Early initiation of breastfeeding and exclusive breastfeeding in Anglophone and Francophone West African countries: systematic review and meta-analysis of prevalence

Early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) are highly effective forms of preventive medicine in many low- and middle-income countries, including Anglophone and Francophone West African countries. Despite the proven benefits of EIBF and EBF in reducing mortality and morbidity, there is limited systematic evidence from West African countries. Hence, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of EIBF and EBF in Anglophone and Francophone West African countries. Six databases were searched for eligible studies based on inclusion criteria and a systematic review and a further meta-analysis were done. The weighted prevalence of EIBF was 51.7% (95% CI: 48.8, 54.6) in Anglophone West African countries and 45.5% (95% CI: 42.0, 48.9) in Francophone West African countries. The pooled prevalence of EBF was 41.2% (95% CI: 36.9, 45.5) in Anglophone West African countries and 30.1% (95% CI: 26.7, 33.5) in Francophone West African countries. Our study showed that the weighted average EIBF and EBF prevalence tended to be higher from studies in Anglophone West African countries than in Francophone West African countries. Despite these findings, EIBF and EBF rates overall in West African countries were suboptimal. A substantial improvement is necessary in promoting EIBF and EBF in West African countries. Programmes should target all mothers in the region no matter their colonial allegiance to achieve Sustainable Development Goals 2 and 3 by 2030.