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Adrizain R, Faridah L, Fauziah N, Berbudi A, Afifah DN, Setiabudi D, Setiabudiawan B. Factors influencing stunted growth in children: A study in Bandung regency focusing on a deworming program. Parasite Epidemiol Control 2024; 26:e00361. [PMID: 38966495 PMCID: PMC11219946 DOI: 10.1016/j.parepi.2024.e00361] [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: 02/09/2023] [Revised: 05/21/2024] [Accepted: 06/03/2024] [Indexed: 07/06/2024] Open
Abstract
The prevalence of neglected tropical diseases, specifically those caused by soil-transmitted helminths (STHs) and other parasites that infest the intestine as part of their life cycle, remains a problem in Indonesia. We assessed the effects of deworming programs and socioeconomic and ecological factors on the incidence rate of infections with STHs and other parasites in an urban area of the Bandung Regency. We recruited 361 children with stunted growth who met the inclusion criteria, and 48 of those children were at high risk of STH infection. The study was conducted between September 2020 and September 2021. We collected possible socioeconomic factors influencing the incidence rate of infections. We found the incidence rate of STH infections among the children with stunted growth to be 3.6%. We confirmed infections with Cyclospora and Cryptosporidium after a Ziehl-Nieelsen stool smear examination in two of the 48 children at risk of infection. We found 43.75% of the children had short stature and weight below the normal limits, while stunting and severe stunting were associated with Ascaris lumbricoides infection (44.70%, p = 0.035). Parents of children with stunted and severely stunted growth were more likely to have a low education level, lack knowledge about deworming program, and to be earning a low income. The mother's occupation had a particularly strong influence on the severity of the stunting (89.58%, p = 0.012). Our results show that deworming programs can affect the growth and development of children and that socioeconomic and ecological factors also play a role.
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Affiliation(s)
- Riyadi Adrizain
- Department of Child's Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java 40161, Indonesia
| | - Lia Faridah
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java 45363, Indonesia
| | - Nisa Fauziah
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java 45363, Indonesia
| | - Afiat Berbudi
- Parasitology Division, Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java 45363, Indonesia
| | - Deviyanthi Nur Afifah
- Bandung Institute of Technology, Faculty of Mathematics and Natural Sciences, Indonesia
| | - Djatnika Setiabudi
- Department of Child's Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java 40161, Indonesia
| | - Budi Setiabudiawan
- Department of Child's Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java 40161, Indonesia
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Okeyo FA, Nyang'echi E, Guyah B. Determinants of diarrheal disease in children undergoing complementary feeding in a low-income urban setting in Kenya. Trop Med Int Health 2024. [PMID: 38993128 DOI: 10.1111/tmi.14035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
OBJECTIVES This study aimed to identify and characterise the determinants influencing the occurrence of diarrheal diseases in children aged 6-24 months undergoing complementary feeding within a low-income urban community in Kenya. METHODS This study followed a cross-sectional design and recruited caregivers of children aged 6-24 months from 302 households. The dependent variable was the 2-week diarrhoea prevalence among children, with independent variables including sociodemographic characteristics, child immunisation and feeding status, and water and sanitation facilities. Data analysis was performed using SPSS. Descriptive statistics and logistic regression analyses were used to assess associations between independent variables and the occurrence of diarrheal diseases. RESULTS The majority of caregivers were female (n = 282, 93.4%), aged 25-34 years (n = 156, 51.7%), had attained secondary school education (n = 154, 51%), were unemployed (n = 162, 53.6%), and earned Ksh 10,000 (USD 100) or less. 296 (98%) indexed children were fully vaccinated against rotavirus. Most households used improved drinking water sources (n = 272, 90.1%). Most caregivers did not regularly wash their hands with soap and water (n = 225, 74.5%). The 2-week diarrhoea prevalence among children was 34.1% (103/302), with 69.9% (72/103) of these cases seeking care at a healthcare facility. Logistic regression analysis revealed that children of caregivers earning Ksh 20,000 and below (aOR = 2.9[1.3-6.5], p = 0.01), and those from households using unimproved sanitation facilities (aOR = 1.9 [CI 1-3.4], p = 0.042), had significantly higher odds of having diarrhoea. CONCLUSION The study found a high prevalence of diarrhoea in Kenyan children aged 6-24 months, with caregiver income and household sanitation facilities significantly impacting the occurrence of the disease. The study suggests integrated approaches, including education, income generation, hygiene, and improved nutrition, to address the burden of diarrheal disease.
