Socio-economic inequalities in the effect of public policies and the COVID-19 pandemic on exclusive breastfeeding in Chile

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dc.contributor.authorNavarro-Rosenblatt, D.
dc.contributor.authorBenmarhnia, T.
dc.contributor.authorBedregal, P.
dc.contributor.authorLopez-Arana, S.
dc.contributor.authorRodriguez-Osiac, L.
dc.contributor.authorGarmendia, M. -L.
dc.date.accessioned2025-01-20T20:19:41Z
dc.date.available2025-01-20T20:19:41Z
dc.date.issued2023
dc.description.abstractObjective: To assess the impact of the addition of 12 maternity leave (ML) weeks (2011), a pay for per-formance (P4P) exclusive breastfeeding (EBF) promotion strategy (2015), and the COVID-19 pandemic in EBF inequalities in Chile.Study design: Interrupted time-series analyses (ITSAs).Methods: Aggregated national EBF data by municipality and month were collected from 2009 to 2020. We assess the impact of the three events in EBF inequalities using two procedures: 1. ITSA stratified by municipal SES quintiles (Q1-Q5); 2. Calculating the EBF slope index of inequality (SII).Results: The EBF prevalence was higher in lower SES municipalities before and after the three time-events. No impact in EBF inequalities was observed after the extended ML. The P4P strategy increased EBF at six months in all SES quintiles (effect size between 4% and 5%), but in a higher level in poorer municipalities (SII:-0.36% and-1.05%). During COVID-19, wealthier municipalities showed a slightly higher EBF at six months prevalence (SII: 1.44%).Conclusion: The null impact of the extended ML in EBF inequalities could be explained by a low access to ML among affiliated to the public health system (20%). The P4P strategy includes multiple interventions that seemed effective in increasing EBF across all SES quintiles, but further in lower quintiles. The re-strictions in healthcare access in poorer municipalities could explain EBF inequalities during COVID-19.(c) 2022 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.puhe.2022.11.001
dc.identifier.eissn1476-5616
dc.identifier.issn0033-3506
dc.identifier.urihttps://doi.org/10.1016/j.puhe.2022.11.001
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/92538
dc.identifier.wosidWOS:000906277100001
dc.language.isoen
dc.pagina.final68
dc.pagina.inicio61
dc.revistaPublic health
dc.rightsacceso restringido
dc.subjectExclusive breastfeeding
dc.subjectInterrupted time-series
dc.subjectHealth policy
dc.subjectCOVID-19
dc.subjectMaternity leave
dc.subjectSocio-economic inequalities
dc.subjectChile
dc.subject.ods03 Good Health and Well-being
dc.subject.ods05 Gender Equality
dc.subject.odspa03 Salud y bienestar
dc.subject.odspa05 Igualdad de género
dc.titleSocio-economic inequalities in the effect of public policies and the COVID-19 pandemic on exclusive breastfeeding in Chile
dc.typeartículo
dc.volumen214
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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