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Kurnia ID, Rachmawati PD, Arief YS, Krisnana I, Rithpho P, Arifin H. Factors associated with infant and young child feeding practices in children aged 6-23 months in Indonesia: A nationwide study. J Pediatr Nurs 2024; 78:82-88. [PMID: 38905786 DOI: 10.1016/j.pedn.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 06/08/2024] [Accepted: 06/09/2024] [Indexed: 06/23/2024]
Abstract
INTRODUCTION Children-related nutrition raises significant attention due to the low implementation of infant and young child feeding (IYCF) practices. However, the factors affecting the low implementation of IYCF remains limited globally. This study aimed to identify factors influencing IYCF in children aged 6-23 months in Indonesia. METHODS We conducted a cross-sectional study using data from the 2017 Indonesian Demographic and Health Survey. A total of 4943 responses were included. We employed binary logistic regression to determine the factors affecting IYCF practices in children aged 6-23 months. The results are reported as odds ratios (OR) with a 95% confidence interval (CI) and a significance level of p < 0.05. RESULTS Several factors significantly influenced IYCF practices among children aged 6-23 months, including the age of the child (OR: 0.42; 95% CI: 0.27-0.65), middle wealth index (OR: 1.85; 95% CI: 1.12-3.08), regional disparities (OR: 0.43; 95% CI: 0.23-0.77), place of residence (OR: 1.77; 95% CI: 1.17-2.68), and a history of childhood diseases like fever (OR: 1.65; 95% CI: 1.05-2.58). CONCLUSION This study highlights the significance of various factors related to IYCF practices among children aged 6-23 months. These factors include maternal aspects such as wealth index, child-related factors like age, a history of childhood illnesses such as fever, and environmental factors such as regional disparities and place of residence. PRACTICE IMPLICATIONS Paediatric nurses can contribute to enhancing maternal knowledge by providing education on the importance of infant and child feeding practices, beginning early in the child's life.
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Affiliation(s)
- Iqlima Dwi Kurnia
- Department of Basic Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya 60115, Indonesia.
| | - Praba Diyan Rachmawati
- Department of Basic Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya 60115, Indonesia.
| | - Yuni Sufyanti Arief
- Department of Basic Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya 60115, Indonesia.
| | - Ilya Krisnana
- Department of Advance Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya 60115, Indonesia.
| | - Pratuma Rithpho
- Faculty of Nursing, Naresuan University, Phitsanulok, Thailand.
| | - Hidayat Arifin
- Department of Basic Nursing, Faculty of Nursing, Universitas Airlangga, Surabaya 60115, Indonesia.
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Fetene SM, Negash WD, Amare T, Belachew TB, Addis B, Asmamaw DB, Kidie AA, Endawkie A, Wubante SM, Zegeye AF, Tamir TT, Fentie EA. Suboptimal micronutrient intake among children aged 6 to 23 months in Ethiopia: Further analysis of the demographic and health survey. PLoS One 2024; 19:e0305232. [PMID: 38980875 PMCID: PMC11232976 DOI: 10.1371/journal.pone.0305232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 05/27/2024] [Indexed: 07/11/2024] Open
Abstract
BACKGROUND The recommended essential micronutrient such as food rich in vitamin-A or iron, multiple micronutrient powder or iron supplement, routine daily consumption of iodine, and vitamin-A supplement are deficient among children in Ethiopia. This has been a significant public health problem despite the government efforts. Although few studies have examined the micronutrient intake among children, they are limited in scope and methodological measurements. Analyzing the micronutrient intake among children across all regions and leveraging all essential micronutrient elements are crucial for generating improved evidence to better inform policy. Thus, we examined the micronutrient intake among children aged 6 to 23 months in Ethiopia. METHODS We used data from the Ethiopian Demographic and Health Survey. A two-stage stratified sampling technique was employed, and 1392 children aged 6 to 23 months were included in our analysis. We conducted a multilevel mixed-effect binary logistic regression analysis to identify determinants of micronutrient intake. In the final model, we used a p-value of less than 0.05 and Adjusted Odds Ratio (AOR) with their 95% confidence interval (CI). RESULTS We found that only 27.6% (95% CI: 26.8-31.6) of children aged 6 to 23 months were received the recommended micronutrients in Ethiopia. We identified that maternal educational status (Educated mothers (AOR = 2.09, 95%CI:1.23-3.58)), health facility delivery (AOR = 2.14, 95%CI:1.42-2.98), household wealth status (middle quantile (AOR = 1.80, 95%CI:1.01-3.21)), children's age (12 to 23 months age (AOR = 2.36, 95% CI: 1.33-4.21)), and mother's exposure to media (AOR = 1.70, 95%CI: 1.42-2.04) were increased micronutrient intake, whereas residing in the rural communities (AOR = 0.27, 95%CI: 0.21-0.34) decreased micronutrient intake. CONCLUSIONS Nearly three-fourths of children aged 6 to 23 months did not receive the recommended essential micronutrients in Ethiopia. Therefore, there is a need to broaden strategies aimed at enhancing the intake by improving information and knowledge dissemination among mothers during facility visits and through media channels.
