Faktor-Faktor Yang Membentuk Praktik Pemberian Asi Eksklusif Di Indonesia Dalam Perspektif Social Ecological Model : Suatu Tinjauan Sistematis

Abstract

Exclusive breastfeeding is a globally recommended health practice essential for optimal infant growth and development, yet its practice in Indonesia continues to face barriers that arise not only from mothers but also from the interpersonal environment, service organizations, communities, and public policy. This review aimed to identify and synthesize the determinants and patterns of exclusive breastfeeding practice among mothers in Indonesia across the five levels of the Social Ecological Model (SEM): individual, interpersonal, organizational, community, and public policy. A systematic literature review was conducted following the PRISMA 2020 guideline, searching PubMed, Garuda and Google Scholar for publications from 2020 to 2026. Following identification, screening, and eligibility assessment, 17 empirical studies (quantitative, qualitative, and mixed-methods) conducted in Indonesia met the inclusion criteria and were analyzed using a thematic/narrative synthesis approach. The findings show that exclusive breastfeeding practice is shaped by maternal knowledge, self-efficacy, and experience at the individual level; spousal and family support at the interpersonal level; health-worker support and workplace lactation facilities at the organizational level; cultural norms and socioeconomic conditions at the community level; and regulatory implementation and maternity protection at the public policy level. These determinants do not operate in isolation but interact to form an ecosystem that shapes the sustainability of exclusive breastfeeding practice. This review concludes that improving exclusive breastfeeding practice in Indonesia requires integrated intervention across levels, rather than maternal education alone.