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Derseh NM, Shewaye DA, Agimas MC, Alemayehu MA, Aragaw FM. Spatial variation and determinants of inappropriate complementary feeding practice and its effect on the undernutrition of infants and young children aged 6 to 23 months in Ethiopia by using the Ethiopian Mini-demographic and health survey, 2019: spatial and multilevel analysis. Front Public Health 2023; 11:1158397. [PMID: 37965505 PMCID: PMC10642280 DOI: 10.3389/fpubh.2023.1158397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 09/29/2023] [Indexed: 11/16/2023] Open
Abstract
Background Inappropriate complementary feeding practices (IACFPs) are major public health issues in Ethiopia, which usually result in stunting and becoming an intergenerational cycle. However, the spatial patterns and determinants of IACFP and its effect on undernutrition are not well understood in Ethiopia. Therefore, the aim of this study was to explore the spatial patterns and determinants of IACFPs and their effects on the undernutrition of infants and young children (IYC) in Ethiopia. Methods This was a nationwide community-based survey study among 1,463 mothers of IYC aged 6-23 months in Ethiopia. The global spatial autocorrelation was assessed using the global Moran's-I to evaluate the spatial clustering of IACFPs. Significant clusters with high and low rates of IACFPs were explored. A multilevel mixed-effect logistic regression with cluster-level random effects was fitted to identify determinants of IACFPs with an AOR and 95% CI. Results The prevalence of IACFPs was 90.22%. The spatial pattern of IACFP in Ethiopia was clustered across regions (Global Moran's I = 0.63, Z-score = 12.77, value of p ≤0.001). Clusters with a high rate of IACFP were detected in southern, northwest, and eastern Ethiopia. Individual and community-level variables accounted for 63% of IACFP variation. Mothers with no education were 3.97 times (AOR = 3.97; 95% CI: 1.64-9.60) more likely to have IACFPs than those with higher education. The poorest HHs had 4.80 times the odds of having IACFPs as the richest HHs (AOR = 4.80, 95% CI: 1.23-18.71). The odds of having IACFPs were 2.18 times (AOR = 2.18; 95% CI: 1.28-3.72) higher among babies with no postnatal checkup. Non-breastfed IYC were 2.8 times (AOR = 2.80; 95% CI: 1.29-6.10) more likely to have IACFP when compared with breastfed ones. IYC with the inadequate introduction of solid, semi-solid, and soft foods, inadequate minimum dietary diversity, and inadequate minimum acceptable diet were more likely to have wasting, underweight, and stunting. Conclusion This study showed the prevalence of IACFPs was very high, which had an effect on undernutrition and showed spatial variation in Ethiopia. Therefore, the government of Ethiopia and stakeholders should focus on women with no education and the poorest HHs, encourage PNC checkups, and encourage breastfeeding in the hotspot areas to minimize IACFPs in Ethiopia.
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Affiliation(s)
- Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gilano G, Sako S, Gilano K. Determinants of timely initiation of complementary feeding among children aged 6-23 months in Ethiopia. Sci Rep 2022; 12:19069. [PMID: 36351974 PMCID: PMC9646799 DOI: 10.1038/s41598-022-21992-w] [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: 04/20/2022] [Accepted: 10/07/2022] [Indexed: 11/11/2022] Open
Abstract
Introducing complementary feeding either early or later than 6 months is associated with future negative health outcomes. However, many women in Ethiopia do not follow WHO standard time to feed their children, which might be due to various demographic, economic, access, and availability of services. Thus, we aimed to identify factors attributing to the problems to assist future interventions. We used cross-sectional EMDHS 2019 for this analysis. We cleaned the data and 4061 women with under 2 years children were identified. We applied multilevel binary logistic regression in Stata v.15. Model comparison was based on log-likelihood ratio, deviance, and other criteria. We presented data using mean, percent, 95% CI, and adjusted odds ratio (AOR). The timely complementary feeding was 36.44% (34.93-37.92%). Factors like preceding birth intervals (AOR = 1.97 95% CI 1.62-1.39), primary education (AOR = 2.26 95% CI 1.40-3.62), secondary above education (AOR = 1.62 95% CI 1.10-2.38), and rich wealth index (AOR = 1.25 95% CI 1.03-1.52) were some of the associated factors. The magnitude of timely initiation of complementary feeding was diminutive. Authors suggest that interventions considering maternal education, empowering mothers economically, equity access to health services, and birth planning a good remedy.
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Affiliation(s)
- Girma Gilano
- grid.442844.a0000 0000 9126 7261Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Sewunet Sako
- grid.442844.a0000 0000 9126 7261Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Kasarto Gilano
- Department of Public Health, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
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Saleem A, Ikram A, Dikareva E, Lahtinen E, Matharu D, Pajari AM, de Vos WM, Hasan F, Salonen A, Jian C. Unique Pakistani gut microbiota highlights population-specific microbiota signatures of type 2 diabetes mellitus. Gut Microbes 2022; 14:2142009. [PMID: 36322821 PMCID: PMC9635555 DOI: 10.1080/19490976.2022.2142009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Biogeographic variations in the gut microbiota are pivotal to understanding the global pattern of host-microbiota interactions in prevalent lifestyle-related diseases. Pakistani adults, having an exceptionally high prevalence of type 2 diabetes mellitus (T2D), are one of the most understudied populations in microbiota research to date. The aim of the present study is to examine the gut microbiota across individuals from Pakistan and other populations of non-industrialized and industrialized lifestyles with a focus on T2D. The fecal samples from 94 urban-dwelling Pakistani adults with and without T2D were profiled by bacterial 16S ribosomal RNA gene and fungal internal transcribed spacer (ITS) region amplicon sequencing and eubacterial qPCR, and plasma samples quantified for circulating levels of lipopolysaccharide-binding protein (LBP) and the activation ability of Toll-like receptor (TLR)-signaling. Publicly available datasets generated with comparable molecular methods were retrieved for comparative analysis of the bacterial microbiota. Overall, urbanized Pakistanis' gut microbiota was similar to that of transitional or non-industrialized populations, depleted in Akkermansiaceae and enriched in Prevotellaceae (dominated by the non-Westernized clades of Prevotella copri). The relatively high proportion of Atopobiaceae appeared to be a unique characteristic of the Pakistani gut microbiota. The Pakistanis with T2D had elevated levels of LBP and TLR-signaling in circulation as well as gut microbial signatures atypical of other populations, e.g., increased relative abundance of Libanicoccus/Parolsenella, limiting the inter-population extrapolation of gut microbiota-based classifiers for T2D. Taken together, our findings call for a more global representation of understudied populations to extend the applicability of microbiota-based diagnostics and therapeutics.
