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Ulizaon of Bole Feeding Pracces and Associated Factors among Mothers
Who Have Infant Less than 12 Months of Age in Agaro Twon, Jimma Zone
South West Ethiopia, 2018
Sheka Shemsi Seid*, Elsa Muluneh, Ismael Ahmed Sinbirro, Tolasa Takele Moga, Tura Koshe Haso
and Shamsedin Amme Ibro
School of Nursing and Midwifery, Faculty of Health Science, Instute of Health, Jimma University, Ethiopia
*Corresponding author: Sheka Shemsi Seid, Lecturer at School of Nursing and Midwifery, Jimma University, Ethiopia, Tel: +251-917-513-841; E-
mail: shekaaa2006@gmail.com
Received date: 29 January 2019; Accepted date: 15 February 2019; Published date: 22 February 2019
Copyright: © 2019 Seid SS, et al. This is an open-access arcle distributed under the terms of the creave commons aribuon license, which
permits unrestricted use, distribuon and reproducon in any medium, provided the original author and source are credited.
Citaon: Seid SS, Muluneh E, Sinbirro IA, Moga TT, Haso TK, et al. (2019) Ulizaon of Bole Feeding Pracces and Associated Factors among
Mothers Who Have Infant Less than 12months of Age in Agaro Twon, Jimma Zone South West Ethiopia, 2018. Health Sci J Vol.13.No.1:630.
Abstract
Background: Breast milk substutes are used commonly
worldwide with bole feeding which should be avoided
due to its impact on opmal breaseeding and
appropriate complementary feeding. Moreover, feeding
boles are associated with diarrheal disease morbidity
and mortality as it is dicult to keep it clean especially in
developing countries where sanitaon is poor.
Objecves: To assess the ulizaon of bole feeding
pracces and associated factors among mothers who
have infant (from birth-12 months of age) in Agaroo town,
Jimma zone Oromia region south west Ethiopia, 2018.
Methodology: A community based cross seconal study
was conducted from March 15 to 30, 2018 in Agaroo
town. A systemac sampling method was applied to
select 222 respondents among mothers who have infant
(from birth-12 months of age). Data was collected through
face to face interview using pretested quesonnaire. Data
analysis was done by using SPSS and to idenfy associated
factor chi-square was used. The data was presented by
graph and tables.
Result: From the total of 222 mothers parcipated in the
study the prevalence of bole feeding was 207 (93.2%).
Mothers return to work 104 (46.8) was the main reasons
for iniaon of bole feeding reported by the mothers
who started bole feeding pracce. The percentage was
high among mothers with educaonal background of
illiterate 92 (41.4%) governmental employer 10 (4.8%)
and whose monthly family income was 1000-1499 birr
100 (45%). There was signicant associaon between
bole feeding pracces and Mothers’ educaon status,
occupaonal status, place of delivery and family monthly
income.
Conclusions: The ulizaons of bole feeding was high at
the study area. Educaonal status, monthly family
income, employments was associated with ulizaon of
bole feeding. The provision of formal and informaon
educaon to the mothers, increasing family monthly
income, the number months for maternal leave and
instuonal delivery could reduce the bole feeding
ulizaons among mothers.
Keywords: Bole feeding pracce; Associated factors
Introducon
Appropriate evidence-based feeding pracces are essenal
for achieving and sustaining proper nutrion and health [1].
Opmal infant and young child feeding pracces as suggested
by the World Health Organizaon include early iniaon of
breast feeding within rst hour of birth; exclusive
breaseeding ll 6 months of age; introducon of
complementary feeding at 6 months while connuing breast-
feeding up to 2 years or beyond and ensuring proper use of
breast-milk substutes. However, breast milk substutes are
used commonly worldwide with bole feeding which should
be avoided due to its impact on opmal breaseeding and
proper complementary feeding. Moreover, feeding boles are
linked with diarrheal disease morbidity and mortality as it is
challenging to keep it clean especially in developing countries
where sanitaon is poor [2].
