To examine the risk factors of prelacteal feeding (PLF) among mothers in sub-Saharan Africa (SSA).

We pooled data from Demographic and Health Surveys in twenty-two SSA countries. The key outcome variable was PLF. A multilevel logistic regression model was used to explore factors associated with PLF.

Demographic and Health Surveys in twenty-two SSA countries.

Mother–baby pairs (n 95348).

Prevalence of PLF in SSA was 32·2 %. Plain water (22·1 %), milk other than breast milk (5·0 %) and sugar or glucose water (4·1 %) were the predominant prelacteal feeds. In the multivariable analysis, mothers who had caesarean section delivery had 2·25 times the odds of giving prelacteal feeds compared with mothers who had spontaneous vaginal delivery (adjusted OR=2·25; 95 % CI 2·06, 2·46). Other factors that were significantly associated with increased likelihood of PLF were mother’s lower educational status, first birth rank, fourth or above birth rank with preceding birth interval less than or equal to 24 months, lower number of antenatal care visits, home delivery, multiple birth, male infant, as well as having an average or small sized baby at birth. Mothers aged 20–34 years were less likely to give prelacteal feeds compared with mothers aged ≤19 years. Belonging to the second, middle or fourth wealth quintile was associated with lower likelihood of PLF compared with the highest quintile.

To achieve optimal breast-feeding, there is a need to discourage breast-feeding practices such as PLF. Breast-feeding promotion programmes should target the at-risk sub-population groups discovered in our study.

This Supplement is a Report of the Conference convened by the Regional Office for South East Asia (SEARO) of the World Health Organization (WHO). The Conference was a follow-up to the WHO Conference of May 2005 in Phuket, Thailand on the Earthquake and Tsunami of 26 December 2004. The invitational meeting brought together representatives of 11 countries impacted by the events. The goal of the Conference was to produce a plan of action that meets the specific needs of the countries and ensure that the countries of the Region will be better equipped to cope with any future event.

The objectives of the Conference were to: (1) identify gaps in the health needs of the affected and vulnerable populations for preparedness, responses, recovery, and rehabilitation; (2) determine the next steps in addressing these gaps; and (3) develop benchmarks and a corresponding framework for action that must be achieved to solidify the capacities and capabilities of the health sector to meet emergencies.

Presentations of background papers, panel discussions, and Working Groups were used. Based, in part, on the materials presented, the Working Groups drafted benchmarks that could mark the progress in achieving the overall goal and proposed strategies that could be used to reach the benchmarks. Representatives of the participating countries summarized the current status of their respective countries relative to each of the defined benchmarks.

The benchmarks relate to: (1) legal framework for preparedness and response; (2) national disaster plan for preparedness and response; (3) budget; (4) rules of engagement for external actors; (5) community plan based on risk identification and vulnerability assessment; (6)community-based capacities; (7) local capacity for provision of essential services and supplies; (8) awareness and advocacy programs; (9) identification of hazards, risks, and vulnerabilities; (10) education and training; (11) “safe” health facilities; and (12) surveillance and early warning systems.

There exists a wide range in the levels of preparedness at all levels in the affected countries particularly at the community level. The country representatives agreed that community-level preparedness, legal frameworks, local and national disaster plans, surveillance and early warning systems, and advocacy and awareness programs demand more attention.

The strategies and mechanisms that will facilitate achievement of the benchmarks were grouped into seven categories: (1) monitoring, evaluation, surveillance, and assessments; (2) education and training (human resource development); (3) information and communications; (4) legislation, policies, and authority; (5) funding; (6) planning and preparedness; and (7) coordination and control. Any or all of the strategies suggested could be implemented by the countries in the Region.

The Conference delivered an important set of benchmarks and strategies that, when implemented, will facilitate the countries and the communities within them reaching better levels of preparedness and response to future events. Attaining the benchmarks will decrease the number of lives lost and minimize the pain and suffering associated with such events.