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Affiliation(s)
- Afshan Saleem
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan,Department of Microbiology, Faculty of Basic and Applied Sciences, University of Haripur, Haripur, Pakistan
| | - Aamer Ikram
- Department of Virology, National Institute of Health, Islamabad, Pakistan
| | - Evgenia Dikareva
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Emilia Lahtinen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Dollwin Matharu
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anne-Maria Pajari
- Department of Food and Nutrition, University of Helsinki, Helsinki, Finland
| | - Willem M. de Vos
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland,Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Fariha Hasan
- Department of Microbiology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Anne Salonen
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Ching Jian
- Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland,CONTACT Ching Jian Haartmaninkatu 3, PO box 21, FI-00014Helsinki, Finland
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Manikam L, Allaham S, Demel I, Bello UA, Naman M, Heys M, Batura N, Llewellyn C, Hayward A, Lakshman R, Gilmour J, Webb Martin K, Irish C, Edwards C, Archibong M, Clarkson C, Marsh M, Delceta D, Nutkins A, Islam L, Bajwa S, Malek S, Bhachu J, Pushpakanthan G, Lakhanpaul M. Developing a community facilitator-led participatory learning and action women's group intervention to improve infant feeding, care and dental hygiene practices in South Asian infants: NEON programme. Health Expect 2022; 25:2416-2430. [PMID: 35894769 PMCID: PMC9615055 DOI: 10.1111/hex.13557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/19/2022] [Accepted: 06/01/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION The Nurture Early for Optimal Nutrition (NEON) study is a multiphase project that aims to optimize feeding, care and dental hygiene practices in South Asian children <2 years in East London, United Kingdom. The multiphase project uses a participatory learning and action (PLA) approach facilitated by a multilingual community facilitator. In this paper, we elaborate on the process and results of the Intervention Development Phase in the context of the wider NEON programme. METHODS Qualitative community-based participatory intervention codevelopment and adaptation. SETTING Community centres in East London and online (Zoom) meetings and workshops. PARTICIPANTS In total, 32 participants registered to participate in the Intervention Development Phase. Four Intervention Development workshops were held, attended by 25, 17, 20 and 20 participants, respectively. RESULTS Collaboratively, a culturally sensitive NEON intervention package was developed consisting of (1) PLA group facilitator manual, (2) picture cards detailing recommended and nonrecommended feeding, care and dental hygiene practices with facilitators/barriers to uptake as well as solutions to address these, (3) healthy infant cultural recipes, (4) participatory Community Asset Maps and (5) list of resources and services supporting infant feeding, care and dental hygiene practices. CONCLUSION The Intervention Development Phase of the NEON programme demonstrates the value of a collaborative approach between researchers, community facilitators and the target population when developing public health interventions. We recommend that interventions to promote infant feeding, care and dental hygiene practices should be codeveloped with communities. Recognizing and taking into account both social and cultural norms may be of particular value for infants from ethnically diverse communities to develop interventions that are both effective in and accepted by these communities. PATIENT AND PUBLIC INVOLVEMENT AND ENGAGEMENT Considerable efforts were placed on Patient/Participant and Public Involvement and Engagement. Five community facilitators were identified, each of which represented one ethnic/language group: (i) Bangladeshi/Bengali and Sylheti, (ii) Pakistani/Urdu, (iii) Indian/Gujrati, (iv) Indian/Punjabi and (v) Sri Lankan/Tamil. The community facilitators were engaged in every step of the study, from the initial drafting of the protocol and study design to the Intervention Development and refinement of the NEON toolkit, as well as the publication and dissemination of the study findings. More specifically, their role in the Intervention Development Phase of the NEON programme was to: 1. Support the development of the study protocol, information sheets and ethics application. 2. Ensure any documents intended for community members are clear, appropriate and sensitively worded. 3. Develop strategies to troubleshoot any logistical challenges of project delivery, for example, recruitment shortfalls. 4. Contribute to the writing of academic papers, in particular reviewing and revising drafts. 5. Develop plain language summaries and assist in dissemination activities, for example, updates on relevant websites. 6. Contribute to the development of the NEON intervention toolkit and recruitment of the community members. 7. Attend and contribute to Intervention Development workshops, ensuring the participant's voices were the focus of the discussion and workshop outcomes.
