Three Essays on Infant and Young Child Feeding and Child Health Outcomes in Sub-Saharan Africa: An Epidemiology and Policy Analysis

Exclusive breastfeeding in the first six months of life and continued complementary breastfeeding up to 24 months is encouraged to ensure optimal infant and young child nutrition and health. The WHO and UNICEF emphasize these optimal Infant and Young Child Feeding (IYCF) practices, especially for regions of the world where extensive child nutrition and healthcare support is lacking or inaccessible.
This dissertation explores the epidemiology of IYCF practices and child health outcomes in sub-Saharan Africa. It also examines the status of IYCF policies and programs in this relatively less studied region of the world. I use publicly available data from the Nigerian Demographic and Health Survey (NDHS) and the WHO/UNICEF Breastfeeding Collective scorecard to answer important questions explored across three studies.
Findings from the first study suggest that longer durations of breastfeeding are associated with fewer reported acute illnesses post-infancy at 24 to 59 months; demonstrating the long-term protective effect of breast milk from illnesses that contribute to the high under-five mortality rates recorded for decades in sub-Saharan Africa. Another important finding from the second study is that the relationship between exclusive breastfeeding, household living environmental conditions, and acute health outcomes in infancy is complex. The results suggest that the efficacy of exclusive breastfeeding in reducing the incidence of diarrhea and acute respiratory illness is strongest for infants living in households with poor sanitation facilities and inadequate building materials respectively. Lastly, findings from the third study indicate that sub-Saharan Africa as a region is yet to meet global and World Health Assembly targets for the implementation of recommended IYCF policies and programs. These findings have implications for child nutrition and health outcomes in especially for a region already disproportionately impacted by high under-five mortality rates.