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Affiliation(s)
- Samrawit Mihret Fetene
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaw Amare
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Banchlay Addis
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Atitegeb Abera Kidie
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia
| | - Abel Endawkie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Woldia, Ethiopia
| | - Sisay Maru Wubante
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar Ethiopia
| | | | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Singh A, Rahut DB, Sonobe T. Exploring minimum dietary diversity among cambodian children using four rounds of demographic and health survey. Sci Rep 2024; 14:14719. [PMID: 38926408 PMCID: PMC11208556 DOI: 10.1038/s41598-024-64714-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Dietary diversity among children is a crucial factor influencing their nutritional status; therefore, this paper uses data from four rounds of the Cambodia Demographic and Health Survey (CDHS) to examine the minimum dietary diversity among children aged 6-23 months. Multilevel binary regression is used to evaluate the variation in minimum dietary diversity at the cluster and province levels. The results show that nearly half of Cambodian children consistently lacked access to vitamin A-rich fruits and vegetables. Although the prevalence of inadequate minimum dietary diversity (MDD) among children significantly dropped from 76% in 2005 to 51% in 2021-2022, it is still high and needs attention. A decomposition analysis (Blinder-Oaxaca decomposition) was further used to understand the drivers of this temporal change in dietary diversity. The empirical results show that clusters represented the most significant source of geographic variation with respect to all eight food groups and MDD. Nutritional policy should improve education and awareness, reduce socio-economic disparities, leverage media, and promote full antenatal care to improve dietary diversity in Cambodia. Initiatives targeting the enhancement of insufficient minimum dietary diversity intake should encompass individual aspects and be customized to suit geographic and community settings.
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Affiliation(s)
- Anjali Singh
- Project Associate (MLE), Project Concern International, New Delhi, Delhi, 110020, India
| | - Dil B Rahut
- Asian Development Bank Institute, 3-2-5 Kasumigaseki, Chiyoda-ku, Tokyo, 100-6008, Japan.
| | - Tetsushi Sonobe
- Asian Development Bank Institute, 3-2-5 Kasumigaseki, Chiyoda-ku, Tokyo, 100-6008, Japan
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Atosona A, Mohammed JA, Issahaku H, Saani K, Addae HY, Azupogo F. Maternal employment status and child age are positive determinants of minimum dietary diversity among children aged 6-23 months in Sagnarigu municipality, Ghana: a cross-sectional study. BMC Nutr 2024; 10:57. [PMID: 38622652 PMCID: PMC11020657 DOI: 10.1186/s40795-024-00865-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 03/22/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Intake of a diversified diet is key to the prevention of malnutrition among children as it results in improved intake of energy and micronutrients, which are deemed critical for better nutritional status of children. This study assessed minimum dietary diversity (MDD) and its determinants among children aged 6-23 months in the Sagnarigu Municipality of Ghana. METHODS This was an analytical cross-sectional study, carried out in the Sagnarigu Municipality, Ghana and involved 369 mother-child pairs selected through a systematic random sampling. A semi-structured questionnaire was used to obtain respondents' socio-demographic characteristics, feeding practices, nutritional knowledge and anthropometry. MDD was assessed using a repeated 24-hour dietary recall method. Chi-square/Fisher exact test and binary logistic regression analysis were used to determine the factors associated with MDD. RESULTS The study found that 24.9% of the children were between the ages of 6-8 months and 75.1% were between the ages of 9-23 months. About 64.2% of the children met the MDD. Children of mothers who were self-employed were approximately 2 times more likely to meet the MDD as compared to children of mothers who were unemployed [Adjusted Odd Ratio (AOR): 1.93, 95% CI (1.13-3.31), P = 0.017]. Also, children aged 9-23 months were approximately 14 times more likely to meet MDD as compared to younger children aged 6-8 months [AOR: 13.98, 95% CI (7.54-25.91), P < 0.001]. CONCLUSION Our study suggests that maternal empowerment may have positive effects on improving the MDD of infants and young children.
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Affiliation(s)
- Ambrose Atosona
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana.
| | - Jawahir Abukari Mohammed
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Huzaifa Issahaku
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | - Khadija Saani
- Department of Nutritional Sciences, School of Allied Health Sciences, University for Development Studies, Tamale, Ghana
| | | | - Fusta Azupogo
- Faculty of Agriculture, Department of Family and Consumer Sciences, Food and Consumer Sciences, University for Development Studies, Tamale, Ghana
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Opoku Agyemang G, Attu SS, Annan RA, Okonogi S, Sakura T, Asamoah-Boakye O. Factors associated with food consumption and dietary diversity among infants aged 6-18 months in Ashanti Region, Ghana. PLoS One 2023; 18:e0294864. [PMID: 38033108 PMCID: PMC10688859 DOI: 10.1371/journal.pone.0294864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/10/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Studies have reported a poor diet quality among children in Ghana and other developing countries. Inadequate dietary diversity among children may lead to deficiencies in micronutrient intake necessary for growth and other cognitive functions. Understanding factors associated with infants' diverse diets is a key step to promoting adequate infant and young child nutrition. This study sought to determine the factors associated with food consumption and dietary diversity (DD) among infants. METHODS In this cross-sectional study among 1503 mothers-infant (aged 6-18 months) pairs from rural, urban, and peri-urban districts of Ashanti Region, factors associated with food consumption and DD were evaluated. The FAO 18-food group DD questionnaire was used to determine previous food group intake, while a structured questionnaire was used to capture data on the mother's socio-demographic parameters and child morbidity. Data were analyzed using descriptive statistics, the Chi-square test, and binary logistic regression to compare mothers and infants who had adequate and inadequate DDS of 9 out of 18 food groups and the predictors of dietary diversity. RESULTS About 64.7% of the infants did not meet the minimum dietary diversity. Over two-third (77.4%) of the children consumed maize porridge the previous day. Foods which were less consumed included vegetables (35%), animal milk (38.9%), and meat (organ 14%, any meat 26%). The mean food group intake from 18 food groups was 7.0, and the majority (64.7%) did not meet the recommended 9 food group intake. Significantly more younger children (6-11 months) (74%, p<0.001) compared with older children (12-18 months) (52.5%) did not meet the minimum DDS. Also compared with the older children, the younger ones had above two times increased odds of inadequate DD (OR = 2.5, p<0.001, 95% CI = 1.4-4.4). When controlled for gender, children from peri-urban areas (OR = 5.2, p = 0.260, 95% CI = 0.2-93.2) and rural areas (OR = 1.8, p = 0.650, 95% CI = 0.2-9.3) had increased odds of lower DD than urban children. Children of unemployed caregivers had an increased odds of low DD (OR = 2.3 p<0.001, 95% CI 1.7-3.2) compared with children of employed caregivers. Finally, children of caregivers with better nutrition knowledge (nine correct answers from 12 questions) had lower odds of having lower dietary diversity (adjusted OR = 0.9, p = 0.85, 95%CI = 0.5-1.6) than those with less knowledge. CONCLUSIONS Low DD was common among infants and associated with infants age, caregivers' areas of residence, employment status, and level of nutrition education. Children who did not meet the minimum dietary diversity were not fed particular foods such as vegetables, animal milk, and organ meat. Proper maternal nutrition education and feeding practices targeting age-specific needs and community livelihood support systems are necessary to improve dietary diversity of infants.