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Affiliation(s)
- Logan Manikam
- Department of Epidemiology and Public HealthUniversity College London Institute of Epidemiology and Health CareLondonUK
- Aceso Global Health Consultants LimitedLondonUK
| | - Shereen Allaham
- Department of Epidemiology and Public HealthUniversity College London Institute of Epidemiology and Health CareLondonUK
- Aceso Global Health Consultants LimitedLondonUK
| | - Isabel‐Catherine Demel
- Aceso Global Health Consultants LimitedLondonUK
- Department of Life Sciences and MedicineKing's College London GKT School of Medical EducationLondonUK
| | | | | | - Michelle Heys
- Specialist Children and Young People's ServicesEast London NHS Foundation TrustLondonUK
- Population, Policy and PracticeUCL Great Ormond Street Institute of Child HealthLondonUK
| | - Neha Batura
- Institute for Global HealthUniversity College LondonLondonUK
| | - Clare Llewellyn
- Department of Behavioural Sciences and HealthUniversity College LondonLondonUK
| | - Andrew Hayward
- Department of Epidemiology and Public HealthUniversity College London Institute of Epidemiology and Health CareLondonUK
| | | | - Jenny Gilmour
- Tower Hamlets GP Care GroupMile End HospitalLondonUK
| | | | - Carol Irish
- Children's Health 0‐19 ServiceLondon Borough of NewhamLondonUK
| | - Chanel Edwards
- Children's Health 0‐19 ServiceLondon Borough of NewhamLondonUK
| | - Mfon Archibong
- Children's Health 0‐19 ServiceLondon Borough of NewhamLondonUK
| | | | | | | | | | - Lily Islam
- Tower Hamlets Community FacilitatorLondonUK
| | | | | | | | | | - Monica Lakhanpaul
- Population, Policy and PracticeUCL Great Ormond Street Institute of Child HealthLondonUK
- Whittington Health NHS TrustLondonUK
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Appropriate Complementary Feeding Practice and Its Associated Factors among Mothers Who Have Children Aged between 6 and 24 Months in Ethiopia: Systematic Review and Meta-Analysis. J Nutr Metab 2022; 2022:1548390. [PMID: 36245817 PMCID: PMC9553750 DOI: 10.1155/2022/1548390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/08/2022] [Accepted: 09/06/2022] [Indexed: 11/28/2022] Open
Abstract
Background Appropriate complementary feeding practices prevent malnutrition among children. The proportion and determinant factors of appropriate complementary feeding practices identified by different studies were inconsistent in Ethiopia. Therefore, this systematic review and meta-analysis aimed to assess the pooled proportion and determinants of appropriate complementary feeding practices among mothers. Methods Databases (PubMed, HINARI, Google Scholar, Cochrane Library, and Web of Science) and university repositories were used to search for important articles. A critical appraisal of the studies was conducted. Data analysis was conducted using STATA version 11. Cochran (Q test) and I2 test were used to test the heterogeneity of the studies. Publication bias was checked using the funnel plot for asymmetry and Egger's regression test. Results Seventeen primary studies with a total sample size of 9166 mothers were involved in this study. The pooled proportion of appropriate complementary feeding practices among mothers who had infants and young children aged between 6 and 24 months was 21.77 (with a 95% CI: 14.07–29.48). Mothers' educational status of secondary school and above (OR = 3.36 with a 95% CI: 3.03–3.69), having repeated antenatal care visits (OR = 4.77 with a 95% CI: 3.49–6.05), child's age between 12 and 24 months (OR = 3.7 with a 95% CI: 2.75–4.65), having repeated postnatal care visits (OR = 3.17 with a 95% CI: 1.96–4.38), health education (OR = 4.88 with a 95% CI: 3.86–5.9), knowledge of mothers (OR = 4.85 with a 95% CI: 3.77–5.93), maternal age between 18 and 35 years (AOR = 2.67 with a 95% CI: 1.64–3.72), institutional delivery (OR = 2.23 with a 95% CI: 1.79–2.68), and higher household wealth (OR = 2.65 with a 95% CI: 1.46–3.84) were found to be statistically significant associated factors of appropriate complementary feeding practices among mothers. Conclusions The pooled proportion of appropriate complementary feeding practices was low in Ethiopia. Knowledge of mothers and maternal health service uptake such as antenatal care, postnatal care, and institutional delivery increase appropriate complementary feeding practices. More focus is required for mothers who have children aged less than 12 months, mothers aged above 35 years and less than 18 years, lower mothers' educational status, and lower household wealth. Therefore, integrated interventions are still required to improve appropriate complementary feeding practices.
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Wanda D, Astuti A, Utami AR, Lita BFF. Community lifestyle influences feeding practices among Indonesian infants and young children. ENFERMERIA CLINICA (ENGLISH EDITION) 2022; 32 Suppl 1:S46-S53. [PMID: 35688567 DOI: 10.1016/j.enfcle.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/30/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To analyze the feeding practices of malnourished infants and young children aged 6-24 months old in Bogor, West Java, Indonesia. METHOD Fourteen mothers or caregivers who had malnourished infants and young children aged 6-24 months were interviewed, focusing on their feeding practices. Informants came from sub-districts in Bogor Regency, Indonesia, which had a higher incidence of malnutrition. The interview process was recorded. Verbatim transcripts of recorded interviews were analyzed using thematic analysis. RESULTS Five major themes were identified: (1) Inappropriate practice of early initiation of breastfeeding, (2) Challenges in decision making to maintain breastfeeding, (3) Lack of complementary feeding practices, (4) Failing to follow feeding recommendations, and (5) Infant and young child feeding constraints. CONCLUSION The feeding practice for malnourished infants and young children is not entirely based on the recommended standards. This situation is caused by several factors such as economic conditions, culture, parental knowledge, family and community health workers' support. Health workers need to provide comprehensive intervention for mothers and families intensively by taking into account the culture and conditions of the related family.
