Factors associated with low adherence to exclusive breastfeeding in the Dibaya health zone, Democratic Republic of Congo

Background Exclusive breastfeeding (EBF) is an effective intervention, preventing 13% of deaths in children under 5 years old with optimal coverage of 90%. According to the Monitoring Improved for Action (MAA) survey conducted in 2013-2014, only 13.7% of children aged 0-6 months were exclusively breastfed, well below the 50% target set by Sustainable Development Goal, SDG 2. Dibaya health zone was a post-conflict Kamuina Nsapu, where most women who devote themselves to rural work and small businesses abandon their children for long hours. Hence, the latter being hungry and crying constantly, those who look after them must give them water and other foods than their mother’s milk. This study aimed to identify the factors associated with low adherence to EBF among breastfeeding women in the Dibaya health zone. Methods This cross-sectional analytical study was carried out among 200 women breastfeeding children aged 6-23 months. We used a four-stage probability sampling starting from the ZS, passing through the selected health area, then the streets/villages and then a plot survey to randomly select households with children aged 6-23 months. The chi-square test showed the current relationships between EBF adherence and the various factors, and the relationship between the various factors will ultimately be ascertained through logistic regression. Results The rate of adherence to the EBF was 12.1%. Porridge and water were most noted among the foods most consumed before 6 months. The factors associated with adherence to the EBF were the type of health area inhabited by the mother, marital status, area of residence, occupation of the husband, the existence of rules/prohibitions in the tribe and the information received on the EBF. It was noted that rural residence reduces adherence to exclusive breastfeeding by 96.2% while lack of knowledge reduces adherence to exclusive breastfeeding by 91.2%. Conclusions Most mothers do not adhere to EBF. The EBF rate is far from reaching the SDG 2 target, which must be above 50%. Intensifying the implementation of regional initiatives (Stronger with breast milk only and First Food) should be part of the strategic options to boost and improve Membership in the EBF. Communication for behaviour change must also focus on the age at which complementary foods are introduced.