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Affiliation(s)
| | | | - Bernard Guyah
- School of Public Health, Maseno University, Kisumu, Kenya
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Capra ME, Decarolis NM, Monopoli D, Laudisio SR, Giudice A, Stanyevic B, Esposito S, Biasucci G. Complementary Feeding: Tradition, Innovation and Pitfalls. Nutrients 2024; 16:737. [PMID: 38474864 DOI: 10.3390/nu16050737] [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: 02/03/2024] [Revised: 02/26/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024] Open
Abstract
According to WHO, "complementary feeding (CF) is the process starting when breast milk alone or infant formula alone is no longer sufficient to meet the nutritional requirements of infants, and therefore, other foods and liquids are needed, along with breast human milk or a breastmilk substitute". CF is one of the most important "critical and sensitive periods" in human life: indeed, timing and approaches to solid foods introduction in an infant's nutrition are of utmost importance as potential epigenetic factors from infancy to adulthood. CF is also deeply influenced by each country and single-family traditions, culture, and beliefs. The aim of our narrative review is to analyze traditional CF practices, including innovative and alternative ones that emerged in the last decades, such as baby-led weaning or plant-based weaning, and to evaluate their effects on the risk of developing non-communicable diseases. Moreover, we will discuss pitfalls and misunderstandings that pediatricians frequently have to face when dealing with complementary feeding. Health care professionals must not have prejudices against parents' wishes or traditions about CF; rather, they should support and educate them in case of any alternative CF choice, always pursuing the infant's adequate growth, neuro- and taste development, and the achievement of correct eating behavior as the primary goal.
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Affiliation(s)
- Maria Elena Capra
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
| | - Nicola Mattia Decarolis
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Delia Monopoli
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Serena Rosa Laudisio
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Antonella Giudice
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Brigida Stanyevic
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University Hospital of Parma, 43126 Parma, Italy
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
- Italian Society of Pediatric Nutrition (SINUPE), 20126 Milan, Italy
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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Farah S, Derese T, Abera L. Minimum acceptable diet and associated factors among children aged 6-23 months in Jig-Jiga, Somali region, eastern Ethiopia, 2022. BMC Nutr 2024; 10:11. [PMID: 38212859 PMCID: PMC10785458 DOI: 10.1186/s40795-023-00740-x] [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: 01/19/2023] [Accepted: 06/28/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND The minimum acceptable diet is the proportion of children aged 6-23 months who consumed the minimum meal frequency and minimum dietary diversity during the previous day or night. The minimum acceptable diet assesses both micronutrient adequacy and the quantity of food consumed during the previous day or night. Inappropriate infant and young child feeding practices during this period result in significant threats to child health through impaired cognitive development. Therefore, this study aims to assess the minimum acceptable diet and associated factors among children aged 6-23 months in Jig-Jiga, Somali region, Eastern Ethiopia. METHODS A community-based, cross-sectional study was conducted in Jig-Jiga town. A systematic random sampling technique was used to select 536 children aged 6-23 months with their mothers. Data were collected using a pre-tested, structured questionnaire. The data were entered into Epi-data 3.1. The data were cleaned and analyzed using SPSS v20. Bi-variable and multivariable logistic regression analyses were done, and model fitness was checked and tested by the Hosmer-Lemeshow goodness of fit test. The results of the adjusted odds ratio with 95% confidence intervals and P < 0.05 were considered statistically significant. RESULT The overall prevalence of a minimum acceptable diet was 47.2% (95% CI: 43.1-51.6). Occupation of fathers (AOR = 0.5, 95%CI: 0.3-0.8), child age of 6-11 months (AOR = 3.6, 95%CI: 1.7-7.7), age of the mother 15-24 years (AOR = 7.6, 95%CI: 1.5-38.146), 25-34 years (AOR = 5.56, 95%CI: 1.17-26.325), mothers who had only one under-five child (AOR = 2.1, 95%CI: 1.298-3.471), and media as a source of information (AOR = 0.16, 95%CI: 0.061-0.433) were associated with the minimum acceptable diet. CONCLUSION This study showed that the prevalence of a minimum acceptable diet was low. Factors associated with a minimum acceptable diet included the father's occupation, the child's age, the mother's age, having one under-five child, and the media as a source of information. Therefore, interventional strategies that focus on family planning and advocacy for infant and young child feeding are required to improve the provision of a minimum acceptable diet.