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Affiliation(s)
- Dessie Wanda
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia.
| | - Astuti Astuti
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
| | - Ayuni Rizka Utami
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
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Between and Within-Country Variations in Infant and Young Child Feeding Practices in South Asia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074350. [PMID: 35410032 PMCID: PMC8998566 DOI: 10.3390/ijerph19074350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/13/2022] [Accepted: 03/22/2022] [Indexed: 11/16/2022]
Abstract
This study aimed to explore variations in Infant and Young Child Feeding (IYCF) practices between different South Asian Countries (SACs) and within their sociodemographic characteristics including place of residence, mother age, mother education, child sex, and wealth quintiles within the SACs. We extracted 0–23 months age children’s data from the nationally representative survey of Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan. Among all SACs, the early initiation of breastfeeding (EIBF) practice was 45.4% with the highest prevalence in the Maldives (68.2%) and the lowest prevalence in Pakistan (20.8%). Exclusive breastfeeding (EBF) practice was 53.9% with the highest prevalence in Nepal (67%) and the lowest prevalence in Afghanistan (42%). Only 13% of children had a minimum acceptable diet (MAD), with the highest prevalence in the Maldives (52%) and the lowest prevalence in India (11%). We found higher IYCF practices among the mothers with secondary or higher levels of education (EIBF: 47.0% vs. 43.6%; EBF: 55.5% vs. 52.0%; MAD: 15.3% vs. 10.0%), urban mothers (MAD: 15.6% vs. 11.8%), and mothers from the richest households (MAD: 17.6% vs. 8.6%) compared to the mothers with no formal education or below secondary level education, rural mothers and mothers from the poorest households, respectively. Mothers from the poorest households had better EIBF, EBF, and continued breastfeeding at 1-year (CBF) practices compared to the mothers from the richest households (EIBF: 44.2% vs. 40.7%; EBF: 54.8% vs. 53.0%; CBF: 86.3% vs. 77.8%). Poor IYCF practices were most prevalent in Afghanistan, Pakistan, and India.
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Al-Awwad NJ, Ayoub J, Barham R, Sarhan W, Al-Holy M, Abughoush M, Al-Hourani H, Olaimat A, Al-Jawaldeh A. Review of the Nutrition Situation in Jordan: Trends and Way Forward. Nutrients 2021; 14:135. [PMID: 35011008 PMCID: PMC8746685 DOI: 10.3390/nu14010135] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 12/23/2021] [Accepted: 12/24/2021] [Indexed: 01/22/2023] Open
Abstract
Jordan is witnessing an escalating pace of nutrition transition, which may be associated with an increased burden of malnutrition and related non-communicable diseases. This review analyzes the nutrition situation in Jordan by exploring specific nutrition indicators, namely infant and young child feeding, low birthweight, micronutrient deficiencies, anthropometric indicators, and food consumption patterns. Results showed that although most children were ever breastfed and early initiation of breastfeeding had a two-fold increasing trend, rates of exclusive breastfeeding below 6 months of age and continued breastfeeding until two years of age were low. Complementary feeding indicators, particularly minimum diet diversity and minimum acceptable diet standards, were suboptimal. An overall low burden of stunting, wasting, and underweight among children under 5 years and remarkable progress in optimizing iodine status among school-aged children were reported. Conversely, the burden of low birthweight and overweight/obesity exacerbated, coexisting with anemia, vitamin A deficiency, and vitamin D deficiency. Overall, fruit and vegetable consumption were inadequate. The consumption of soft drinks and salt on the other hand was higher than recommended. This review acknowledges the double burden of malnutrition in Jordan and recommends the prioritization and evaluation of interventions towards improving the population's nutritional status and achieving nutrition targets.
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Affiliation(s)
- Narmeen Jamal Al-Awwad
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Jennifer Ayoub
- Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Rawhieh Barham
- Nutrition Department, Ministry of Health, Amman 11118, Jordan;
| | - Wafaa Sarhan
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid 22110, Jordan;
| | - Murad Al-Holy
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Mahmoud Abughoush
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
- Science of Nutrition and Dietetics Program, College of Pharmacy, Al Ain University, Abu Dhabi 64141, United Arab Emirates
| | - Huda Al-Hourani
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Amin Olaimat
- Department of Clinical Nutrition and Dietetics, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan; (N.J.A.-A.); (M.A.-H.); (M.A.); (H.A.-H.); (A.O.)
| | - Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean, World Health Organization, Cairo 7608, Egypt
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Wanda D, Astuti A, Utami AR, Lita BFF. Community lifestyle influences feeding practices among Indonesian infants and young children. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Shaker‐Berbari L, Qahoush Tyler V, Akik C, Jamaluddine Z, Ghattas H. Predictors of complementary feeding practices among children aged 6-23 months in five countries in the Middle East and North Africa region. MATERNAL & CHILD NUTRITION 2021; 17:e13223. [PMID: 34137179 PMCID: PMC8476411 DOI: 10.1111/mcn.13223] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 05/06/2021] [Accepted: 05/06/2021] [Indexed: 01/13/2023]
Abstract
Ensuring diets of children aged 6-23 months meet recommended guidance is crucial for growth and development and for the prevention of malnutrition including stunting, wasting and micronutrient deficiencies. Despite some improvement, indicators related to undernutrition and overnutrition fall short of global targets in the Middle East and North Africa (MENA) region that consist of low- and middle-income countries witnessing political and social changes and a nutrition transition. This research aims at reviewing the situation related to the diets of children aged 6-23 months in five selected countries in the MENA region, examining factors affecting complementary feeding and providing recommendations for guiding effective strategies to improve it. The study triangulated data on complementary feeding status and predictors from semistructured interviews with 30 key informants, and multivariable analysis of household surveys in Egypt, Jordan, Lebanon, State of Palestine and Sudan including data on refugees in Lebanon and Jordan. There remain considerable gaps in complementary feeding differing noticeably among geographic areas. Findings from qualitative and quantitative analyses showed that maternal factors, including maternal education and age, household level factors such as paternal education and wealth, community-level factors (culture and geographic location), and utilization of health services, were associated with minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) at varied levels in the five countries. Interventions to improve complementary feeding practices should include actions tailored to the needs of the population at multiple levels including at the caregiver's level, household, service use, community and policy level.
