F: The relationship between health worker support and exclusive breastfeeding in Indonesia: a Systematic Review and Meta-Analysis
Abstract
Exclusive breastfeeding for the first six months is recommended by the World Health Organization and UNICEF because it provides optimal nutrition and immune protection for infants. However, the coverage of exclusive breastfeeding in Indonesia remains below the global target. Support from health workers is considered an important factor influencing breastfeeding practices, yet previous studies have reported inconsistent results. This systematic review and meta-analysis was conducted in March 2026 following PRISMA guidelines. A literature search was conducted in Google Scholar, PubMed, ScienceDirect, and Garuda databases for articles published between 2021 and 2026. Data analysis was performed using Review Manager 5.4 with the Odds Ratio (OR) effect size and 95% confidence interval using the Mantel–Haenszel method with a random effects model. Sensitivity analysis was performed using Review Manager 5.4. Publication bias was analyzed using funnel plots and Egger's test. A total of 11 cross-sectional studies were included in this study. Meta-analysis showed that support from health workers significantly increased the likelihood of exclusive breastfeeding [5.77 (95% CI: 3.88–8.57)]. Sensitivity analysis showed an OR of 5.39 (95% CI: 3.60–8.08) (OR = 6.47; 95% CI: 4.13–10.14). Risk of bias was mostly moderate. Egger's test indicated publication bias (p = 0.0126). Health worker support is significantly associated with exclusive breastfeeding practices in Indonesia, although family and social factors may also influence breastfeeding outcomes.
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