Continued Breastfeeding as Perceived by Ownership Index Quintile: Secondary Data from the 2023 Indonesian Health Survey
https://doi.org/10.33860/jik.v20i1.4286
Keywords:
Breastfeeding Sustainability, Socio-Economic, Exclusive Breastfeeding, Maternal HealthAbstract
Background: The WHO recommends breastfeeding until two years of age to support health and prevent stunting, but breastfeeding sustainability in Indonesia remains low. This study aims to analyze factors associated with breastfeeding sustainability in children aged 12 and 23 months in Indonesia using secondary data from the 2023 Indonesian Health Survey (SKI).
Methods: This cross-sectional quantitative study involved 10.769 children aged 12-23 months from 345.000 toddler households, selected through purposive sampling with inclusion criteria (mothers without twins, last child, no specific disease, child without congenital abnormalities) and exclusion (incomplete data), using a two-stage sampling technique (census block PPS and systematic household sampling). Data were analyzed using bivariate ( chi-square ) and multivariate analysis.
Result: The result showed a significant relationship between ownership index quintile, exclusive breastfeeding, , maternal education, place of birth, ANC staff, and ANC location, with p-values of <0.001 (<0.005) respectively, and the continuation of breastfeeding, but the ANC variable was not related, with a p-value of 0.062. The location or place of ANC at the maternity hospital/clinic was the main predictor with a value (AOR 1.5; 95% CI: 1.2 - 1.9), indicating that mothers who underwent ANC examinations at maternity home/clinics were 1.5 times more likely to continue breastfeeding after controlling for other variables
Conclusion: Socioeconomic disparities influence access to maternal health services. Breastfeeding sustainability is influenced by socioeconomic factors, facilities, and health services
References
Abdel-Razzaq, A.I., & Choudhury, T. (2021). Comparison of weighted and unweighted methods of wealth indices for assessing Socio-Economic status. Heliyon, 7(2), e06163. https://doi.org/10.1016/j.heliyon.2021.e06163
Adnan, Y., & Ekasari, R. (2025). Socioeconomic disparities in maternal health facility utilization at hospitals: Evidence from Indonesia's 2018 Basic Health Research. Social Medicine, 18(1), 45-52. https://doi.org/10.71164/socialmedicine.v18i01.2025.1763
Andriani, H., Kuo, HW, & Pongou, R. (2022). Continuum of care in maternal, newborn and child health in Indonesia: Evidence from the Indonesia Demographic and Health Survey. Journal of Public Health Research, 11(4), 22799036221127619. https://doi.org/10.1177/22799036221127619
Ariani, Lipoeto, NI, Chundrayetti, E., Malini, H., Bachtiar, H., Sulastri, D., Mayetti, Neherta, M., & Siahaan, SS (2025). The effect of postpartum visits on breastfeeding among traditional market traders in North Sumatra, Indonesia. African Journal of Reproductive Health, 29(7), 145-156. https://doi.org/10.29063/ajrh2025/v29i7.11
Ekholuenetale, M., Mistry, S. K., & Chimoriya, R. (2021). Socioeconomic inequalities in early initiation and exclusive breastfeeding practices in Bangladesh: findings from the 2018 demographic and health survey. International Breastfeeding Journal, 16(1), 73. https://doi.org/10.1186/s13006-021-00420-1
Farrag, N.S., Hashad, R.E., & El-Gilany, A.H. (2022). The practice of breastfeeding in public and its associated factors among Egyptian mothers. Breastfeeding Medicine, 18(4), 292-299. https://doi.org/10.1089/bfm.2022.0177
Hernández-Vásquez, A., Chacón-Torrico, H., Vargas-Fernández, R., & Bendezu-Quispe, G. (2020). Factors associated with exclusive breastfeeding in Peruvian women based on the 2018 Demographic and Health Survey. Revista Española de Nutrición Humana y Dietética, 24(1), 18-26. https://doi.org/10.14306/renhyd.24.1.942