The bole is used not only used to give milk but all other
types of uids e.g. water, tea, juice etc. The semisolid cereals
are also diluted as a drink to be given through the bole. The
adverse eects of bole-feeding are well known. They are
more profound in the under developed world due to economic
resources, lack of clean water, unhygienic surroundings and
illiteracy amongst mothers. The prevalence of unsuitable
and/or low-quality boles and teats further aggravate the
situaon in developing countries. The hazards of bole-
Research Article
iMedPub Journals
www.imedpub.com
DOI: 10.21767/1791-809X.1000630
Health Science Journal
ISSN 1791-809X Vol.13 No.1:630
2019
© Copyright iMedPub | This article is available from: www.hsj.gr 1
feeding include over diluon of milk with resultant
malnutrion. There is increased suscepbly to diarrhea and
other Gastrointesnal Tract (GIT) infecons, ear infecons,
allergic tendency and dental caries. Recently a detailed
comprehensive report, using data both from developed and
developing countries highlighted the increased relave risk of
infant mortality amongst formula fed versus breast-fed infants
[3-7].
According to the 2016 Ethiopian Demographic and Health
Survey (EDHS), only 58% of infants less than 6 months were
exclusively breased. Even higher prevalence of bole feeding
(38%) was reported in some areas of the country such as
Oromia region [8-11].
Lack of appropriate breast feeding and complementary
feeding pracces leads to child malnutrion, many countries
worldwide are experiencing a sharp increase in the prevalence
of malnutrion and suer from the double burden of both
types of malnutrion [12]. In 2012 about 99 million children
under 5 years of age were underweight and 162 million
stunted. At the same me, about 44 million children under 5
were overweight or obese. In the same year 67 percent of all
underweight children lived in Asia and 29% in Africa [11-13].
There is no recent study conducted in Agaroo town that
explored the signicance of the major factors that are
assumed to iniate or smulate the pracce of bole-feeding.
Thus, the purpose of this study was idenfy the factors
associated with bole feeding pracce in Agaroo town in order
to obtain the baseline data that will help the concerned bodies
to plan and Implement feasible Intervenon to alleviate the
problem.
Methods and Materials
Study area and study period
Agaroo is a town and separate woreda in south-western
Ethiopia located in the Jimma Zone of the Oromia Region, it
sits at a latude and longitude of 7°51′N 36°35′E, and an
elevaon of 1560 m above sea level. Agaroo town is located
385 Km southwest of Addis Ababa, a capital city of Ethiopia
and 45 Km from Jimma zone. The town has ve kebeles. In
2007/2008, the total populaon of the town is 40,114 of which
about 51% were males, while 49% were females. In the town,
there are eight clinics, two health posts, two health centers
and one hospital. The study period was conducted from May
18 to 21, 2018
Study design: A community-based cross-seconal study was
conducted.
Sample size determination and sampling
procedure
The sample size is determined by using a single populaon
proporon formula considering the following assumpons:
expected proporon of bole feeding pracce (19.6%) from
previously study in Holeta, 95% condence level and a margin
of error of 5% [8].
Z α/2=Condence interval at 95% level (1.96)
d= is the degree of precision (marginal error) 5%
=
/2)21
2
Where,
n=sample size
p=proporon of home delivery=19.6%=0.196
d=marginal error=5%=0.05
Z a/2=Z value of 95% condence=1.96 from the Z-table
Substute the values in to the formula:
n=(1.96)20.196(1-0.196)/(0.05)2=242
Since the source populaon is less than 10,000, using the
correcon formula the nal sample size is:
nf = n
1 + n
N
=242
1 + 242
1250
= 202
Considering non response rate and add 10%
202*0.1=20.2
202+20.2=222
222 is the nal sample size
Since I was selected one kebele (Birbirsawantan) from the
ve kebeles
K= N/n → 430/202=2
Therefore, the mothers are selected every 2 interval.
Sampling Procedure
Simple random sampling technique was used to select
kebeles (one kebele from the ve kebeles). Then from the
selected Kebele a systemic random sampling technique was
conducted to select 222 mothers who have birth-12 month of
age infant by using lists from health post. Mothers are selected
every two interval. If more than one eligible mother was
encountered in the household, a loery method was used to
determine the mothers to be interviewed. Revisit of three
mes was made in a case where eligible respondents are not
available at the me of the survey and the next house was
used.
