Determinants of Exclusive Breastfeeding: a Cross Sectional Study in the Work Area of Bulili Public Health Center in South Palu, Palu City
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Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia Open Access Macedonian Journal of Medical Sciences. 2021 Aug 06; 9(E):566-573. https://doi.org/10.3889/oamjms.2021.6181 eISSN: 1857-9655 Category: E - Public Health Section: Public Health Education and Training Determinants of Exclusive Breastfeeding: A Cross Sectional Study in the Work Area of Bulili Public Health Center in South Palu, Palu City Muhammad Rizki Ashari1*, Nur Asri Zuhria1, Bambang Dwicahya2 1Department of Health Administration and Policy, Faculty of Public Health, Tadulako University, Palu, Indonesia; 2Departement of Environmental Health, Faculty of Public Health, Tompotika University, Central Sulawesi, Indonesia Abstract Edited by: Sasho Stoleski BACKGROUND: Breastfeeding has an important role in maintaining the health and survival of babies because Citation: Ashari MR, Zuhria NA, Dwicahya B. Determinants of Exclusive Breastfeeding: A Cross when they are exclusively breastfed, they will have a good immune system compared to babies who are not Sectional Study in the Work Area of Bulili Public Health exclusively breastfed. Exclusive breastfeeding in Indonesia is regulated in Government Regulation Number 33 of Center in South Palu, Palu City. Open Access Maced J 2012 concerning Exclusive Breastfeeding which explains that breast milk is given to babies from birth for 6 months, Med Sci. 2021 Aug 06; 9(E):566-573. https://doi.org/10.3889/ oamjms.2021.6181 without being added or replaced with other foods/drinks. This is emphasized in Article 6 of Government Regulation Keywords: Determinants; Exclusive breastfeeding; Public Number 33 of 2012 concerning Exclusive Breastfeeding, that every mother who gives birth is obliged to provide health center *Correspondence: Muhammad Rizki Ashari, Exclusive Breastfeeding for her baby unless there is a medical indication that makes it impossible for a mother to Department of Health Administration and Policy, Faculty breastfeed, or the mother is separate from the baby. Data from the Palu City Health Office shows that the lowest of Public Health, Tadulako University, Palu, Indonesia. E-mail: [email protected] amount of exclusive breastfeeding is in the Bulili Community Health Center with a proportion of 37.17%. Received: 11-Apr-2021 Revised: 23-Jul-2021 AIM: The aim of this study is to find out the Determinants of Exclusive Breastfeeding in the work area of Bulili Public Accepted: 27-Jul-2021 Health Center. Copyright: © 2021 Muhammad Rizki Ashari, Nur Asri Zuhria, Bambang Dwicahya MATERIALS AND METHODS: This research used a quantitative method with cross-sectional study approach, and Funding: This research did not receive any financial support simple random sampling method. The population in this study was all mothers who had babies aged 0–6 months with Competing Interests: The authors have declared that no a total sample of 103 respondents. Data collection was carried out using a questionnaire using a Likert scale for the competing interests exist Open Access: This is an open-access article distributed variables of exclusive breastfeeding and the Guttman scale for the variables of maternal employment status, family under the terms of the Creative Commons Attribution- support, health workers support, and policy. NonCommercial 4.0 International License (CC BY-NC 4.0) RESULTS: Data were analyzed using univariate and bivariate analysis. Chi-square test results summarizes the following: maternal work (p = 0.434), formula milk promotion (p = 0.029), family support (p = 0.019), health workers support (p = 0.572), and policy (p = 0.001). Mothers who have babies aged 0–6 months are obliged to fulfill the children’s rights, which is to provide exclusive breastfeeding for 6 months without providing any other foods/drinks such as water, bananas, honey, or formula milk. CONCLUSION: Mother’s occupation and formula milk promotion are not related to exclusive breastfeeding, while variables such as supports from families, health workers, and policy are related to exclusive breastfeeding. Introduction Based on data from the Health Profile of the Republic of Indonesia in 2018, the coverage of exclusive breastfeeding in Indonesia is 68.74%, exceeding the Sustainable development goals (SDGs) 2018 strategic plan target of 47%. The region with the are a continuation of the global goal, the Millennium highest exclusive breastfeeding coverage was West development goals which ended in 2015. One of the Java, accounting for 90.79% in 2018, while the region targets of SDGs to be achieved is to reduce child with the lowest exclusive breastfeeding coverage was mortality with an indicator of decreasing Infant Mortality Gorontalo with percentage