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Affiliation(s)
- Shukri Farah
- Health Professional in Somalia Regional State Administration, Jijiga, Ethiopia
| | - Tariku Derese
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia.
| | - Legesse Abera
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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Mekonen EG, Zegeye AF, Workneh BS. Complementary feeding practices and associated factors among mothers of children aged 6 to 23 months in Sub-saharan African countries: a multilevel analysis of the recent demographic and health survey. BMC Public Health 2024; 24:115. [PMID: 38191351 PMCID: PMC10775555 DOI: 10.1186/s12889-023-17629-w] [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: 10/17/2023] [Accepted: 12/31/2023] [Indexed: 01/10/2024] Open
Abstract
INTRODUCTION Malnutrition is a public health problem in sub-Saharan Africa with an increased morbidity and mortality rate than in other parts of the world. Poor complementary feeding practices are one of the major causes of malnutrition during the first two years of life. Therefore, this study aimed to determine the prevalence and associated factors of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries. METHODS A multilevel mixed-effect analysis was carried out using recent demographic health survey data from 19 sub-Saharan African countries, which were conducted between 2015 and 2020. A total weighted sample of 60,266 mothers of children aged 6 to 23 months were included in the study. The demographic health survey employs a stratified two-stage sampling technique. Data extracted from the recent DHS data sets were cleaned, recorded, and analyzed using STATA/SE version 14.0 statistical software. Multilevel mixed-effects logistic regression was used to determine the factors associated with complementary feeding practice. Variables with a p-value less than 0.05 and adjusted odds ratio (AOR) with a 95% confidence interval (CI) were reported as statistically significant variables associated with appropriate complementary feeding practices. RESULTS The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan African countries was 13.02% (95% CI: 12.75-13.29%). Maternal educational level [AOR = 0.69, 95% CI (0.64, 0.74)] and [AOR = 0.52, 95% CI (0.47, 0.57)], marital status of the mother [AOR = 0.85, 95% CI (0.74, 0.96)], sex of household head [AOR = 1.78, 95% CI (1.09, 1.27)], total children ever born [AOR = 1.52, 95% CI (1.18, 1.96)], [AOR = 1.43, 95% CI (1.14, 1.81)], and [AOR = 1.31, 95% CI (1.04, 1.64)], media exposure [AOR = 0.74, 95% CI (0.69, 0.79)], ANC visits attended during pregnancy [AOR = 0.73, 95% CI (0.63, 0.80)] and [AOR = 0.67, 95% CI (0.62, 0.74)], place of delivery [AOR = 0.92, 95% CI (0.85, 0.98)], currently breastfeeding [AOR = 1.12, 95% CI (1.01, 1.23)], PNC checkup [AOR = 0.75, 95% CI (0.70, 0.80)], the current age of the child [AOR = 0.26, 95% CI (0.24, 0.28)] and [AOR = 0.14, 95% CI (0.13, 0.16)], birth order [AOR = 1.31, 95% CI (1.09, 1.58)], number of under 5 children in the household [AOR = 0.76, 95% CI (0.59, 0.97)], community illiteracy [AOR = 1.09, 95% CI (1.02, 1.18)], and country category [AOR = 1.62, 95% CI (1.18, 2.22)] were significantly associated with appropriate complementary feeding practices. CONCLUSION The prevalence of appropriate complementary feeding practices among mothers of children aged 6 to 23 months in sub-Saharan Africa was relatively low. Higher maternal educational level, female household head, having media exposure, attending more ANC visits, health facility delivery, currently breastfeeding, having PNC follow-up, low community illiteracy, and living in the West Africa region increase the odds of appropriate complementary feeding practices. Women empowerment, increasing maternal health services accessibility, promoting breastfeeding behavior, increasing media exposure of the household, and improving the proportion of health facility delivery are strongly recommended.