Data Collecon Tools and Procedures
Data was collected using pretested, structured interviewer-
administered quesonnaire. The quesonnaire was
administered through face to face interview by four (4) trained
data collectors (college students) and the data collecon was
strictly supervised by one health extension worker. A two days
training was given for data collectors and supervisors about
Health Science Journal
ISSN 1791-809X Vol.13 No.1:630
2019
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the condenality of the informaon, respondent’s rights,
informed consent and technique of the interview before
starng the actual work. Data was collected on daily basis from
morning to evening including weekends for the period of 3
days starng from May 18, 2018 G.C. The quesonnaire needs
20-40 minutes to interview one study parcipants. Daily
meeng was conducted between data collectors, supervisors
and principal invesgator for discussion regarding presenng
dicules and to assess the progress of data collecon.
Data Quality Control
The quesonnaire is adapted from previously done similar
researches and translates Afaan oromo (local language) to
obtain data from the study parcipants and to ensure
understandability and clarity the contents properly. The
quesonnaire was back translated to English. Prior to the
actual data collecon acvies (one week prior to data
collecon), the instrument were pre-tested on mothers (5% of
sample size) on one of the unselected kebeles (tamsajida).
Necessary changes (addion of alternave responses, removal
of some repeated quesons and skipping paerns) was made
aer pre-tesng based on the informaon obtained from
parcipants to make quesons more understandable.
On-going supervision of the data collecon acvies was
undertaken by one supervisor throughout the data collecon
period. The completeness of the quesonnaire and accuracy of
the informaon recorded was checked at the end of each day
by supervisors and principal invesgators. Code was given for
quesonnaire during data collecon so that any idened
errors was traced back using the codes. Completeness of the
collected data were nally reviewed by principal invesgator.
Data Processing and Analysis
The associaon between the outcome variables (bole
feeding) and independent variables was analyzed by using chi
square. Frequency distribuons, cross-tabulaons, and graphs
were used to describe the variables of the study. Findings were
presented in text, tables, and graphs.
Ethical Consideraon
The study was conducted aer geng Ethical clearance
from the Instuonal Review Board of, Faculty of Health
Science, Instute of Health, in Jimma University. Ocial leer
of cooperaon was also being obtained from the health oce
of Agaroo town and from selected Kebeles through a formal
leer. Parcipaon in the study was asked only on the
voluntary basis. Wrien informed consent was obtained from
each parcipant prior to the interview to conrm willingness
aer explaining the objecve of the study. The respondents
were told that they have the right to refuse or terminate at any
point of the interview. No personal ideners of the study
parcipants were taken hence all informaon obtained from
the study parcipants were kept strictly condenal.
Results
Socio demographic characteriscs
A total of 222 mothers having children less than 12 months
of age included in the in the study giving a response rate of
100%.
The age of study respondent were between range of 15-49
years with majority of them 80 (36%) in age group of 30-34
years. Majority of mothers 202 (90.9%) mothers were married
and only 3% of them were single. With respect to Ethnicity
More than half of study parcipants 125 (56.3%) were Oromo
followed by Amhara 46 (21.1%). almost half 110 (49.5%) study
parcipants were Muslim. 107 (48.1%) of mothers had an
esmated monthly income of <1000 birr. majority 95 (43%) of
the mothers were illiterate. Around half 110 (49.5%) of
mothers were house wife followed by merchant 50 (22.5)
(Table 1).
Table 1 Socio demographic characteriscs of the respondents, Agaro, Southwest Ethiopia, 2018.