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Affiliation(s)
- Linda Shaker‐Berbari
- United Nations Children's Fund (UNICEF) Regional Office for Middle East and East Africa RegionAmmanJordan
| | - Vilma Qahoush Tyler
- United Nations Children's Fund (UNICEF) Regional Office for Middle East and East Africa RegionAmmanJordan
| | - Chaza Akik
- Center for Research on Population and Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
| | - Zeina Jamaluddine
- Center for Research on Population and Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
- London School of Hygiene and Tropical MedicineLondonUK
| | - Hala Ghattas
- Center for Research on Population and Health, Faculty of Health SciencesAmerican University of BeirutBeirutLebanon
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Ahmed KY, Agho KE, Page A, Arora A, Ogbo FA. Interventions to improve infant and young child feeding practices in Ethiopia: a systematic review. BMJ Open 2021; 11:e048700. [PMID: 34400457 PMCID: PMC8370540 DOI: 10.1136/bmjopen-2021-048700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE In Ethiopia, despite the implementation of several interventions to improve infant and young child feeding (IYCF) practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia. SOURCE OF INFORMATION A systematic search was conducted on seven computerised bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies published between the year 2000 and May 2021. STUDY ELIGIBILITY CRITERIA Interventional studies that measured IYCF indicators (early initiation of breast feeding (EIBF), exclusive breast feeding (EBF), the introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet) as outcome variables were included. STUDY APPRAISAL AND SYNTHESIS All included studies were examined for biases related to interventional studies (ie, selection bias, performance bias, attrition bias, detection bias and reporting bias). Author reports of effect size measures were used to narratively report the findings of each study. RESULTS Of the 23 eligible studies, 14 studies were quasi-experimental and 9 studies were cluster randomised trials (CRTs). Eight quasi-experimental studies had a serious risk of bias, while two CRTs had a high risk of bias. Four studies for EBF and six studies for EIBF showed significant impacts of policy advocacy, health service strengthening, interpersonal communication, community mobilisation and mass media campaigns. Six studies for MDD and three studies for MMF indicated significant effects of community-level and health facility complementary feeding promotions on infants and young children. Interventions that delivered in combination increased the impacts in improving EIBF, MDD and MMF compared with a single intervention. CONCLUSION Our review showed that 12 out of 21 eligible studies that implemented in the form of community-level and health facility interventions improved EIBF, EBF, and/or MDD in Ethiopia. PROTOCOL REGISTRATION NUMBER PROSPERO, CRD42020155519.
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Affiliation(s)
- Kedir Y Ahmed
- Department of Public Health, Samara University, Samara, Afar, Ethiopia
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Kingsley Emwinyore Agho
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- School of Health Sciences, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- School of Health Sciences, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- Oral Health Services, Sydney Dental Hospital, Surry Hills, New South Wales, Australia
- Health Equity Laboratory, Campbelltown, New South Wales, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- Barmera Medical Clinic (Lake Bonney Private Medical Clinic), Barmera, South Australia, Australia
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Ali M, Arif M, Shah AA. Complementary feeding practices and associated factors among children aged 6-23 months in Pakistan. PLoS One 2021; 16:e0247602. [PMID: 33630931 PMCID: PMC7906416 DOI: 10.1371/journal.pone.0247602] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/10/2021] [Indexed: 12/03/2022] Open
Abstract
Premature mortality and undernutrition rates in Pakistan are among the highest in the world. Inadequate infant and young child feeding are the major causes of premature mortality and undernutrition. Yet, very little is known about the determinants of complementary feeding practices in Pakistan. Therefore, this study aims to identify the determinants of inadequate complementary feeding practices among children aged 6 to 23 months in Pakistan by using the latest nationally representative data from the Pakistan Demographic and Health Survey (2017–18). The results show that only 12% of children consume a minimum acceptable diet, 21% achieve minimum dietary diversity, and 38% reach minimum meal frequency. Multivariate regression analysis shows that child age, child weight at birth, mother’s access to newspapers/magazines at the individual level, wealth at the household level, and prenatal visits at the community level are significant predictors of complementary feeding practices among children aged 6–23 months in Pakistan. These findings show that, in addition to poverty alleviation, raising awareness through health practitioners, increasing access to media, and expanding access to child and maternal healthcare can improve complementary feeding practices in Pakistan. This consequently reduces premature mortality and undernutrition.