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Affiliation(s)
- Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, 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
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Rahman MA, Kundu S, Rashid HO, Tohan MM, Islam MA. Socio-economic inequalities in and factors associated with minimum dietary diversity among children aged 6-23 months in South Asia: a decomposition analysis. BMJ Open 2023; 13:e072775. [PMID: 38128933 DOI: 10.1136/bmjopen-2023-072775] [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] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE This study aimed to determine the factors associated with minimum dietary diversity (MDD) and estimate the socioeconomic inequalities in MDD among children from five South Asian countries. DESIGN Cross-sectional. SETTING The study used the most recent round of secondary databases of Demographic Health Survey data of Bangladesh (2017-2018), India (2019-2021), Maldives (2016-2017), Nepal (2018) and Pakistan (2017-2018). PARTICIPANTS This study used information on MDD and other explanatory variables from a total of 136 980 (weighted) children aged 6-23 months. METHODS Multivariable logistic regression was employed to identify the factors associated with MDD and concentration index (CIX) and Lorenz curve were used to measure the socioeconomic inequalities in MDD. RESULTS The overall weighted prevalence of MDD in South Asia was 23.37%. The highest prevalence of MDD was found among children from Maldives (70.7%), while the lowest was in Pakistan (14.2%). Living in affluent versus poor households, having a mother who is employed versus a mother who is unemployed, exposure to various forms of media (newspapers and magazines), seeking antenatal care (ANC) more than four times compared with those who sought ANC less than four times and having children older than 4 years old are the most common significant factors associated with MDD deficiency. This study found the value of the CIX for MDD (MDD: CI=0.0352; p<0.001) among children with a higher socioeconomic status, suggesting inequality in MDD in favour of the more among well-off households. CONCLUSION Inequality in the prevalence of MDD favours the affluent. Health policy and intervention design should prioritise minimising socioeconomic inequalities concerning the MDD. In addition, policy-makers should prioritise the associated factors of MDD such as education, wealth status, employment, media exposure while designing intervention or policies.
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Affiliation(s)
| | - Satyajit Kundu
- Biochemistry and Food Analysis, Patuakhali Science and Technology University, Patuakhali, Bangladesh
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Terefe B, Jembere MM, Abie Mekonnen B. Minimum meal frequency practice and associated factors among children aged 6-23 months old in The Gambia: a multilevel mixed effect analysis. Sci Rep 2023; 13:22607. [PMID: 38114621 PMCID: PMC10730716 DOI: 10.1038/s41598-023-49748-0] [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: 08/18/2023] [Accepted: 12/11/2023] [Indexed: 12/21/2023] Open
Abstract
A proxy measure for a child's energy needs, minimum meal frequency (MMF) looks at how often children were fed things other than breast milk. Infants and young children who do not consume enough food frequently are more likely to suffer from malnutrition, which can lead to increased morbidity and mortality as well as stunting and micronutrient deficiencies. There is no MMF recommended by studies in The Gambia. Hence, the purpose of this study was to evaluate the practice of MMF and the factors that influence it in children aged 6-23 months in The Gambia. Data from The Gambian Demographic and Health Survey (GDHS-2019/20) were used to identify factors affecting the MMF at individual and community levels. A multi-level regression model and weighted samples of 2100 children were employed for the investigation. After being examined by a p-value of < 0.25 in