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Affiliation(s)
- Godwin Opoku Agyemang
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| | - Samuel Selorm Attu
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| | - Reginald Adjetey Annan
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
| | - Satoru Okonogi
- Department of Agricultural and Resource Economics, the University of Tokyo, Tokyo, Japan
| | - Takeshi Sakura
- Department of Agricultural and Resource Economics, the University of Tokyo, Tokyo, Japan
| | - Odeafo Asamoah-Boakye
- Department of Biochemistry and Biotechnology, College of Science, Kwame Nkrumah University of Science and Technology, PMB, Kumasi, Ghana
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Terefe B, Jembere MM, Assimamaw NT. The prevalence and multilevel analysis of minimum dietary diversity intake and its determinants among 6-23 months old infants in The Gambia: further analysis of the Gambian demographic and health survey data. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:98. [PMID: 37705103 PMCID: PMC10498527 DOI: 10.1186/s41043-023-00442-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Poor infant and young child feeding (IYCF) practices are a significant issue both globally and in developing nations, and they have a significant role in undernutrition, healthy growth, and development, particularly in the first 2 years of life. Improving children's general health and wellbeing requires recognizing and decreasing preventable drivers of malnutrition. Hence, this study aimed to assess the prevalence and possible determinants of minimum dietary diversity among 6-23 months old babies in the Gambia. METHODS Data from the 2019-2020 Gambia demographic and health survey were used. The study included a total of 2100 weighted 6-23 months old children. To identify characteristics significantly linked with minimum dietary diversity among infants, a multilevel fixed-effect analysis approach was used. After adjusting other confounding variables, variables with a p value of 0.25 were incorporated into a multivariable multilevel regression analysis to determine associated variables. An adjusted odds ratio with a 95% confidence interval was then applied. RESULTS Only 22.22% (95% CI 18.55, 21.99) of infants had received the minimum dietary diversity. Mothers, who had mass media exposure (aOR = 2.71, CI = (1.02, 6.21), wealthier (aOR = 1.70, CI = 1.02, 2.85), child age of (aOR = 4.14, CI = 2.98, 5.76), and (aOR = 4.97, CI = 3.54, 6.98), have shown a positive statistical association with the outcome variable, respectively. Regarding regions mothers who came from Kanifing (aOR = 0.49, CI = 0.25, 0.94), Janjanbureh (aOR = 0.38, CI = 0.18, 0.82), and Basse (aOR = 0.51, CI = 0.26, 0.99) had showed less likelihood odds to provide the minimum dietary diversity (MDD) for their babies compared to Banjul local government area, respectively. CONCLUSION The World Health Organization dietary evaluation tool suggests that the MDD value be extremely low, even though it might be slightly higher than the numbers for some nations. The country may need to take drastic measures to tackle child malnutrition.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Po. Box: 196, Gondar, Amhara, Ethiopia.
| | - Mahlet Moges Jembere
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Raru TB, Merga BT, Mulatu G, Deressa A, Birhanu A, Negash B, Gamachu M, Regassa LD, Ayana GM, Roba KT. Minimum Dietary Diversity Among Children Aged 6-59 Months in East Africa Countries: A Multilevel Analysis. Int J Public Health 2023; 68:1605807. [PMID: 37325176 PMCID: PMC10267305 DOI: 10.3389/ijph.2023.1605807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Objective: To find out the determinants of minimum dietary diversity (MDD) among under-five children in East Africa based on the 2017 revised indicator. Methods: Secondary data from the demographic and health survey (DHS) of eight countries in East Africa were combined. A total of 27,223 weighted samples of children aged 6-59 months were included. Multi-level logistic regression analysis was employed to identify the determinants of dietary diversity. Results: The magnitude of adequate MDD in East Africa was found to be 10.47% with 95% CI (10.12-10.84) with the lowest and highest magnitude in Ethiopia and Rwanda respectively. Having a mother in the age group of 35-49, having a mother with higher educational attainment, and having a post-natal check-up within 2 months were significant factors in determining adequate MDD. Conclusion: The magnitude of adequate MDD intake among children aged 6-59 months in East Africa is relatively low. Therefore, strengthening interventions focused on improving the economic status of households, the educational status of mothers, and diversified food consumption of children aged 6-59 months should get priority to improve the recommended feeding practice of children.