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Affiliation(s)
- Muhammad Ali
- Department of Economics, School of Social Sciences and Humanities, National University of Sciences and Technology, Islamabad, Pakistan
| | - Muhammad Arif
- Department of Mass Communication, School of Social Sciences and Humanities, National University of Sciences and Technology, Islamabad, Pakistan
| | - Ashfaq Ahmad Shah
- School of Management Science and Engineering, Nanjing University of Information Science and Technology (NUIST), Nanjing Jiangsu Province, P. R. China
- * E-mail:
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13
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Abiyu C, Belachew T. Effect of complementary feeding behavior change communication delivered through community-level actors on dietary adequacy of infants in rural communities of West Gojjam Zone, Northwest Ethiopia: A cluster-randomized controlled trial. PLoS One 2020; 15:e0238355. [PMID: 32881945 PMCID: PMC7470293 DOI: 10.1371/journal.pone.0238355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 08/13/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Attaining the recommended level of adequacy of the infant's diet remains a serious challenge in most developing countries. Complementary foods, particularly in developing countries, are inadequate in quality and quantity that can result in adverse health and nutrition consequences in infants. This could be not only because of lack of food but also associated with caregiver's poor knowledge, harmful cultural norms and behaviors on infant feeding. The promotion of optimal complementary feeding through behavior change interventions is a global health priority. However, many of the interventions targeted only mothers/caregivers of infants, and studies that engaged other family members are limited worldwide. Moreover, such interventions are scarce in developing countries, including Ethiopia. This trial aimed to evaluate the effectiveness of complementary feeding behavior change communication delivered through community-level actors on the dietary adequacy of infants. METHODS We conducted a cluster-randomized controlled trial in rural communities of West Gojjam Zone, Northwest Ethiopia. Trial participants in the intervention clusters received complementary feeding behavior change communication for 9 months whereas those in the control clusters received only the usual care. Trained women development army leaders delivered the intervention. A pre-tested, structured interviewer-administered questionnaire was used for data collection. Generalized estimating equations regression analyses adjusted for baseline covariates and clustering were used to test the intervention effects. RESULTS The intervention showed positive statistically significant effects on the consumption of dairy products [RR = 1.8; 95% CI: 1.04-3.13], eggs [RR = 3; 95% CI: 1.35-6.56], vitamin A-rich fruits and vegetables [RR = 2.7; 95% CI: 1.17-6.1], other fruits and vegetables [RR = 5; 95% CI: 2.49-10.58] and animal-source foods [RR = 2; 95% CI: 1.39-2.87]. The proportions of infants who achieved minimum dietary diversity [RR = 3; 95% CI: 1.34, 7.39], minimum meal frequency [RR = 2.4; 95% CI: 1.37-4.29], and minimum acceptable diet [RR = 2.7; 95% CI: 1.13-7.23] were significantly higher in the intervention as compared to control groups. CONCLUSIONS Complementary feeding behavior change communication delivered through community-level actors significantly improved the dietary adequacy of infants. TRIAL REGISTRATION ClinicalTrials.gov, NCT03488680. Registered 5 April 2018- Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03488680.
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Affiliation(s)
- Chalachew Abiyu
- School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tefera Belachew
- Faculty of Public Health, Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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14
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Lakhanpaul M, Benton L, Lloyd-Houldey O, Manikam L, Rosenthal DM, Allaham S, Heys M. Nurture Early for Optimal Nutrition (NEON) programme: qualitative study of drivers of infant feeding and care practices in a British-Bangladeshi population. BMJ Open 2020; 10:e035347. [PMID: 32565459 PMCID: PMC7307527 DOI: 10.1136/bmjopen-2019-035347] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES To explore optimal infant feeding and care practices and their drivers within the British-Bangladeshi population of East London, UK, as an exemplar to inform development of a tailored, coadapted participatory community intervention. DESIGN Qualitative community-based participatory research. SETTING Community and children's centres and National Health Service settings within Tower Hamlets, London, UK. PARTICIPANTS 141 participants completed the community study including: British-Bangladeshi mothers, fathers, grandmothers and grandfathers of infants and young children aged 6-23 months, key informants and lay community members from the British-Bangladeshi population of Tower Hamlets, and health professionals working in Tower Hamlets. RESULTS 141 participants from all settings and generations identified several infant feeding and care practices and wider socioecological factors that could be targeted to optimise nutritional outcomes. Our modifiable infant feeding and care practices were highlighted: untimely introduction of semi and solid foods, overfeeding, prolonged parent-led feeding and feeding to 'fill the belly'. Wider socioecological determinants were highlighted, categorised here as: (1) society and culture (e.g. equating 'chubby baby' to healthy baby), (2) physical and local environment (e.g. fast food outlets, advertising) and (3) information and awareness (e.g. communication with healthcare professionals around cultural norms). CONCLUSIONS Parenting interventions should be codeveloped with communities and tailored to recognise and take account of social and cultural norms and influence from different generations that inform infant feeding and care practices and may be of particular importance for infants from ethnically diverse communities. In addition, UK infant feeding environment requires better regulation of marketing of foods for infants and young children if it is to optimise nutrition in the early years.
