Early initiation of breastfeeding in anglophone and francophone West African countries: systematic review and meta-analysis of associated factors

Objectives: Despite the benefits of early initiation of breastfeeding (EIBF) as a preventive medicine, the practice is suboptimal in West Africa (48.7 %), and there is limited systematic review evidence on the associated factors. This study aimed to aggregate the evidence on factors associated with EIBF in Anglophone and Francophone West African countries. Study design: A systematic review and meta-analysis was conducted to explore the research objectives. Methods: Six databases were searched for published studies that reported factors associated with EIBF in Anglophone and Francophone West African countries from January 1, 2008 to March 31, 2024. All relevant studies were reviewed, and odds ratios were extracted and meta-analysed. Results: The pooled analysis showed that caesarean section delivery in both Anglophone (AOR: 0.74; 95 % CI: 0.69, 0.81) and Francophone (AOR: 0.25; 95 % CI: 0.21, 0.30) regions, and unskilled birth attendance (AOR: 0.79; 95 % CI: 0.75, 0.83), babies perceived to be small at birth (AOR: 0.93; 95 % CI: 0.88, 0.98), rural residence (AOR: 0.89; 95 % CI: 0.85, 0.94) and mothers who wanted pregnancy now or later (AOR: 0.89; 95 % CI: 0.85, 0.92) in Anglophone regions delayed initiation of breastfeeding (DIBF). All 17 studies included were classified as medium or high quality. Conclusion: Future interventions and policies to improve EIBF should focus on addressing the factors associated with DIBF, with particular emphasis on babies delivered via caesarean section. This is crucial in reducing neonatal mortalities in the region to progress towards attaining Sustainable Development Goals 2 and 3 by 2030.