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Affiliation(s)
- Temam Beshir Raru
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bedasa Taye Merga
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gutema Mulatu
- Department of Environmental Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Alemayehu Deressa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abdi Birhanu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Belay Negash
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mulugeta Gamachu
- School of Medicine, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Departments of Public Health, Rift Valley University, Harar, Ethiopia
| | - Lemma Demissie Regassa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Galana Mamo Ayana
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Paramashanti BA, Dibley MJ, Alam A, Huda TM. Wealth- and education-related inequalities in minimum dietary diversity among Indonesian infants and young children: a decomposition analysis. Glob Health Action 2022; 15:2040152. [PMID: 35389332 PMCID: PMC9004518 DOI: 10.1080/16549716.2022.2040152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Over the last two decades, Indonesia has experienced remarkable economic growth. However, the percentage of infants and young children meeting the minimum dietary diversity (MDD) criteria has stagnated. Despite the growing body of evidence of the association between MDD and socioeconomic factors, there is little information about socioeconomic inequalities in MDD in Indonesia. Objectives The current study seeks to quantify the wealth- and education-related inequalities in MDD among infants and young children in Indonesia and determine the contribution of different factors to these disparities. Methods We included a total of 5038 children aged 6–23 months of the 2017 Indonesia Demographic and Health Survey. We measured wealth- and education-related inequalities using the concentration curve and Wagstaff normalised concentration index. Using a concentration index decomposition analysis, we then examined factors contributing to wealth- and education-related inequalities in MDD. Results The concentration indices by household wealth and maternal education were 0.220 (p < 0.001) and 0.192 (p < 0.001), respectively, indicating more concentration of inequalities among the advantaged population. The decomposition analysis revealed that household wealth (29.8%), antenatal care (ANC) visits (16.6%), paternal occupation (15.1%), and maternal education (11.8%) explained the pro-rich inequalities in MDD in Indonesia. Maternal education (26.1%), household wealth (19.1%), ANC visits (14.9%), and paternal occupation (10.9%) made the most considerable contribution to education-related inequalities in MDD. Conclusions There is substantial wealth- and education-related inequalities in MDD. Our findings suggest an urgent need to address the underlying causes of not reaching dietary diversity by promoting infant and young child feeding equity in Indonesia.
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Affiliation(s)
- Bunga A Paramashanti
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Yunitasari E, Al Faisal AH, Efendi F, Kusumaningrum T, Yunita FC, Chong MC. Factors associated with complementary feeding practices among children aged 6-23 months in Indonesia. BMC Pediatr 2022; 22:727. [PMID: 36539759 PMCID: PMC9769005 DOI: 10.1186/s12887-022-03728-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/31/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Complementary foods with breastfeeding are foods or drinks given to children aged 6-23 months to meet their nutritional needs. The non-optimal provision of complementary feeding influences malnutrition in children of this age. AIMS To analyze the factors associated with complementary feeding practices among children aged 6-23 months in Indonesia. METHODS A cross-sectional design was employed using data from the 2017 Indonesia Demographic and Health Survey. A total of 502,800 mothers with children aged 6-23 months were recruited through multistage cluster sampling. Data were analyzed using a logistic regression test to determine the correlation between predisposing, enabling, and reinforcing factors and complementary feeding practices. RESULTS A prevalence values of analysis showed that approximately 71.14%, 53.95%, and 28.13% of the children met MMF, MMD, and MAD, respectively. The probability of achieving minimum dietary diversity (MDD) was high in the following: children aged 18-23 months (odds ratio [OR] = 9.58; 95% confidence interval [CI] = 7.29-12.58), children of mothers with higher education (OR = 5.95; 95% CI = 2.17-16.34), children from households with upper wealth index (OR = 2.53; 95% CI = 1.85-3.48), children of mothers who received childbirth assistance by professionals (OR = 1.63; 95% CI = 1.20-2.20), and children of mothers who had access to the Internet (OR = 1.26; 95% CI = 1.06-1.50). Moreover, children from households with the upper wealth index (OR = 1.40; 95% CI = 1.03-1.91), children whose mothers were employed (OR = 1.19; 95% CI = 1.02-1.39) living in urban areas (OR = 1.28; 95% CI = 1.06-1.54) and children of mothers who received childbirth assistance by professionals (OR = 1.33; 95% CI = 0.98-1.82) were more likely to meet Minimum Meal Frequency (MMF). Finally, children aged 18-23 months (OR = 2.40; 95% CI = 1.81-3.17), of mothers with higher education (OR = 3.15; 95% CI = 0.94-10.60), from households with upper wealth index (OR = 1.41; 95% CI = 1.05-2.90) and born with professional childbirth assistance (OR = 1.82; 95% CI = 1.21-2.75) were significantly associated with minimum acceptable diet (MAD). CONCLUSIONS The findings revealed that the prevalence of MDD and MAD in Indonesia was low. Strategies such as improving health services, economic conditions, and education level of mothers are needed to improve infant and young child feeding in Indonesia.
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Affiliation(s)
- Esti Yunitasari
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ahmad Hisyam Al Faisal
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ferry Efendi
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Tiyas Kusumaningrum
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Fildzah Cindra Yunita
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Mei Chan Chong
- grid.10347.310000 0001 2308 5949Department of Nursing, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Moga Lencha F, Jebero Zaza Z, Ena Digesa L, Mulatu Ayana T. Minimum dietary diversity and associated factors among children under the age of five attending public health facilities in Wolaita Soddo town, Southern Ethiopia, 2021: a cross-sectional study. BMC Public Health 2022; 22:2368. [PMID: 36527009 PMCID: PMC9758836 DOI: 10.1186/s12889-022-14861-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Poor quality diets are the greatest obstacles to survival, growth, development, and learning in children. Dietary diversity is a major problem in developing countries including Ethiopia. For better feeding practices and focused interventions, it is essential to identify dietary diversity in children. In order to draw firm conclusions, previous studies in Ethiopia were unable to get a thorough picture of the dietary diversity among children under the age of five. Therefore, the purpose of this study was to identify minimum dietary diversity and associated factors among children under the age of five attending public health facilities in Wolaita Soddo town, Southern Ethiopia. METHODS An institution-based cross-sectional study design was used from February to March, 2021. The sample size of the study was 406. A simple random sampling was used to select the study participants. The minimum dietary diversity of the children was assessed by a standardized dietary assessment tool. The information was gathered using a standardized questionnaire that was administered by an interviewer. The collected data were entered into Epi Data 4.6 then exported to SPSS 26 for analysis. A multivariable logistic regression model was used to identify the independent predictors of the study. The statistical significance level was set at P < 0.05, and the degree of the association was measured using an AOR with a 95% CI. RESULTS A total of 399 participants were involved in this study. Nearly half (52.1%) of the study children met the minimum dietary diversity. The most popular foods were grains, roots, and tubers (79.2%), followed by dairy products (58.1%), vitamin A-rich fruits and vegetables, and grains, roots, and tubers (58.1%). Children whose mothers worked as daily workers had a lower likelihood of meeting the minimal dietary diversity requirement. However, children with separate eating plates from adults, households with food security, low monthly food expenditure, collaborative decision-making on household spending, birth intervals greater than 24 months, and health education on infant and young child feeding were more likely to achieve the minimal dietary diversity requirements. CONCLUSION The proportion of the minimum dietary diversity was higher than in previous studies from Ethiopia. The minimum dietary diversity was higher than in previous studies from Ethiopia. Family planning for birth spacing, nutritional counseling on infant and young child feeding, and parent communication in a child's feeding are critical to improve dietary diversity in a child's feeding.