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Affiliation(s)
- Monica Lakhanpaul
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
- Whittington Health NHS Trust, London, UK
| | - Lorna Benton
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Oliver Lloyd-Houldey
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Logan Manikam
- Department of Epidemiology and Public Health, University College London Institute of Epidemiology and Health Care, London, UK
- Aceso Global Health Consultants Ltd, London, UK
| | - Diana Margot Rosenthal
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
| | - Shereen Allaham
- Department of Epidemiology and Public Health, University College London Institute of Epidemiology and Health Care, London, UK
- Aceso Global Health Consultants Ltd, London, UK
| | - Michelle Heys
- Population, Policy and Practice, University College London Institute of Child Health, London, UK
- Specialist Children's and Young People's Services, East London NHS Foundation Trust, London, Newham, UK
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Choudhary N, Schuster R, Brewis A, Wutich A. Water insecurity potentially undermines dietary diversity of children aged 6-23 months: Evidence from India. MATERNAL & CHILD NUTRITION 2020; 16:e12929. [PMID: 31999395 PMCID: PMC7083507 DOI: 10.1111/mcn.12929] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 10/17/2019] [Accepted: 11/19/2019] [Indexed: 01/22/2023]
Abstract
Dietary diversity is a crucial pathway to child nutrition; lack of diversity may deprive children of critical macro and micronutrients. Though water along with hygiene and sanitation is a known driver of child undernutrition, a more direct role of household water in shaping dietary diversity remains unexplored. Existing literature provides a sound theoretical basis to expect that water could affect dietary diversity among young children. Here, we test the proposition that suboptimal household access to water and low regional water availability associate with lower dietary diversity among young children. Using the nationally representative 2015-2016 India Demographic and Health Survey data, we conducted a probit analysis on the sample of 69,841 children aged 6-23 months to predict the probability that a child achieves minimum standards of dietary diversity (MDD). After controlling for relevant socioeconomic and gender-related covariates, we found that children in household with suboptimal household water access were two percentage points less likely to achieve MDD, when compared with those from households with optimal water access. Children in high water availability regions had nine percentage points greater probability of achieving MDD compared with children from low water availability regions, accounting for household water access. As dietary diversity is central to nutrition, establishing the role of water access in shaping early childhood dietary diversity broadens the framework on how household material poverty shapes child malnutrition-independent of sanitation and hygiene pathways. This provides additional window for nutrition planning and intervention wherein water-based strategies can be leveraged in multiple ways.
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Affiliation(s)
- Neetu Choudhary
- Center for Global Health, School of Human Evolution and Social ChangeArizona State UniversityTempeArizona
| | - Roseanne Schuster
- Center for Global Health, School of Human Evolution and Social ChangeArizona State UniversityTempeArizona
| | - Alexandra Brewis
- Center for Global Health, School of Human Evolution and Social ChangeArizona State UniversityTempeArizona
| | - Amber Wutich
- Center for Global Health, School of Human Evolution and Social ChangeArizona State UniversityTempeArizona
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Akber S, Mahmood H, Fatima R, Wali A, Alam A, Sheraz SY, Yaqoob A, Najmi H, Abbasi S, Mahmood H, Dibley MJ, Hazir T. Effectiveness of a mobile health intervention on infant and young child feeding among children ≤ 24 months of age in rural Islamabad over six months duration. F1000Res 2019; 8:551. [PMID: 31700614 PMCID: PMC6820820 DOI: 10.12688/f1000research.17037.3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Childhood development is highly influenced by feeding practices at infancy and young age of the children. Unfortunately, according to the National Nutrition Survey (2011), the prevalence of exclusive breastfeeding in Pakistan was 21% at four months, and 13% at six months of age with 51.3% of mothers initiating semisolid foods to their children at the recommended 6-8 months of age. Pakistan Demographic & Health Survey (PDHS 2018) however; indicates that only 48% of infants are exclusively breastfed which has been improved from 38% as reported in the past five years but still more improvement is envisaged. Methods: A quasi-experimental study design was employed for this post-intervention survey assessing effectiveness of mobile health (mhealth) regarding infant & young child feeding (IYCF) among pregnant and lactating mothers in Tarlai, Islamabad from May to June 2018. A total of 135 mothers who were earlier included in the intervention phase were recruited after obtaining verbal & written consent. The data was entered in EpiData (3.1) and analyzed in SPSS version 21. Results: The mean age of these pregnant and lactating mothers was 30.5 years ± 4.5 SD with the majority of mothers in the age group of 25 to 29 years. After intervention, the overall knowledge of mothers regarding IYCF nutrition was raised among 94 mothers (69.6%) as compared to 74 (54.8%) mothers prior to the intervention. Overall attitude regarding IYCF was found to be positive among 86 (63.7%) of the mothers, whereas 88 (65.2%) of the mothers had good IYCF related practices. Conclusion: Our post-intervention survey signifies the effectiveness of mhealth in raising knowledge, attitude, and practices of mothers regarding IYCF in rural Islamabad. However, implementation of mhealth in masses requires future research specifically to address cost-effectiveness of such interventions in maternal & child health programmes.
