Determinants of the Practice of Exclusive Breastfeeding in Guinea: Evidence from 2018 Guinean Demographic and Health Survey

Background: Exclusive breastfeeding is recognized as one of the key interventions with proven effectiveness in reducing child morbidity and mortality and malnutrition. However, with the current trend in breastfeeding rates in Guinea, the World Health Assembly target of at least 50% by 2025 is likely to be compromised.The objective of this study was to identify the individual and contextual determinants of the practice of Exclusive Breastfeeding in Guinea. Method: We conducted a secondary analysis of data from the 2018 Guinea Demographic and Health Survey (DHS). The study population consisted of women who gave birth between the ages of 15 and 49. Our sample consisted of women who had their last birth six (06) months prior to collection. The enumeration areas were our second level. A multilevel logistic regression was performed using Stata version 15.1 software. Three statistical models were implemented: The final model was obtained using the bottom-up step-by-step method. The intra-class correlation coefficient was calculated. Results: : On the 851 women included in our study, 33% reported having exclusively breastfed during the first 6 months of life of their children. After a multivariate analysis, the variables associated with exclusive breastfeeding are : children aged 2-3 months (OR = 0.53 CI95% = [0.36-0.79]) and children aged 4-5 months (OR = 0.23 IC95% = [0.14-0.36] and p= 0.0000), women in the Faranah area (OR = 2.69 IC95% = [1.21-5.94] and p= 0. 014) and those in Mamou (OR = 2.27 IC95% = [1.00-5.94] and p= 0.049), women who gave birth in a health facility (OR = 1.94 IC95% = [1.34-2.80] and p= 0.0000) and women living in polygamous households (OR = 0.68 IC95% = [0.48-0.98] and p= 0.042). Conclusion: The practice of exclusive breastfeeding remains low in Guinea. For the achievement of Sustainable Development Goals, particularly the improvement of exclusive breastfeeding practices, the individual and contextual determinants identified in this study should be taken into consideration in policies and programmes.