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Affiliation(s)
- Fikre Moga Lencha
- grid.442844.a0000 0000 9126 7261College of Medicine and Health Sciences, Arba Minch University, P.O. Box;21, Arba Minch, Ethiopia
| | - Zenebe Jebero Zaza
- grid.442844.a0000 0000 9126 7261College of Medicine and Health Sciences, Arba Minch University, P.O. Box;21, Arba Minch, Ethiopia
| | - Lankamo Ena Digesa
- grid.442844.a0000 0000 9126 7261College of Medicine and Health Sciences, Arba Minch University, P.O. Box;21, Arba Minch, Ethiopia
| | - Tegegn Mulatu Ayana
- grid.442844.a0000 0000 9126 7261College of Medicine and Health Sciences, Arba Minch University, P.O. Box;21, Arba Minch, Ethiopia
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Kundu S, Das P, Rahman MA, Al Banna MH, Fatema K, Islam MA, Srivastava S, Muhammad T, Dey R, Hossain A. Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis. Sci Rep 2022; 12:21712. [PMID: 36522494 PMCID: PMC9755277 DOI: 10.1038/s41598-022-26305-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.
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Affiliation(s)
- Satyajit Kundu
- grid.443020.10000 0001 2295 3329Global Health Institute, North South University, Dhaka, 1229 Bangladesh ,grid.263826.b0000 0004 1761 0489School of Public Health, Southeast University, Nanjing, 210096 China ,grid.443081.a0000 0004 0489 3643Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Pranta Das
- grid.24434.350000 0004 1937 0060Department of Statistics, University of Nebraska–Lincoln, Lincoln, NE 68583-0963 USA ,grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Ashfikur Rahman
- grid.412118.f0000 0001 0441 1219Development Studies Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Md. Hasan Al Banna
- grid.443081.a0000 0004 0489 3643Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Kaniz Fatema
- grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Akhtarul Islam
- grid.412118.f0000 0001 0441 1219Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, 9208 Bangladesh
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
| | - Rakhi Dey
- grid.472353.40000 0004 4682 8196Department of Statistics, Government Brajalal College, National University of Bangladesh, Gazipur, 1704 Bangladesh
| | - Ahmed Hossain
- grid.412789.10000 0004 4686 5317College of Health Sciences, University of Sharjah, 27272 Sharjah, United Arab Emirates ,grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
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12
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Jalata DD, Asefa BG. Trends and Determinants of Dietary Diversity in Children Aged 6-59 Months in Ethiopia: Analysis of 2005-2016 Demographic and Health Survey. Curr Dev Nutr 2022; 6:nzac135. [PMID: 36475020 PMCID: PMC9718648 DOI: 10.1093/cdn/nzac135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/23/2022] [Accepted: 08/25/2022] [Indexed: 04/22/2024] Open
Abstract
Background Dietary diversity may be associated with health and optimum growth in children. Objectives In this study we analyzed the trends and determinants of minimum dietary diversity (MDD) among Ethiopian children aged 6 to 59 mo. Methods Ethiopian Demographic Health Survey (EDHS) data of 3 consecutive years (2005, 2011, and 2016) were analyzed. A total of n = 2396 (2005), n = 3385 (2011), and n = 3723 (2016) children aged 6 to 59 mo were included for measurement of trends and identification of the determinants of MDD. The associations between the study factors and MDD were investigated using multiple logistic regression analysis. Results The proportion of children who fulfilled the MDD decreased from 2.46% in 2005 to 1.57% in 2011 but sharply increased to 7.82% in 2016. Adjusted regression analysis revealed that exposure of mothers to media, particularly watching television, maternal education, and household wealth were associated with a greater likelihood of mothers providing diversified diets to their children across the 3 y of EDHS data. Conclusions A decrease in MDD was observed from the years 2005 to 2011, after which a sharp increase was noted in 2016. In all 3 y of the EDHS, media exposure, maternal education, and household wealth were the consistent factors positively affecting dietary diversity among children aged 6 to 59 mo. Future intervention programs to increase dietary diversity in children should emphasize improving access to media exposure, education, and antenatal care visits.