Characteristics Group
Bottle feeding practice
Yes No Total
Age of mother
15-19 2 (0.9%) 0 2 (0.9%)
20-24 29 (13%) 1 (0.4%) 30 (13.5%)
25-29 72 (32.4%) 3 (1.3%) 75 (34%)
30-34 75 (34%) 5 (2.2%) 80 (36%)
>35 29(13%) 6 (2.7%) 35 (16%)
Marital status
Single 7 (3%) 0 7 (3%)
Married 192 (86.4%) 10 (4.5%) 202 (90.9%)
Divorced 7 (3.1%) 5 (2.2%) 12 (5.4%)
Widowed 1 (0.4%) 0 1 (0.4%)
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Ethnicity
Oromo 145 (65.3%) 10 (4.5%) 155 (69.8%)
Amhara 44 (19.8%) 3 (1.3%) 47 (21.1%)
Other (Debub) 18 (8.1%) 2 (0.9%) 20 (9%)
Religion
Muslim 102 (45.9%) 8 (3.6%) 110 (49.5%)
Orthodox 92 (41.4%) 3 (1.3%) 95 (43%)
Protestant 13 (5.8%) 4 (1.8%) 17 (8%)
Educational back ground of the mother
Illiterate 90 (40.5%) 5 (2.2%) 95 (43%)
Primary 63 (28.3%) 2 (0.9%) 65 (29.2%)
Secondary 45 (20.2%) 5 (2.2%) 50 (23%)
Above secondary 9 (4.0%) 3 (1.3%) 12 (5.4%)
Occupational states of mothers
House wife 107 (48.1%) 3 (1.3%) 110 (49.5%)
Merchant 50 (22.5%) 0 50 (22.5%)
Daily labor 25 (11.2%) 7 (3.1%) 32 (14.3%)
Government employee 10 (4.5%) 5 (2.2%) 15 (6.7%)
Farmer 10 (4.5%) 0 10 (4.5%)
Student 5 (2.2%) 0 5 (2.2%)
Educational status of the husband
Illiterate 58 (26.1%) 2 (0.9%) 60 (27%)
Primary 55 (24.7%) 5 (2.2%) 60 (27%)
Secondary 43 (19.3%) 2 (0.9%) 45 (20.2%)
Above secondary 31 (13.9) 6 (2.7%) 37 (16.6%)
Occupational status of husband
Merchant 78 (35.1%) 2 (0.9%) 80 (36%)
Daily labor 50 (22.5%) 5 (2.2%) 55 (24.7%)
Farmer 30 (13.5%) 5 (2.2%) 35 (15.7%)
Government employee 27 (12.1%) 3 (1.3%) 30 (13.5%)
House wife 20 (9%) 0 20 (%)
Student 2 (0.9%) 0 2 (0.9%)
Monthly family in came (Birr)
<500 52 (23.4%) 7 (3.1%) 59 (26.5%)
500-999 35 (15.7%) 5 (2.2%) 40 (18%)
1000-1499 100 (45%) 3 (1.3%) 103 (46.3%)
>1500 20 (9%) 0 20 (9%)
Obstetric condion of the respondent
From total of the study parcipants 192 (86.4%) and 182
(81.9%) had history of ANC and PNC follow up respecvely. Of
those who had history of ANC follow 187 (84.2%) respondents
received advice on advantage of breast feeding during ANC
follow up. The majority of the respondent 212 (95.4%) were
give birth at health instuon and 10 (4.5%) were give birth at
home, among those were give birth at health instuon 182
(81.9%) of respondents was give birth vaginally and 40 (18%)
were by caesarean secon. 212 (95.4%) of the respondents
was assisted by health professionals. Of total respondent 65
(29.2%) of them has four children and 85 (38.2%) were in age
range of 11-20 years (Table 2).
Table 2 Obstetrics condion of the respondents, Agaro, Southwest Ethiopia, 2018.
Variables No (%)
Number of children One 21 11.2
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Two 55 24.7
Three 52 23.4
Four 65 29.2
>five 29 13
Total 222 100
Age of youngest child
02-May 27 12.1
06-Oct 55 24.7
Nov-20 88 38.2
21-24 25 11.2
>25 5 2.2
Total 197 88.7
ANC follow up while you are pregnant for this last child
Yes 197 88.7
No 25 11.2
Total 222 100
What you advised during ANC follow up
About advantage of breast feeding 187 84.2
About hazards of bottle feeding 10 4.5
Total 197 88.7
Where did you delivery for the last child
Health institutions 212 95.4
Home 10 4.6
Total 222 100
Mode of delivery for the last child
Vaginally 182 81.9
Caesarean section 40 18.1
Total 222 100
Assisted you during delivery last child
Health professional 212 95.4
Traditional birth attendant 10 4.6
Total 222 100
PNC follow up for last child
Yes 182 81.9
No 40 18.1
Total 222 100
Child feeding pracce
The overall prevalence of bole feeding pracce in the
study area was 207 (93.2%). Among mothers who bole feed
their infants, the reason to starng bole feeding were
mothers return to work, availability of formula milk,
inadequate breast milk and ill of mothers which accounts 104
(46.8%), 70 (31.5%), 30 (13.5%) and 3 (1.3%) respecvely. 95
(42.7%) of respondents feeds there infant >5 mes per day. 90
(40.5) mothers clean bole twice per day and 102 (45.9%)
were clean the bole by rising with water and soap two mes
per day. Most of the mothers 160 (72%) were breast feed their
child immediately aer birth and 135 (60.8%) mothers had got
informaon about advantage of breast feeding from health
professional. 142 (63.9%) and 75 (33.7%) mothers were use
cow milk and formula milk for bole feeding respecvely.