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Affiliation(s)
- Subhana Akber
- Maternal, Neonatal and Child Health Research Network, Islamabad, Pakistan
| | - Hana Mahmood
- Maternal, Neonatal and Child Health Research Network, Islamabad, Pakistan
| | - Razia Fatima
- National TB Control Programme, Islamabad, Pakistan
| | - Ahmed Wali
- Provincial TB Control Program Balochistan, Quetta, Pakistan
| | - Ashraful Alam
- School of Public Health, University of Sydney, Sydney, Australia
| | | | | | - Hina Najmi
- MNCH, Sukh Initiative, Karachi, Pakistan
| | - Saleem Abbasi
- Maternal, Neonatal and Child Health Research Network, Islamabad, Pakistan
| | - Humaira Mahmood
- Maternal, Neonatal and Child Health Research Network, Islamabad, Pakistan
| | - Michael J Dibley
- School of Public Health, University of Sydney, Sydney, Australia
| | - Tabish Hazir
- Maternal, Neonatal and Child Health Research Network, Islamabad, Pakistan
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Wuneh AG, Ahmed W, Bezabih AM, Reddy PS. Dietary Diversity and Meal Frequency Practices among Children Aged 6-23 Months in Agro Pastoral Communities in Afar Region, Ethiopia: A Cross-sectional Study. Ecol Food Nutr 2019; 58:575-596. [PMID: 31353951 DOI: 10.1080/03670244.2019.1644328] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Inappropriate infant and young child feeding practices in the first two years of life are among the major causes of childhood malnutrition in developing countries, including Ethiopia. Dietary diversity refers to increasing the consumption of a variety of foods across and within the food groups. Therefore, this study aimed to assess the minimum dietary diversity and minimum meal frequency practices among children aged 6-23 months in Agro pastoral communities, Afar Region, Ethiopia.Methods: A community-based cross-sectional study was conducted from December 1-30, 2018. A multi-stage stratified sampling followed by a systematic random sampling technique was used to select participants. An interviewer-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with minimum dietary diversity and meal frequency. The adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals (CI) were computed to see the association between the outcome and independent variables. The statistical significance was declared at p-value <0.05.Results: The proportion of children who met the minimum dietary diversity and meal frequency were 21.8% (95% CI: 19.0%-24.7%) and 43.8% (95% CI: 40.4%-47.2%) respectively. Maternal education (AOR = 2.5, 95% CI = 1.1-5.3 and AOR = 3.9, 95% CI = 1.3-11.5), maternal occupation (AOR = 4.2, 95% CI = 2.3-7.8), sex of child (AOR = 2.6, 95% CI = 1.5-4.5) and history of postnatal care visit (AOR = 1.8, 95% CI = 1.1-3.2) were independently associated with minimum dietary diversity. Similarly, age of child (AOR = 2.8, 95% CI = 1.4-5.5 and AOR = 5.3, 95% CI = 2.3-12.4), sex of child (AOR = 2.6, 95% CI = 1.4-4.6) and history of postnatal care visit (AOR = 2.2, 95% CI = 1.3-3.8) were the factors significantly associated with minimum meal frequency practices.Conclusions: The current study showed that the proportions of children who met the minimum dietary diversity and meal frequency were low. Increasing maternal education, being a housewife, being a male child and attending a postnatal care visit were independently associated with minimum dietary diversity. Likewise, increasing the age of a child, being a male child and attending a postnatal care visit were significantly associated with minimum meal frequency. Improving maternal education and health care utilization, health and nutrition counseling during postnatal care visits are highly recommended to improve infant and young child feeding practices.Abbreviations ANC: Ante Natal Care, DHS: Demographic and Health Surveys, EDHS: Ethiopian Demographic and Health Surveys, RERC: Research and Ethical Review Committee, IYCF: Infant and Young Child Feeding, MDD: Minimum Dietary Diversity, MMF: Minimum Meal Frequency, PNC: Post Natal Care, WHO: World Health Organization.
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Affiliation(s)
- Abel Gebre Wuneh
- Department of Public Health, College of Medical and Health Sciences, Samara University, Semera, Ethiopia
| | - Woisa Ahmed
- Department of Public Health, WHO-Ethiopia: Afar Region Branch Office, Semera, Ethiopia
| | | | - P Surender Reddy
- Department of Public Health, College of Medical and Health Sciences, Samara University, Semera, Ethiopia
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Manikam L, Lingam R, Lever I, Alexander EC, Amadi C, Milner Y, Shafi T, Stephenson L, Ahmed S, Lakhanpaul M. Complementary Feeding Practices for South Asian Young Children Living in High-Income Countries: A Systematic Review. Nutrients 2018; 10:E1676. [PMID: 30400582 PMCID: PMC6266308 DOI: 10.3390/nu10111676] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/25/2018] [Accepted: 11/03/2018] [Indexed: 01/13/2023] Open
Abstract
Sub-optimal nutrition among South Asian (SA) children living in high-income countries is a significant problem. High rates of obesity have been observed in this population, and differential complementary feeding practices (CFP) have been highlighted as a key influence. Our aim was to undertake a systematic review of studies assessing CFP in children under two years of age from SA communities living in high-income countries, including dietary diversity, timing, frequency and promotors/barriers. Searches covered January 1990⁻July 2018 using MEDLINE, EMBASE, Global Health, Web of Science, BanglaJOL, OVID Maternity and Infant Care, CINAHL, Cochrane Library, POPLINE and World Health Organisation (WHO) Global Health Library. Eligible studies were primary research on CFP in SA children aged 0⁻2 years. Search terms were "children", "feeding" and "South Asian", and derivatives. Quality appraisal used the Evidence for Policy and Practice Information (EPPI) Weight of Evidence scoring. From 50,713 studies, 13 were extracted with ten from the UK, and one each from the USA, Canada and Singapore. Sub-optimal CFP were found in all studies. All ten studies investigating timing reported complementary feeding (CF) being commenced before six months. Promoters/barriers influencing CFP included income, lack of knowledge, and incorrect advice. This is the first systematic review to evaluate CFP in SA children living in high-income countries and these findings should inform the development of effective interventions for SA infants in these settings.
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Affiliation(s)
- Logan Manikam
- UCL Institute of Epidemiology & Health Care, 1-19 Torrington Place, London WC1E 6BT, UK.
| | - Raghu Lingam
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Sydney 2031, Australia.
| | - Isabel Lever
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Emma C Alexander
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Chidi Amadi
- Royal Surrey County Hospital, Egerton Road, Guildford GU2 7XX, UK.
| | - Yasmin Milner
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Taimur Shafi
- GKT School of Medical Education, Guy's Campus, London SE1 1UL, UK.
| | - Lucy Stephenson
- Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Sonia Ahmed
- Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
| | - Monica Lakhanpaul
- Population, Policy & Practice, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK.
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