چکیده (انگلیسی):

Appropriate breastfeeding is one of the cost effective measures in the broader strategy for Integrated Management of Childhood Illness (IMCI) Programme which was adopted by the international community in the 1990s to reduce infant and child mortality especially in developing countries such as Kenya. Although Kenya experienced great improvements towards attainment of full immunization coverage in 1990s and early 2000s, it also experienced high HIV and malaria prevalence rates in some parts of the country during the two decades. This paper used the 2008/09 Kenya Demographic and Health Survey data to analyze the impact of breastfeeding duration in the face of varying levels of immunization coverage and HIV/AIDS risk perception. A total of 6,079 births born 59 months or less preceding the survey were used in the analysis. Life table and generalized linear regression in log linear format were the main methods applied. To determine the breastfeeding effect, other broad community level contextual and socio-economic as well as individual level biological and household environmental factors were controlled for in the analysis. Births in communities with longer breastfeeding duration exceeding 13 months had about 34 per cent lower infant and child mortality when compared with their other counterparts. Longer breastfeeding duration was also found to have beneficial effect on child survival even in lower immunization and higher HIV/AIDS risk situations. Multiple births and those born to mother in widowed/divorced/separated marital status had undesired effect on child mortality. The study results underscores the need for strengthening aspects of the IMCI Programme aimed at promoting breastfeeding and immunization of children as stipulated in the Ministry of Health guidelines which are also in line with those provided by the World Health Organization (WHO) and the United Programme on HIV/AIDS (UNAIDS). Further research is also necessary to explain the mechanism and key proximate determinants through which breastfeeding and immunization act to strongly influence childhood mortality in Kenya.