Herwansyah, H., Febriawati, H., Yandrizal, Y., Nurjannah, N., & Pratama, MY (2024). Understanding interpersonal influences on maternal health service utilization at community health centers: A mixed-methods study in Indonesia. Healthcare, 13(1), 42. https://doi.org/10.3390/healthcare13010042
Hodgkin, K., Joshy, G., & Lokuge, K. (2025). Pregnancy-related risk and birth setting trends: Insights from Indonesian Demographic Health Survey data. medRxiv . https://doi.org/10.1101/2025.01.19.25320813
Magare, AR, Adchitre, SA, Jadhav, VS, & Mahajan, SM (2020). Sociodemographic determinants affecting exclusive breastfeeding practices. International Journal of Medical Science and Clinical Invention, 7(12), 5061-5066. https://doi.org/10.18535/IJMSCI/V7I12.09
Marthias, T., Anindya, K., McPake, B., Atun, R., Arfyanto, H., Hulse, E., & Mirelman, AJ (2022). Associations between Indonesia's national health insurance, effective coverage in maternal health and neonatal mortality: a multilevel interrupted time-series analysis 2000–2017. Journal of Epidemiology and Community Health, 76(12), 1043-1050. https://doi.org/10.1136/jech-2021-217213
Mawa, R. (2023). Socio-economic status and exclusive breastfeeding among infants in a Ugandan cross-sectional study. BMC Nutrition, 9(1), 44. https://doi.org/10.1186/s40795-023-00698-x
Neves, P.A.R., Barros, A.J.D., Baker, P., Piwoz, E., Santos, T.M., Gatica-Domínguez, G., Vaz, J.S., Rollins, N., & Victora, C.G. (2020). Consumption of breast milk, formula and other non-human milk by children aged under two years: analysis of 86 low and middle income countries. medRxiv . https://doi.org/10.1101/2020.06.02.20120519
Poirier, M. J. P. (2024). Systematic comparison of household income, consumption, and assets to measure health inequalities in low- and middle-income countries. Scientific Reports, 14(1), 3170. https://doi.org/10.1038/s41598-024-54170-1
Poirier, M. J. P., Grépin, K. A., & Grignon, M. (2020). Approaches and alternatives to the wealth index to measure socioeconomic status using survey data: a critical interpretive synthesis. Social Indicators Research, 148(1), 1-46. https://doi.org/10.1007/s11205-019-02187-9
Sebayar, SK, Efendi, F., Astutik, E., Hadisuyatmana, S., Has, EMM, & Kuswanto, H. (2022). Utilization of postnatal care services in Indonesia and its association with women's empowerment: An analysis of 2017 Indonesian Demographic Health Survey data. Maternal and Child Health Journal, 26(4), 847-859. https://doi.org/10.1007/s10995-021-03324-y
UNICEF & WHO. (2023). Global breastfeeding scorecard 2023. UNICEF. https://www.unicef.org/documents/global-breastfeeding-scorecard-2023
World Health Organization. (2023). Infant and young child feeding. WHO. https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding
World Health Organization. (2025). Breastfeeding. WHO. https://www.who.int/health-topics/breastfeeding
Xie, K., Marathe, A., & Deng, X. (2023). Alternative approaches for creating a wealth index: the case of Mozambique. BMJ Global Health, 8(8), e012639. https://doi.org/10.1136/bmjgh-2023-012639
Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
Donabedian, A. (1988). The quality of care: How can it be assessed? JAMA, 260(12), 1743-1748. https://doi.org/10.1001/jama.1988.03410120089033
Elder, G. H. (1998). The life course as developmental theory. Child Development, 69(1), 1-12. https://doi.org/10.1111/j.1467-8624.1998.tb06128.x
Epstein, R. M., & Hundert, E. M. (2002). Defining and assessing professional competence. JAMA, 287(2), 226-235. https://doi.org/10.1001/jama.287.2.226
Green, L. W., & Kreuter, M. W. (2019). Health program planning: An educational and ecological approach (5th ed .). McGraw-Hill Education.