From the total respondents 85 (38.2%) has two boles to feed
their infants. All mothers were gate safe water from pipe and
they have toilet facility. From 207 bole feed infants (120
(54%), 40 (18%), 5 (2.2%), 5 (2.2%)) had history of diarrhea,
voming, respiratory infecon and weight loose in past one
month respecvely (Table 3).
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© Copyright iMedPub 5
Variables No (%)
Is the child currently on bottle feeding
Yes 207 93.2
No 15 6.8
Total 222 100
Reason to start bottle feeding
Mother return to work 104 46.8
Inadequate breast milk 30 13.5
Availability of formula milk 70 31.5
Mother ill 3 1.3
Total 207 93.2
Did you think the breast feeding per day
Immediately after birth 160 72
After one day 5 2.2
When the mother fills comfortable 40 18
Don’t know 17 7.6
total 222 100
How many times child bottle feeding per day
Two 1 0.4
Three 41 18.4
Four 70 31.5
>five 95 42.7
Total 207 93.2
How many times do you have clean the bottle per day
Every feed 50 22.5
Two times per day 90 40.5
Once daily 55 24.7
Every six hours 12 5.4
Total 207 93.2
How do you keep clean the bottle
Boiling 90 40.5
Rising with a water and soap 102 45.9
Only rising the water 15 6.7
Total 207 93.2
Did you offer additional food with the bottle feeding
Yes 207 93.2
No 15 6.7
Total 222 100
Additional food with the bottle feeding
Yes 207 93.2
No 15 6.7
Total 222 100
What kind of fluid are you offering to the baby with the bottle feeding
Cow milk 142 63.9
Formula milk 65 29.2
Expressed breast milk
Total 207 93.2
Up to 1 year 50 22.5
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Table 3 Child feeding pracce of the respondents, Agaro, Southwest Ethiopia, 2018.
How long did you offer the bottle feeding
Until the baby discontinuous 157 70.7
Total 207 93.2
Factors associated with bole feeding
pracce
Chi-square analyses was done to idenfy factors associated
with bole feeding pracce. The Chi square analyses showed
that there were signicant associaon between bole feeding
pracce with educaonal status of the mother x2 (8.91)=0.031,
p<0.05, occupaonal status of the mother x2 (36.0)=0.000,
p<0.05 and monthly family income X2 (8.40)=0.038, p<0.05,
but there is no signicant associaon between bole feeding
pracce with age of the mother (Table 4).
Table 4 Associaon between bole feeding pracces and Socio-demographic characterisc of the respondent, Agaro, southwest
Ethiopia, 2018.
Variable
Bottle feeding practice
Yes No X2p-value
No. (%) No. (%)
Age of the mother
15-19 2 1 0 0 7.63 0.106
20-24 29 14 1 0.5
25-29 72 34.8 3 1.4
30-34 75 36.2 5 2.4
>35 29 14 6 2.9
Educational status of the mother
Illiterate 92 44.4 3 1.4
Primary 60 29 5 2.4 8.91 0.031
Secondary 45 21.7 5 2.4
Above secondary 10 4.8 2 1
Occupational status of the mother
House wife 107 51.7 3 1.4
Merchant 50 24.2 0 0
Daily labor 25 12.1 7 3.4 36 0
government employee 10 4.8 5 2.4
Farmer 10 4.8 0 0
Student 5 2.4 0 0
Family income per month
<500 52 25.1 7 3.4
500-999 35 16.9 5 2.4 8.4 0.038
1000-1499 100 48.3 3 1.4
>1500 20 9.7 0 0
Chi square analyses showed that there were signicant
associaon between bole feeding pracce with place of
delivery x2 (35.3)=0.000, p<0.05, but there is no signicant
associaon with bole feeding pracce and number of
children, ANC follow up and PNC follow up (Table 5).
