title: Factors Affecting Exclusive Breastfeeding among Women in Muheza District Tanga Northeastern Tanzania: A Mixed Method Community Based Study.
abstract: OBJECTIVE
  Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6% of all under-five deaths in developing countries. Prevalence of EBF is low globally (35%), and in sub Saharan Africa ranges between 22 and 33%. Like other developing countries the prevalence of EBF is 50% in Tanzania. There is limited information in Tanzania on factors influencing EBF apart from information specific for HIV positive women. This study aimed at examining factors that affect EBF practice among women in Muheza district, Tanga region, northeastern Tanzania.
  
  
  METHODS
  A community based cross-sectional study using both qualitative and quantitative methods was conducted from April to June 2014. To collect relevant information, a total of 316 women with infants aged 6-12 months were interviewed using a questionnaire and 12 key informants using in-depth interview guide. Qualitative data was analyzed using thematic analysis while bivariate and multivariate logistic regression analysis were used assess association between EBF and predictor variables.
  
  
  RESULTS
  The prevalence of EBF was 24.1%. The perception that mothers' breast milk is insufficient for child's growth, child being thirsty and the need to introduce herbal medicine for cultural purposes were among the important factors for early mixed feeding. In multivariate analysis advanced maternal age (OR 2.6; 95% CI 1.18-5.59) and knowledge on EBF duration and advantages (OR 2.2; 95% CI 1.2-3.8) remained significantly associated with EBF practice.
  
  
  CONCLUSIONS
  The prevalence of EBF in our study is low compared with the national prevalence. Strategies to target beliefs that breast milk is insufficient for growth need to be strengthened in the community. Furthermore opportunity to increase EBF training during ante and postnatal visits for women should be enhanced as more than 90% of women in the district use skilled attendants during pregnancy and delivery.
authors.affiliation: St Augustine Muheza, Institute of Health and Allied Sciences, P O Box 5, Muheza, Tanga, Tanzania. maonga8@gmail.com.|Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), P O Box 2240, Moshi, Tanzania. maonga8@gmail.com.
authors.forename: Aubrey R
authors.identifier: http://orcid.org/0000-0001-9758-0133
authors.initials: AR
authors.lastname: Maonga
authors.affiliation: Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), P O Box 2240, Moshi, Tanzania.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mahande
authors.affiliation: Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), P O Box 2240, Moshi, Tanzania.|Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), P O Box 2240, Moshi, Tanzania.|Department of Community Medicine, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania.
authors.forename: Damian J
authors.initials: DJ
authors.lastname: Damian
authors.affiliation: Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), P O Box 2240, Moshi, Tanzania.|Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College (KCMU Co), P O Box 2240, Moshi, Tanzania.|Department of Community Medicine, Kilimanjaro Christian Medical Centre, P O Box 3010, Moshi, Tanzania.
authors.forename: Sia E
authors.initials: SE
authors.lastname: Msuya
mesh_terms: D000293:Adolescent; D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000635:transmission; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D008880:Midwifery; D011247:Pregnancy; D015995:Prevalence; D012959:Socioeconomic Factors; D013636:Tanzania
keywords: Community based study; Exclusive breastfeeding; Factors; Sub Saharan Africa; Tanzania; Women; Worldwide