the binary regression, factors with a p-value of < 0.05 were judged statistically significant. This study found that about 57.95% had provided MMF. Primary and secondary educated mothers (aOR = 1.44, CI 1.11, 1.87), and (aOR = 1.43, CI 1.09, 1.86), wealthiest (aOR = 1.76, CI 1.04, 2.99), 35-49 years old mothers (aOR = 1.35, CI 1.01, 1.79), female household head (aOR = 0.72, CI 0.53, 0.98), breastfeeding status(aOR = 0.10, CI 0.07, 0.15), currently working (aOR = 1.27, CI 1.04, 1.56), 12-17 months child (aOR = 1.40, CI 1.13, 1.73), 18-23 months child (aOR = 1.44, CI 1.08, 1.91) have shown association with MMF. Regarding regions Mansakonko, Kerewan, Kuntaur, and Janjanbureh local government areas have shown (aOR = 3.51, CI 1.77, 6.97), (aOR = 5.17, CI 2.67, 9.99), (aOR = 2.26, CI 1.14, 4.47), and (aOR = 2.35, CI 1.19, 4.64) as compared to Banjul local government area. Comparing MMF in The Gambia to WHO standards, it must be considered low. Encouragement of women and coordinated enhancement of the current nutritional intervention are therefore effective in boosting children's consumption of a variety of foods.
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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, P.O. 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
| | - Birhanu Abie Mekonnen
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Amhara, Ethiopia
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Ahmed KT, Karimuzzaman M, Pinky GN, Dasgupta DP, Rahman L, Hossain MM, Rahman A. Association of dietary diversity of 6-23 months aged children with prenatal and postnatal obstetric care: evidence from a nationwide cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:120. [PMID: 37932856 PMCID: PMC10629119 DOI: 10.1186/s41043-023-00470-7] [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: 04/14/2023] [Accepted: 11/01/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND Dietary diversity is a key determinant of infant and young child eating patterns for a variety of food groups taken by children between the ages of 6-23 months. The study aimed to examine the association between prenatal and postnatal obstetric care factors of mother and child's dietary diversity, and specific food practices in Bangladesh. METHODS This study analyzed the data of 2497 children between the age of 6-23 extracted from the latest countrywide Bangladesh Demographic Health Survey 2017-2018 and explored relationships between prenatal and postnatal obstetric care received by mother and dietary diversity score (DDS), minimum dietary diversity (MDD), and introduction of solid, semi-solid, and soft foods (ISSSF) of their children. RESULTS Findings revealed that ≥ 4 antenatal care (ANC) visits care visits increased the DDS (adjusted [Formula: see text]: 0.32, 95% CI [0.21, 0.43]), increased the likelihood of MDD (AOR 1.54, 95% CI [1.23, 1.93]), and ISSSF (AOR 1.24, 95% CI [1.08, 1.48]), consuming eggs (AOR 1.47, 95% CI [1.23, 1.76]), and vitamin A vegetables and fruits (AOR 1.38, 95% CI [1.15, 1.66]). Moreover, DDS (adjusted β: 0.05, 95% CI [0.00, 0.11]) and MDD (AOR 1.66, 95% CI [1.31, 2.11]) are linked to childbirth in a medical facility. The C-section delivery influences the DDS (adjusted [Formula: see text]: 0.05, 95% CI [0.00, 0.10]), MDD (AOR 1.39, 95% CI [1.10, 1.75]), and ISSSF (AOR 1.22, 95% CI [1.02, 1.48]). Besides, postnatal visits within 48 h of delivery linked to MDD (AOR 0.66, 95% CI [0.49, 0.89]) and ISSSF (AOR 0.76, 95% CI [0.59, 0.97]), and physicians or professionals providing postnatal checkups were significantly associated with DDS (adjusted [Formula: see text]: 0.09, 95% CI [0.02, 0.16]), MDD (AOR 1.69, 95% CI [1.26, 2.26]), and ISSSF (AOR 1.30, 95% CI [1.04, 1.62]). CONCLUSION Knowledge of child nutritional feeding should emphasize during prenatal and postnatal obstetric care of mother, particularly during antenatal and postnatal visits, C-section delivery, and birth in a healthcare facility to eradicate malnutrition and establish healthy child feeding practices.