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Affiliation(s)
- Dassalegn Daraje Jalata
- Food Science and Nutrition Research Department, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Bezuayehu Gutema Asefa
- Food Science and Nutrition Research Department, National Fishery and Aquatic Life Research Center, Ethiopian Institute of Agricultural Research, Sebeta, Ethiopia
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Ba DM, Ssentongo P, Gao X, Chinchilli VM, Richie JP, Maiga M, Muscat JE. Prevalence and determinants of meeting minimum dietary diversity among children aged 6-23 months in three sub-Saharan African Countries: The Demographic and Health Surveys, 2019-2020. Front Public Health 2022; 10:846049. [PMID: 36081474 PMCID: PMC9445207 DOI: 10.3389/fpubh.2022.846049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 08/08/2022] [Indexed: 01/21/2023] Open
Abstract
Background Dietary diversity is an indicator of nutritional adequacy, which plays a significant role in child growth and development. Lack of adequate nutrition is associated with suboptimal brain development, lower school performance, and increased risk of mortality and chronic diseases. We aimed to determine the prevalence and determinants of meeting minimum dietary diversity (MDD), defined as consuming at least five out of eight basic food groups in the previous 24-h in three sub-Saharan African countries. Methods A weighted population-based cross-sectional study was conducted using the most recent Demographic and Health Surveys (DHS). MDD data were available between 2019 and 2020 for three sub-Saharan African countries (Gambia, Liberia, and Rwanda). The study population included 5,832 children aged 6-23 months. A multivariable logistic regression model was developed to identify independent factors associated with meeting MDD. Results Overall, the weighted prevalence of children who met the MDD was 23.2% (95% CI: 21.7-24.8%), ranging from 8.6% in Liberia to 34.4% in Rwanda. Independent factors associated with meeting MDD were: age of the child (OR) = 1.96, 95% CI: 1.61, 2.39 for 12-17 months vs. 6-11 months], mothers from highest households' wealth status (OR = 1.86, 95% CI: 1.45-2.39) compared with the lowest, and mothers with secondary/higher education (OR = 1.69, 95% CI: 1.35-2.12) compared with those with no education. Mothers who were employed, had access to a radio, and those who visited a healthcare facility in the last 12 months were more likely to meet the MDD. There was no significant association between the child's sex and the odds of fulfilling the MDD. Conclusions There is substantial heterogeneity in the prevalence of MDD in these three sub-Saharan African countries. Lack of food availability or affordability may play a significant role in the low prevalence of MDD. The present analysis suggests that policies that will effectively increase the prevalence of meeting MDD should target poor households with appropriate materials or financial assistance and mothers with lower literacy. Public health interventions working with sectors such as education and radio stations to promote health education about the benefits of diverse diets is a critical step toward improving MDD in sub-Saharan Africa and preventing undernutrition.
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Affiliation(s)
- Djibril M. Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States,*Correspondence: Djibril M. Ba
| | - Paddy Ssentongo
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Xiang Gao
- Department of Nutritional Sciences, Penn State University, State College, PA, United States,Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China
| | - Vernon M. Chinchilli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - John P. Richie
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
| | - Mamoudou Maiga
- Northwestern University, Department of Biomedical Engineering, Evanston, IL, United States
| | - Joshua E. Muscat
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States
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Demsash AW, Chereka AA, Kassie SY, Donacho DO, Ngusie HS, Tegegne MD, Melaku MS, Wubante SM, Hunde MK. Spatial distribution of vitamin A rich foods intake and associated factors among children aged 6-23 months in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey. BMC Nutr 2022; 8:77. [PMID: 35953835 PMCID: PMC9367059 DOI: 10.1186/s40795-022-00573-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 07/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background Inadequate micronutrients in the diet and vitamin A deficiency are worldwide public health problems. In developing regions, many preschool children are undernourished, become blind every year and died before the age of 23 months. This study was aimed to explore the spatial distribution of vitamin A rich foods intake among children aged 6–23 months and identify associated factors in Ethiopia. Methods Ethiopian Mini Demographic and Health Survey 2019 dataset with a total 1407 children aged 6–23 months was used. Data management and processing were done using STATA version 15 software and Microsoft Office Excel. ArcMap version 10.7 software was used for mapping and spatial visualization of the distribution. Spatial scan statistics was performed using SaTScan version 9.5 software for Bernoulli-based model. Multilevel mixed effect logistic regression model was employed to identify associated factors. Results Overall, 38.99% (95% CI: 36.46–41.62) of children aged 6– 23 months took vitamin A rich foods. Poor intake of vitamin A rich foods was significantly clustered Dire Dawa city, Somali and Harari regions of Ethiopia. Children aged 6–23 months lived in the primary cluster were 70% (RR = 1.70, P-value < 0.001) more likely to intake vitamin A rich foods than children lived outside the window. In the multilevel mixed effect logistic regression analysis, Primary educational status (AOR:1.42, 95% CI: 1.05, 1.93) and higher educational status (AOR:3.0, 95% CI: 1.59, 5.65) of mother, Dire Dawa (AOR:0.49, 95% CI: 0.22, 1.12) city, Afar (AOR: 0.16, 95% CI: 0.07, 0.36), Amhara (AOR: 0.37, 95% CI: 0.19, 0.71) and Somali (AOR: 0.02, 95% CI: 0.003, 0.08) regions of Ethiopia, children aged 13–23 months (AOR: 1.80, 95% CI: 1.28, 2.36), Mothers’ exposure to media (AOR: 1.41, 95% CI: 1.04, 1.92) were statistically significant factors for vitamin A rich foods intake among children aged 6–23 months. Conclusions Only 4 out of ten children took vitamin A rich foods which is too low compared to the national target and significantly clustered in Ethiopia. Mother’s educational status, Region, Child age and Mother’s media exposure are significant factors vitamin A rich foods intake. Stakeholders should strengthen mothers’ education status, creating awareness for mothers on child feeding and using locally available natural resource to produce vitamin A rich foods.