of 30.71%. Six provinces Rate to 12/1000 live births in 2030. One effort that can in Indonesia have not achieved the 2018 Strategic be done to reduce the mortality rate of babies is by Plan target, including DKI Jakarta, Central Java, giving exclusive breastfeeding [1]. Banten, North Sulawesi, Riau, and Gorontalo, while Exclusive breastfeeding in Indonesia is nine provinces have not submitted their data, such as regulated in Government Regulation No. 33 of 2012, Riau Islands, Bangka Belitung Islands, Papua, South implying that exclusive breastfeeding program is held in Sumatra, South Kalimantan, North Sumatra, Central health care facilities, and health workers are required to Sulawesi, Maluku, and West Papua [3]. provide education and information related to exclusive On average, the percentage of exclusive breastfeeding to mothers and family members of the breastfeeding coverage in Central Sulawesi Province babies through counseling and mentoring since pregnancy from 2017 to 2018 experienced insignificant upward until the exclusive breastfeeding period is over [2]. trend from year to year, showing an increase from 56.6% 566 https://oamjms.eu/index.php/mjms/index Ashari et al. Determinants of Exclusive Breastfeeding in 2017 to 57.7% in 2018. Based on district/city program the relationship between maternal work, formula milk manager reports in 2018 the highest average coverage promotion, family support, health workers’ support, and was in Parigi Moutong Regency (80.1%), compared to policy towards exclusive breastfeeding in the Work 2017, in which the highest percentage of coverage for Area of Bulili Public Health Center in 2020. infants who were given exclusive breastfeeding was in Banggai Laut Regency (77.7%). The lowest coverage of infants who received exclusive breastfeeding was in Banggai Islands District (40.6%) and Toli-toli District Materials and Methods (50.8%) in 2017, while in 2018 the lowest coverage percentage was in Buol District (39.5%), and North Morowali Regency (43.8%) [4]. The type of research used in this study was Based on data from Palu City Public Health a quantitative method with cross-sectional study Office in 2019, exclusive breastfeeding coverage in approach. The subjects in this study were mothers who the last 3 years experienced fluctuating data trends. had babies aged 0–6 months. The sample technique In the past 3 years, Exclusive breastfeeding coverage in this study was Simple Random Sampling. Total reached 58.0%, 59.9%, and decreased back to 58.8% sample was 103 respondents. The sample inclusion in 2017, 2018, and 2019, respectively. This coverage criteria in this study constituted mothers who had babies has not reached the target of 80% minimum service 0–6 months, mothers who lived in the work area of the standard for National Exclusive Breastfeeding. The Bulili Community Health Center, and mothers who were highest coverage of exclusive breastfeeding is in willing to be respondents. While the exclusion criteria the Work Area of Sangurara Public Health Center with in this study were mothers who had babies more than the percentage of 75.31%. While the lowest coverage 6 months, mothers who did not live in the work area of of exclusive breastfeeding in 2019 was in Bulili Public the Bulili Community Health Center, and mothers who Health Center with the percentage of 37.17% [5]. were not willing to be respondents. This research was Bulili Public Health Center is one of the public conducted at Bulili Public Health Center of Palu City. Data health centers in Palu City. The Work Area of Bulili collection was carried out using a questionnaire using a Public Health Center consists of two sub-districts, they Likert scale for the variable of exclusive breastfeeding are Petobo Village and South Birobuli Village. Based on and the Guttman scale for the variables of maternal data in 2017, the Exclusive Breastfeeding coverage of employment status, family support, health workers Bulili Public Health Center managed to reach 38.33%, support, and policy. The questionnaire in this study was and in 2018, there was a decrease in exclusive tested for validity and reliability before distribution. Data breastfeeding from the previous year to 36.25%, and analysis used univariate analysis and bivariate analysis. in 2019 increased to (37.17%). So it can be seen that the exclusive breastfeeding coverage at Bulili Public Health Center is still low and has fluctuated in the past 3 years. The achievement of exclusive breastfeeding at Results Bulili Public Health Center has not reached the target of 80% minimum service standard for National Exclusive Breastfeeding coverage [6]. Univariate analysis The low exclusive breastfeeding coverage can Univariate analysis aims to obtain a description be affected by maternal work. Because mothers are of the distribution or the proportion of variables under busy at work,