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Affiliation(s)
| | - Md Karimuzzaman
- DREXEL Dornsife School of Public Health, DREXEL University, Philadelphia, USA.
| | - Guliva Nazneen Pinky
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Dibbya Pravas Dasgupta
- Center for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Labiba Rahman
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | - Md Moyazzem Hossain
- Department of Statistics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
- School of Mathematics, Statistics, and Physics, Newcastle University, Newcastle Upon Tyne, NE1 7RU, UK.
| | - Azizur Rahman
- School of Computing, Mathematics and Engineering, Charles Sturt University, Wagga Wagga, NSW, 2678, Australia
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Kulwa KBM, Mamiro PS, Kolsteren PW. Nutrition Education Package Focusing on Infant and Young Child Feeding in Tanzania. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:493-508. [PMID: 37245148 DOI: 10.1016/j.jneb.2023.04.002] [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: 09/22/2022] [Revised: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a nutrition education package on feeding practices, nutrient intakes and growth of infants in rural Tanzania. DESIGN Cluster-randomized controlled trial in 18 villages allocated to nutrition education package (n = 9) or routine health education (n = 9 villages), measured at baseline (6 months) and end of the trial (12 months). SETTING Mpwapwa district. PARTICIPANTS Infants aged 6-12 months and their mothers. INTERVENTION(S) Six months of nutrition education package (group education, counseling, cooking demonstrations) and regular home visits by village health workers. MAIN OUTCOME MEASURE(S) Primary outcome measure was the mean change in length-for-age z-scores. Secondary outcomes included mean changes in weight-for-length z-scores (WLZ), intakes of energy, fat, iron and zinc, the proportion of children consuming foods from ≥ 4 food groups (ie, dietary diversity) and consuming the recommended number of semisolid/soft meals and snacks per day (ie, meal frequency). ANALYSIS Multilevel mixed-effects regression models. RESULTS Mean change in length-for-age z-scores (β = 0.20, P = 0.02), energy (in kcal) (β = 43.8, P = 0.02), and fat (in grams) (β =2.7, P = 0.03) intakes were significant in the intervention but not in the control group. There was no effect on iron and zinc intakes. More infants in the intervention than the control group consumed meals from ≥ 4 food groups (71.8% vs 45.3%, P = 0.002). The mean increase in meal frequency (β = 0.29, P = 0.02) and dietary diversity (β = 0.40, P = 0.01) were more significant in the intervention than control. CONCLUSIONS AND IMPLICATIONS The nutrition education package is feasible and can be implemented with high coverage, demonstrating the potential to improve feeding practices, nutrient intake and growth in rural Tanzania.
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Affiliation(s)
- Kissa B M Kulwa
- Department of Human Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Tanzania.
| | - Peter S Mamiro
- Department of Human Nutrition and Consumer Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Patrick W Kolsteren
- Department of Food Technology, Safety and Health, Faculty of Bioscience Engineering, Ghent University, Ghent, Belgium
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Herman H, Mansur AR, Chang YJ. Factors associated with appropriate complementary feeding: A scoping review. J Pediatr Nurs 2023:S0882-5963(23)00107-0. [PMID: 37150632 DOI: 10.1016/j.pedn.2023.04.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/09/2023]
Abstract
PROBLEM Childhood stunting becomes a vital point of an underlying problem in early life. Appropriate and adequate complementary feeding is necessary for children to prevent malnutrition and introduce healthy eating habits. Knowledge of factors related to complementary feeding practices is needed to design strategies that improve optimal complementary feeding and avoid malnutrition in children. However, factors related to appropriate complementary feeding practices have not been systematically examined; hence, the present study aims to synthesize the available evidence on factors associated with proper complementary feeding practices. METHODS A scoping review was conducted. Five databases were searched for relevant studies, including Medline, Embase, Cochrane, CINAHL, and Web of Science. The studies selected for review were those published in English from 2009 to 2022 on complementary feeding practices and related factors, measuring at least three complementary feeding indicators, and available in full text. The criteria resulted in 30 eligible articles that were selected, extracted, and then analyzed using descriptive and content analysis. FINDING Factors associated with complementary feeding practice include maternal factors (knowledge, attitude, self-efficacy, parity, antenatal care visit, place of delivery, and postnatal check-up), socio-environmental factors (age, educational level, income, employment status, residence, household size, mother's ethnicity, and support) and informational factors (exposure to media, source of information and intervention). CONCLUSION AND IMPLICATION Maternal, socio-environmental, and informational factors are associated with appropriate complementary feeding in infants and young children. Further research is necessary to identify causal relationships between the three groups of factors and complementary feeding practices.