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Affiliation(s)
| | - Alex Ayenew Chereka
- Health Informatics Department, College of Health Science, Mattu University, Mettu, Ethiopia
| | - Sisay Yitayih Kassie
- Health Informatics Department, College of Health Science, Mattu University, Mettu, Ethiopia
| | - Dereje Oljira Donacho
- Health Informatics Department, College of Health Science, Mattu University, Mettu, Ethiopia
| | - Habtamu Setegn Ngusie
- Health Informatics Department, College of Health Science, Mattu University, Mettu, Ethiopia
| | - Masresha Derese Tegegne
- Health Informatics Department, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mequannent Sharew Melaku
- Health Informatics Department, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Health Informatics Department, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Mekonnen Kenate Hunde
- Lifelong Learning and Community Development Department, College of Education and Behavioral Scieence , Mattu University, Mettu, Ethiopia
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Belay DG, Aragaw FM, Teklu RE, Fetene SM, Negash WD, Asmamaw DB, Fentie EA, Alemu TG, Eshetu HB, Shewarega ES. Determinants of Inadequate Minimum Dietary Diversity Intake Among Children Aged 6-23 Months in Sub-Saharan Africa: Pooled Prevalence and Multilevel Analysis of Demographic and Health Survey in 33 Sub-Saharan African Countries. Front Nutr 2022; 9:894552. [PMID: 35845763 PMCID: PMC9284213 DOI: 10.3389/fnut.2022.894552] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Inappropriate feeding practices result in significant threats to child health by impaired cognitive development, compromised educational achievement, and low economic productivity, which becomes difficult to reverse later in life. There is minimal evidence that shows the burden and determining factors of inadequate dietary intake among children aged under 2 years in sub-Saharan African (SSA) countries. Therefore, this study aimed to assess the pooled magnitude, wealth-related inequalities, and other determinants of inadequate minimum dietary diversity (MDD) intake among children aged 6-23 months in the SSA countries using the recent 2010-2020 DHS data. Methods A total of 77,887 weighted samples from Demographic and Health Survey datasets of the SSA countries were used for this study. The Microsoft Excel and STATA version 16 software were used to clean, extract, and analyze the data. A multilevel binary logistic regression model was fitted. The concentration index and curve were applied to examine wealth-related inequalities in the outcomes. P-value < 0.05 with 95% CI was taken to declare statistical significance. Results The pooled magnitude of inadequate MDD intake among children aged 6-23 months in SSA was 76.53% (95% CI: 73.37, 79.70), ranging from 50.5% in South Africa to 94.40% in Burkina Faso. Individual-level factors such as women having secondary and above education (AOR = 0.66; 95% CI; 0.62, 0.70), being employed (AOR = 0.76; 95% CI; 0.72, 0.79), having household media exposure (AOR = 0.69; 95% CI; 0.66, 0.72), richest wealth (AOR = 0.46; 95% CI; 0.43, 0.50), having health institution delivery (AOR = 0.87;95% CI; 0.83, 0.91), and community-level factor such as living in upper middle-income country (AOR = 0.42; 95% CI; 0.38, 0.46) had a significant protective association, whereas rural residence (AOR = 1.29; 95% CI; 1.23, 1.36) has a significant positive association with inadequate MDD intake among children aged 6-23 months. Inadequate MDD intake among children aged 6-23 months in SSA was disproportionately concentrated on the poor households (pro-poor) (C = -0.24; 95% CI: -0.22, -0.0.26). Conclusion and Recommendations There is a high magnitude of inadequate minimum dietary diversity intake among children aged 6-23 months in SSA. Variables such as secondary and above maternal education, having an employed mother, having exposure to media, richest wealth, having health institution delivery, and living in the upper middle-income country have a significant negative association, whereas living in rural residence has a significant positive association with inadequate MDD intake. These findings highlight that to increase the MDD intake in the region, policy makers and other stakeholders need to give prior attention to enhancing household wealth status, empowering women, and media exposure.
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Affiliation(s)
- Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rediet Eristu Teklu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Samrawit Mihret Fetene
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Habitu Birhan Eshetu
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ever Siyoum Shewarega
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alemu TG, Techane MA, Wubneh CA, Assimamaw NT, Belay GM, Tamir TT, Muhye AB, Kassie DG, Wondim A, Terefe B, Tarekegn BT, Ali MS, Fentie B, Gonete AT, Tekeba B, Kassa SF, Desta BK, Ayele AD, Dessie MT, Atalell KA. Spatial variation and determinates of dietary diversity among children aged 6-23 months in Ethiopia: spatial and multilevel analysis using Ethiopian Demography Health Survey (EDHS) 2019. Arch Public Health 2022; 80:152. [PMID: 35668474 PMCID: PMC9169324 DOI: 10.1186/s13690-022-00905-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 05/22/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Minimum dietary diversity is the consumption of five or more food groups from the eight World Health Organization recommended food groups. Adequately diversified diet, in terms of amount and composition, is critical for optimal growth, development, and long-term health outcomes in the first 2 years. Understanding the regional variation of dietary diversity and the underlying factors is crucial for developing and implementing interventions. However, the use of spatial approaches in dietary studies has not been widely established. Therefore, this study aimed to explore the spatial patterns and determinates of minimum dietary diversity practice among 6-23 months children in Ethiopia. METHODS Secondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 1578 children aged 6-23 months was included for this study. The Global Moran's I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariable multilevel logistic regression was used for factor analyses. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association. RESULTS Overall, 87.4% (95% CI: 85.7 to 88.9%) of children in 2019 had inadequate Minimum dietary diversity. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) notably observed in Somali, Afar, Eastern and western Amhara, western Tigray, Benishangul, and Northeastern and western parts of the southern nations, nationality and peoples' regions. Inadequate dietary diversity was significantly higher among young children, uneducated mother, married women, younger mother, no postnatal check, community with higher level of poverty and community level uneducated woman. CONCLUSION According to the findings of this study inadequate Minimum dietary diversity for children as measured by World Health Organization dietary assessment shows high. Children's dietary diversity was distributed non-randomly in different districts across Ethiopia's regions. The findings of the study provided critical evidence about dietary diversity and associated factors. Hence, policy should focused on improve education status of Mother, boosting economic status of the community, increased maternal continuum of care and focused on young children nutrition may advance dietary diversity.
