s health are undoubtedly of great interest worldwide. However, there is inequalities in the coverage of exclusive breastfeeding (EBF), early initiation of breastfeeding (EIBF) and mother and newborn skin-to-skin contact (SSC) in many resource-constrained settings. The aim of this study was to explore regional prevalence and examine the socioeconomic inequalities in EBF, EIBF and SSC in Nigeria.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e: Data on 2,936 infants under six months old were extracted from the 2018 Nigeria Demographic and Health Survey (NDHS) to determine EBF. In addition, data from 21,569 children were analyzed for EIBF and SSC. Concentration index (CI) and concentration curve were used to measure socioeconomic inequalities in EBF, EIBF and SSC.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: The prevalence of EBF, EIBF and SSC were 31.8%, 44.2% and 12.1% respectively. Furthermore, Ogun State had the highest prevalence of EBF (71.4%); while Bayelsa State had the highest prevalence of SSC (67.8%) and EIBF (96.2%) respectively. Urban dwellers had higher prevalence of EBF, SSC and EIBF across household wealth quintile and by levels of mothers’ education in contrast to their rural counterparts. We quantified the degree of wealth-related and mothers education inequalities in EBF, SSC and EIBF. There were pro-rich EBF (CI = 0.118; p\u0026lt; 0.001), EIBF (CI = 0.103; p=0.002) and SSC (CI = 0.152; p\u0026lt; 0.001) respectively. Also, EBF (CI = 0.157; p\u0026lt; 0.001), EIBF (CI = 0.091; p\u0026lt; 0.001) and SSC (CI = 0.156; p\u0026lt; 0.001) were significantly more concentrated among mothers with higher educational attainment. The test for differences between urban versus rural was significant in EBF, SSC and EIBF by mothers educational attainment. But this was only significant in EIBF by household wealth respectively.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Socioeconomic status determined breastfeeding practices and SSC in Nigeria. Breastfeeding practices interventions should target all mothers, especially those of low socioeconomic status and to ensure improvements in baby friendly initiatives.\u0026nbsp;\u003c/p\u003e","manuscriptTitle":"Regional prevalence and socioeconomic inequalities in infant care practices: evidence from 2018 Nigeria Demographic and Health Survey","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2021-01-25 16:28:15","doi":"10.21203/rs.3.rs-44307/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2020-07-27 14:54:34","doi":"10.21203/rs.3.rs-44307/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"44e72db1-da4b-47b8-a5ea-db12313ff240","owner":[],"postedDate":"January 25th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":206310,"name":"Health Policy"},{"id":206311,"name":"Maternal \u0026 Fetal Medicine"},{"id":206312,"name":"Pediatrics"}],"tags":[],"updatedAt":"2021-08-15T12:03:02+00:00","versionOfRecord":[],"versionCreatedAt":"2021-01-25 16:28:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-44307","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-44307","identity":"rs-44307","version":["v2"]},"buildId":"GqpaHPwrfC8PjnIFayRh5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}