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Affiliation(s)
- Hermalinda Herman
- Maternal and Child Health Nursing Department, Faculty of Nursing Andalas University, Padang, West Sumatera, Indonesia; PhD Candidate, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Arif Rohman Mansur
- Maternal and Child Health Nursing Department, Faculty of Nursing Andalas University, Padang, West Sumatera, Indonesia
| | - Ying-Ju Chang
- Professor, Institution of Allied Health Science & Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Director of Nursing, National Cheng Kung University Hospital, Tainan, Taiwan; College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Gebretsadik GG, Tadesse Z, Ambese TY, Mulugeta A. Trends in and predictors of animal source food consumption among 6-23 months age children in Tigrai, Northern Ethiopia: evidence from three consecutive ethiopian demographic and health surveys, EDHS 2005-2016. BMC Nutr 2023; 9:43. [PMID: 36890578 PMCID: PMC9996887 DOI: 10.1186/s40795-023-00699-9] [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: 03/12/2022] [Accepted: 03/02/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND Despite numerous interventions, child undernutrition continues as a problem of global concern. Although consumption of animal source foods has shown positive associations with child undernutrition, no much evidence exists on its trends and predictors among children in Tigrai. OBJECTIVES This study aimed to investigate the trends in and predictors of consumption of animal source foods among children 6-23 months of age in Tigrai. METHODOLOGY This study used complex data of 756 children extracted from three consecutive Ethiopian Demographic and Health Surveys. Data were analyzed using STATA 14.0 by accounting for sampling weight and cluster and strata variables. Multivariable logistic regression was used to determine the independent predictors of animal source foods consumption. Odds ratio and 95% confidence interval were used to measure strength of association at a statistical significance of p < 0.05. RESULTS Although statistically not significant (p-trend = 0.28), animal source foods consumption increased from 31.3% to 2005 through 35.9% in 2011 to 41.5% in 2016. For every month increase in the age of a child, a 9% increment in the odds of animal source food consumption was observed. Muslim children showed 3.1 times higher odds of animal source food consumption than Orthodox Christians. The likelihood of animal source foods consumption were 33% lower among children born to mothers who didn't attend formal education as compared to their counterparts. A unit increase in the number of household assets and number of livestock led to a 20% and 2% increase in the odds of animal source foods consumption, respectively. CONCLUSION Animal source foods consumption showed a statistically non-significant increase over the three consecutive Ethiopian Demographic and Health Surveys. This study found out that consumption of animal source foods might be increased through pro-maternal education policies, programs with household asset increasing schemes, and pro-livestock projects. Our study also highlighted the need for considering religion as one important player when planning or undertaking ASF programs.