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Affiliation(s)
- Tewodros Getaneh Alemu
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masresha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chalachew Adugna Wubneh
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getaneh Mulualem Belay
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Addis Bilal Muhye
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Destaye Guadie Kassie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Wondim
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bethelihem Tigabu Tarekegn
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Beletech Fentie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Selam Fisiha Kassa
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bogale Kassahun Desta
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Demsie Ayele
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tilahun Dessie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kendalem Asmare Atalell
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Molla W, Adem DA, Tilahun R, Shumye S, Kabthymer RH, Kebede D, Mengistu N, Ayele GM, Assefa DG. Dietary diversity and associated factors among children (6-23 months) in Gedeo zone, Ethiopia: cross - sectional study. Ital J Pediatr 2021; 47:233. [PMID: 34895268 PMCID: PMC8665621 DOI: 10.1186/s13052-021-01181-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/08/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Different foods and food groups are good sources for various macro- and micronutrients. Diversified diet play an important role in both physical and mental growth and development of children. However, meeting minimum standards of dietary diversity for children is a challenge in many developing countries including Ethiopia. OBJECTIVE To assess dietary diversity and associated factors among children (6-23 months) in Gedieo Zone, Ethiopia. METHOD Community based cross-sectional study was carried out at Gedieo Zone, Ethiopia, from January to March 15, 2019. Multi-stage sampling technique was used to get a total of 665 children with the age of between 6 and 23 months from their kebeles. Data was collected by using face-to-face interview with structured questionnaire. Data was entered into Epidata version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for analyses. Variables having p < 0.25 at bivariate analysis were fitted to multivariable analysis. Multivariable logistic regression model was used at 95% confidence interval and with P-Value < 0.05. Bivariate. RESULT A total of 665 children were participated with response rate of 96.2%. Only 199(29.9%) of children were met the minimum requirements for dietary diversity. Age of children [AOR 4.237(1.743-10.295))], Educational status [AOR 2.864(1.156-7.094)], Number of families [AOR 2.865(1.776-4.619))] and household wealth index [AOR4.390(2.300-8.380)] were significantly associated with Dietary Diversity of children. CONCLUSION Only, one out of four children aged of 6-23 months attained the minimum dietary diversity score. Children from low socioeconomic status and mothers with no formal educational attainment need special attention to improve the practice of appropriate feeding of children.
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Affiliation(s)
| | | | - Ruth Tilahun
- Department of Midwifery, Dilla University, Dilla, Ethiopia
| | - Seid Shumye
- Department of Psychiatry, Dilla University, Dilla, Ethiopia
| | | | - Daniel Kebede
- Department of Midwifery, Dilla University, Dilla, Ethiopia
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Paramashanti BA, Huda TM, Alam A, Dibley MJ. Trends and determinants of minimum dietary diversity among children aged 6-23 months: a pooled analysis of Indonesia Demographic and Health Surveys from 2007 to 2017. Public Health Nutr 2021; 25:1-12. [PMID: 34743776 PMCID: PMC9991623 DOI: 10.1017/s1368980021004559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 09/22/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine minimum dietary diversity (MDD) trends and determinants among children aged 6-23 months. DESIGN Secondary analysis of the Indonesia Demographic and Health Surveys (IDHS) between 2007 and 2017. The primary outcome was MDD, the consumption of at least five out of eight food groups (MDD-8). We included a total of 5015 (IDHS 2007), 5050 (IDHS 2007) and 4925 (IDHS 2017) children aged 6 to 23 months to estimate trends of MDD-8 and to identify factors associated with MDD-8. We used multiple logistic regression analysis adjusted for the complex sampling design to investigate the association between the study factors and MDD-8. SETTING Indonesia. PARTICIPANT A total of 14 990 children aged 6-23 months. RESULTS Over the 10 years, the percentage of children who consumed a diversified diet was 53·1 % in 2007, 51·7 % in 2012 and 53·7 % in 2017. Multivariate analyses showed that older age children, higher maternal education, maternal weekly access to media, paternal non-agricultural occupation, history of at least four antenatal care visits and wealthier households were associated with the increased odds of MDD-8. Children living in rural areas, Sulawesi and Eastern Indonesia, were less likely to eat a diversified diet. CONCLUSIONS The proportion of children meeting MDD-8 has stagnated in the last decade. Child, parental, health care, household and community factors are associated with MDD-8. Therefore, nutrition education programmes and behaviour change communication activities should target mothers and families from socio-economically and geographically disadvantaged populations.
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Affiliation(s)
- Bunga A Paramashanti
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
- Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta55183, Indonesia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
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Infant and Young Child Feeding Practices among Adolescent Mothers and Associated Factors in India. Nutrients 2021; 13:nu13072376. [PMID: 34371886 PMCID: PMC8308797 DOI: 10.3390/nu13072376] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022] Open
Abstract
Adequate infant and young child feeding (IYCF) improve child survival and growth. Globally, about 18 million babies are born to mothers aged 18 years or less and have a higher likelihood of adverse birth outcomes in India due to insufficient knowledge of child growth. This paper examined factors associated with IYCF practices among adolescent Indian mothers. This cross-sectional study extracted data on 5148 children aged 0–23 months from the 2015–2016 India National Family Health Survey. Survey logistic regression was used to assess factors associated with IYCF among adolescent mothers. Prevalence of exclusive breastfeeding, early initiation of breastfeeding, timely introduction of complementary feeding, minimum dietary diversity, minimum meal frequency, and minimum acceptable diet rates were: 58.7%, 43.8%, 43.3%, 16.6%, 27.4% and 6.8%, respectively. Maternal education, mode of delivery, frequency of antenatal care (ANC) clinic visits, geographical region, child’s age, and household wealth were the main factors associated with breastfeeding practices while maternal education, maternal marital status, child’s age, frequency of ANC clinic visits, geographical region, and household wealth were factors associated with complementary feeding practices. IYCF practices among adolescent mothers are suboptimal except for breastfeeding. Health and nutritional support interventions should address the factors for these indicators among adolescent mothers in India.
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