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© Copyright iMedPub 7
Variable
Bottle feeding practices
Yes No X2 p-value
No. (%) No. (%)
Number of children
One 19 9.2 2 1 2.02 0.731
Two 50 24.2 5 2.4
Three 50 24.2 2 1
Four 60 29 5 2.4
>five 28 13.5 1 0.5
ANC follow up for last child
Yes 185 89.4 12 5.8
No 22 10.6 3 1.4 1.23 0.268
PNC follow up for the last child
Yes 171 82.6 11 5.3
No 36 17.4 4 1.9 0.815 0.367
Place of delivery
Home 9 4.3 1 0.5
Health institutions 198 95.7 14 6.8 35.3 0
Discussions
The prevalence of bole feeding in this study was higher
compared to other study conducted in Indian which was 18.4%
[14-23]. This dierence might be due to variaon in socio
cultural and economic aspect among study parcipant. The
nding of this study also higher than study conducted in
western Uganda which reported that the prevalence of bole
feeding was (10%) [24-26]. The dierence might be due to
socioeconomic dierence between study parcipants and
dierence in sample size, study seng and design. Community
based cross seconal study conducted in Bangladesh showed
that the proporon of bole-feeding was (37.3%) [24] which is
lower than the nding of this study and Another study
conducted at Holeta and shashemene town in Ethiopia
reported that the prevalence of bole feeding was 19.6% [27]
and 20.9% [28] respecvely which is lower than the nding of
the present study the dierence might be due to dierence
study period, study design and sample sizes.
This study found that mothers return to work 104 (46.8) was
the main reasons for iniaon of bole feeding by the
mothers who started bole feeding pracce while study
conducted in urban Libyan reported that the major reason for
iniaon of bole feeding were inadequacy of breast milk
(55.9%) and breast or Nipple condion (mothers ill) (8.4%)
[25]. But study conducted at Jimma revealed that insucient
breast milk as the main reason for starng bole-feeding
(70.9%) [29]. The addressed reason was dierent from study
conducted in Holeta [27]. But the current nding was in line
with the study conducted in the same town before een
years [28,29]. This implies that there were no signicant
changes regarding bole feeding over the years which could
be due to lack of an intervenon and prevenve measures.
This study found that socio demographic variables like
educaonal status of the mother, occupaonal status of
mother, monthly family income and place of delivery were
associated with bole feeding in line with this study the other
study also reported that the bole feeding pracce were
higher among mothers with beer educaonal background
and relavely high monthly income [25,30] while in contrast to
these study Community based cross seconal study done in
Jimma south west Ethiopia showed that the of bole-feeding
pracce was found to be higher among single and divorced
(71.4%) [29]. This nding was also inconsistent with another
study conducted near capital city of Ethiopia at town called
Holeta, which showed that bole feeding was associated with
infants’ age, mothers’ age, number of children, Lack of
previous counseling on bole feeding, and lack of aending
post natal care [27]. The observed dierence could be due to
the dierence in study seng and composion in study
populaon as this study was conducted at a remote town
where there could be lack of awareness about the danger of
bole feeding as more governmental and nongovernmental
organizaon working on maternal and child health are not
commonly available in this remote town compared to the
study conducted around the capital city of the country.
Health Science Journal
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2019
8This article is available from: www.hsj.gr
Table 5 Associaon between bole feeding pracces and obstetrics condion of the mother.
Conclusion
In conclusions, the prevalence of the bole feeding pracce
in the study seng was higher compared to other similar
study conducted throughout the country and the world. The
addressed associated factors were mostly consistent with the
other studies. Therefore, an intervenon and prevenon
measure that could reduce the pracce of bole feeding
should be taken by the concerned bodies. Furthermore it is
important that further community based intervenonal
studies be conducted on a larger scale to broaden the
understanding obtained from this inial study.
Acknowledgment
This study was funded by Jimma University postgraduate
oce. The authors are thankful to Faculty of Public Health,
Jimma University, For Its nancial and technical support. They
are also grateful to the Jimma university medical center sta
and administrators for their support in the whole process of
the study. Finally, they thank the research assistants who
contributed to data collecon.
Author Contribuons
Shemsi SS and Muluneh E hypothesized the study, searched
literature, and trained the research assistants in data
collecon. He also wrote the results and discussion secons.
Sinbiro IA, Haso Tk,Moga TT and Ibro SA contributed to the
design of the study, advised on methods and data
interpretaon, and analyzed the data. They also crically
revised and edited the manuscript. All the authors read and
approved the nal manuscript.
Disclosure
The authors declare that they have no compeng interests
in this work.
References
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and Young Child feeding pracces: Conclussion of a census
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Health Organizaon.
3. Morais TB, Sigulam DM, Maranhao HS, Morais MB (2005)
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