Background: Deaths of an estimated 820,000 children under the age of five could be prevented globally every year with increased breastfeeding. Breastfeeding decreases the risk of respiratory tract infections and diarrhea, both in developing and developed countries. Other benefits include lower risks of asthma, food allergies, celiac disease, type 1 diabetes, and leukemia. Breastfeeding may also improve cognitive development and decrease the risk of obesity in adulthood. In Indonesia, exclusive breastfeeding has not reached the desired target. Health promotion by Indonesian Breastfeeding Association (AIMI) participation is one way to increase exclusive breastfeeding coverage. This study aimed to determine the effectiveness of health promotion through the Association of Indonesian Breastfeeding Mothers (AIMI) in increasing coverage of exclusive breastfeeding in Surabaya, East Java, using PRECEDE-PROCEED model.
Subjects and Method: This was a cohort retrospective study conducted at AIMI Surabaya branch office and 6 community health centers in Surabaya, East Java, from December 2017 and January 2018. A total sample of 120 lactating mothers was selected for this study by simple random sampling. The dependent variable was breastfeeding. The independent variables were AIMI participation, maternal knowledge, maternal education, maternal attitude, family support, and peer support. The data were collected by questionnaire and analyzed by path analysis.
Results: Exclusive breastfeeding directly increased with AIMI participation (b= 1.02; 95% CI= -0.19 to 2.24; p= 0.101), better maternal knowledge (b= 1.48; 95% CI= 0.15 to 2.79; p=0.029), positive maternal attitude (b= 2.22; 95% CI= 1.03 to 3.38; p<0.001), and stronger family support (b= 2.69; 95% CI= 1.25 to 4.11; p<0.001). Exclusive breastfeeding indirectly increased with higher maternal education and strong peer support.
Conclusion: Exclusive breastfeeding increases with AIMI participation, better maternal knowledge, positive maternal attitude, and stronger family support. Exclusive breastfeeding indirectly increases with higher maternal education and strong peer support.
Keywords: exclusive breastfeeding, PRECEDE-PROCEED model, Indonesian Breastfeeding Association (AIMI)