BackgroundEarly initiation of breastfeeding (EIBF) lowers the risk for all-cause mortality in babies, including those with low birth weight. However, rates of neonatal mortality and delayed initiation of breastfeeding remain high in most low- and middle-income countries. This study aimed to assess the trends and factors associated with EIBF in Namibia from 2000 to 2013.MethodsAn analysis of EIBF trends was conducted using data from three Namibia Demographic Health Surveys. The present sample included singleton children younger than 2-years from 2000 (n = 1655), 2006–2007 (n = 2152) and 2013 (n = 2062) surveys. Descriptive statistics were used to analyse respondents’ demographic, socioeconomic and obstetric characteristics. Factors associated with EIBF were assessed using univariate analysis and further evaluated using multivariable logistic regression analysis.ResultsEIBF significantly decreased from 82.5% (confidence interval [CI]: 79.5–85.0) in 2000 to 74.9% (72.5–77.2) in 2013. Factors associated with EIBF in 2000 were urban residence (adjusted odds ratio 0.58, 95% CI: 0.36–0.93), poorer household wealth index (1.82, 1.05–3.17), lack of antenatal care (0.14, 0.03–0.81), small birth size (0.38, 0.24–0.63) and large birth size (0.51, 0.37–0.79). In 2013, factors associated with EIBF were maternal age of 15–19 years (2.28, 1.22–4.24), vaginal delivery (2.74, 1.90–3.93), married mothers (1.57, 1.16–2.14), delivery assistance from health professionals (3.67, 1.23–10.9) and birth order of fourth or above (1.52, 1.03–2.26).ConclusionsNamibia has experienced a declining trend in EIBF rates from 2000 to 2013. Factors associated with EIBF differed between 2000 and 2013. The present findings highlight the importance of continued commitment to addressing neonatal health challenges and strengthening implementation of interventions to increase EIBF in Namibia.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-1811-4) contains supplementary material, which is available to authorized users.

Participants was 35.3 (standard deviation: 7.1) years. The demographics (98%), foetal heart rate (80.5%), temperature, pulse and respiratory (74.5%) and maternal blood pressure (73.2%) section of the partograph were the most charted. The least charted sections were foetal descent (19.5%), cervical dilatation (21.5%) and uterine contractions (24.8%). Use of the partograph was associated with the female gender with a 58% (aOR: 0.42. 95% CI: 0.19-0.91) lower odds compared to male nurses. The findings highlight a persistent gap in the use of the partograph in Kenya despite the recent countrywide BEmONC training. There is a need for enhanced on-job training for nurses and midwives on the use of the partograph but also a need to explore the possibility of using the electronic partograph that are effective in reducing adverse foetal outcomes and improve adherence to labour care and strengthen routine support supervision to review nurses-midwives in the use of the partograph. In low resource setting, the completion rate of partograph is low despite heavy investment in training of healthcare workers on Basic Emergency Obstetric and Neonatal Care (BEmONC), which promotes the use of partographs to monitor the progress of labour. In Kenya, the rate of caesarean section, instrumental delivery and APGAR score less than 7 at 1 min has increased. Therefore, this study determined the extent of use of partograph as a tool for monitoring the progress of the mother and the foetus during labour in selected Western counties in Kenya. This cross-sectional study was conducted in Kisumu and Vihiga counties in Western Kenya between May and June 2019. Validated self-administered questionnaires and checklists were used to collect data from participants and randomly chosen participant-filled partograph. Sample characteristic and extent of use of partograph were described using frequencies and percentages while factors associated with partograph use were assessed using multivariable logistic regression. Statistical significance was set at p<0.05. Out of 149 participants, 104 (69.8%) were female, 144 (96.6%) were nurses, 52% worked in health centres, 37% had worked for seven or more years and trained on BEmONC within 1 to 2 years.