Gupta, M. (2024). Socioeconomic moderators of the association between delayed breastfeeding initiation and place of delivery: Cross-sectional study. JMIR Public Health and Surveillance, 10(1), e57254. https://doi.org/10.2196/57254
Haile, Z. T., & Chertok, IRA (2022). Association between place of birth and timely initiation of breastfeeding among Cambodian women: A population-based study. International Breastfeeding Journal, 17(1), 66. https://doi.org/10.1186/s13006-022-00508-0
Herwansyah, H., Febriawati, H., Yandrizal, Y., Nurjannah, N., & Pratama, MY (2024). Understanding interpersonal influences on maternal health service utilization at community health centers: A mixed-methods study in Indonesia. Healthcare, 13(1), 42. https://doi.org/10.3390/healthcare13010042
Hodgkin, K., Joshy, G., & Lokuge, K. (2025). Pregnancy-related risk and birth setting trends: Insights from Indonesian Demographic Health Survey data. medRxiv . https://doi.org/10.1101/2025.01.19.25320813
Kristna, P., Ariescha, PAY, Sari, N., Hutabarat, V., Hadi, M., & Halawa, KA (2024). Strengthening awareness regarding the importance of antenatal care (ANC) in Mekar Sari village in 2024. Putri Hijau Community Service Journal, 5(1), 234-241. https://doi.org/10.36656/jpmph.v5i1.2154
Kundu, S. (2023). Prevalence of and factors associated with early initiation of breastfeeding in Bangladesh: A multilevel modeling. International Health, 15(4), 403-413. https://doi.org/10.1093/inthealth/ihac087
Marthias, T., Anindya, K., McPake, B., Atun, R., Arfyanto, H., Hulse, E., & Mirelman, AJ (2022). Associations between Indonesia's national health insurance, effective coverage in maternal health and neonatal mortality: A multilevel interrupted time-series analysis 2000–2017. Journal of Epidemiology and Community Health, 76(12), 1043-1050. https://doi.org/10.1136/jech-2021-217213
Muis, U.A., & Utomo, B. (2019). Determinants of exclusive breastfeeding: Analysis of 2017 Indonesian Demographic and Health Survey Data. International Journal of Scientific and Research Publications, 9(7), 347-354. https://doi.org/10.29322/IJSRP.9.07.2019.P9147
Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64(1), 12-40.
Rasul, N., Afzal, S., & Ijaz, S. (2022). To assess factors influencing and practice of early initiation of breast feeding. Pakistan Journal of Medical and Health Sciences, 16(2), 289. https://doi.org/10.53350/pjmhs22162289
Rosenstock, I. M. (1966). Why people use health services. Milbank Memorial Fund Quarterly, 44(3), 94-127. https://doi.org/10.2307/3348967
Santos-Rosales, Y.R., Correa-Lopez, M.Y., Mayta-Tovalino, F., & Barja-Ore, J. (2023). Lactancia materna exclusiva en el Perú y sus factores asociados: Un analysis de regresón multivariado. Revista de Obstetricia y Gynecology de Venezuela, 83(2), 206-216. https://doi.org/10.51288/00830206
Sebayar, SK, Efendi, F., Astutik, E., Hadisuyatmana, S., Has, EMM, & Kuswanto, H. (2022). Utilization of postnatal care services in Indonesia and its association with women's empowerment: An analysis of 2017 Indonesian Demographic Health Survey data. Maternal and Child Health Journal, 26(4), 847-859. https://doi.org/10.1007/s10995-021-03324-y
Singh, P., Kumar, R., Meena, G.S., & Lal, P. (2022). Prevalence and determinants of exclusive breastfeeding among children less than two years of age in a rural area of Delhi, India. MAMCJMS, 8(2), 133-138. https://doi.org/10.4103/mamcjms.mamcjms_133_21
Terefe, B., Asmamaw, DB, & Wassie, GT (2024). Determinants of early initiation of breastfeeding following birth in West Africa: A multilevel analysis using data from multi-country national health surveys. PLOS ONE, 19(4), e0302143. https://doi.org/10.1371/journal.pone.0302143
von Bertalanffy, L. (1968). General systems theory: Foundations, development, applications. George Braziller.
Walle, A.D., & Gebreegziabher, Z.A. (2024). Prediction of delayed breastfeeding initiation among mothers having children less than 2 months of age in East Africa: Application of machine learning algorithms. Frontiers in Public Health, 12, 1413090. https://doi.org/10.3389/fpubh.2024.1413090
Woldeamanuel, B. T. (2020). Trends and factors associated with early initiation of breastfeeding, exclusive breastfeeding and duration of breastfeeding in Ethiopia: Evidence from the Ethiopia Demographic and Health Survey. International Breastfeeding Journal, 15(1), 3. https://doi.org/10.1186/s13006-019-0248-3
Published
How to Cite
Issue
Section
License
Authors who publish with Poltekita : Jurnal Ilmu Kesehatan agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.

This work is licensed under a Creative Commons Attribution-ShareAlike 2.0 Generic License.
Poltekita : Jurnal Ilmu Kesehatan is licensed under a Creative Commons Attribution-Share Alike 4.0 International License
You are free to:
- Share, copy and redistribute the material in any medium or format
- Adapt, remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.