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Affiliation(s)
| | - Zuriyash Tadesse
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Tesfay Yohannes Ambese
- Department of Public Health Surveillance, Ethiopian Public Health Institute Tigrai Branch, Mekelle, Ethiopia
| | - Afework Mulugeta
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Sunuwar DR, Bhatta A, Rai A, Chaudhary NK, Tamang MK, Nayaju S, Singh DR. The factors influencing inappropriate child feeding practices among families receiving nutrition allowance in the Himalayan region of Nepal. BMC Nutr 2023; 9:33. [PMID: 36803665 PMCID: PMC9940375 DOI: 10.1186/s40795-023-00691-3] [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: 08/30/2022] [Accepted: 02/09/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Child feeding practices during the first two years of life are crucial to ensure good health and nutrition status. This study aimed to assess the factors influencing inappropriate child feeding practices in children aged 6 - 23 months in families receiving nutrition allowance in the remote Mugu district, Nepal. METHODS A community-based cross-sectional study was conducted among 318 mothers who had children aged 6 - 23 months of age in the seven randomly selected wards. Systematic random sampling technique was used to select the desired number of respondents. Data were collected using pre-tested semi-structured questionnaire. Bivariate and multivariable binary logistic regression was used to estimate crude odds ratio (cOR), and adjusted odds ratio (aOR), and 95% confidence intervals (CIs) to understand factor associated with child feeding practices. RESULTS Almost half of the children aged 6 - 23 months were not consuming a diverse diet (47.2%; 95% CI: 41.7%, 52.7%), did not meet the recommended minimum meal frequency (46.9%; 95% CI: 41.4%, 52.4%) and did not consume minimum acceptable diet (51.7%; 95% CI: 46.1%, 57.1%). Only 27.4% (95% CI: 22.7%, 32.5%) of children met the recommended complementary feeding practices. Multivariable analysis showed maternal characteristics such as mothers who gave birth at home (aOR = 4.70; 95% CI: 1.03, 21.31) and mothers in unpaid employment (aOR = 2.56; 95% CI: 1.06, 6.19) were associated with increased odds of inappropriate child feeding practices. Household economy (i.e. family with < 150 USD monthly income) was also associated with increased odds of inappropriate child feeding practices (aOR = 1.19; 95% CI: 1.05, 2.42). CONCLUSION Despite the receipt of nutritional allowances, child feeding practices among 6 - 23 months children were not optimal. Additional context-specific behavior change strategies on child nutrition targeting mothers may be required.
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Affiliation(s)
- Dev Ram Sunuwar
- Department of Nutrition and Dietetics, Nepal Armed Police Force Hospital, Kathmandu, Nepal. .,Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal.
| | - Anuradha Bhatta
- grid.444739.90000 0000 9021 3093Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
| | - Anjana Rai
- grid.1024.70000000089150953School of Public Health and Social Work, Queensland University of Technology, Brisbane City, Australia
| | | | - Man Kumar Tamang
- grid.1003.20000 0000 9320 7537Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Suvash Nayaju
- grid.444739.90000 0000 9021 3093Department of Public Health, Asian College for Advance Studies, Purbanchal University, Lalitpur, Nepal
| | - Devendra Raj Singh
- grid.15751.370000 0001 0719 6059School of Human and Health Sciences, University of Huddersfield, Huddersfield, UK ,Research Section, Swadesh Development Foundation, Siraha, Nepal
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Naja F, Hwalla N, Chokor FAZ, Zgheib R, Nasreddine L. Infant and young child feeding practices in Lebanon: a cross-sectional national study. Public Health Nutr 2023; 26:143-159. [PMID: 35369892 PMCID: PMC11077449 DOI: 10.1017/s1368980022000842] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 03/15/2022] [Accepted: 03/28/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To assess infant and young child feeding (IYCF) practices in Lebanon and investigate their associations with socio-demographic and lifestyle factors. DESIGN A cross-sectional national survey was conducted in 2012-2013. In addition to a socio-demographic and lifestyle questionnaire, a 24-h dietary recall for the children was collected, with mothers as proxies. IYCF practices were assessed based on the 2021 indicators of the WHO. SETTING Lebanon. PARTICIPANTS Children aged 0-23 months and their mothers (n 469). RESULTS While the majority of infants were ever breastfed (87·6 %), the prevalence of exclusive breast-feeding (BF) in those under 6 months of age was 11·0 %. Early initiation of BF was 28 %. A greater child's birth order, partner's support for BF, higher parental education, maternal BF knowledge and non-smoking were associated with higher odds of meeting BF recommendations. As for complementary feeding, 92·8 % of children (6-23 months) met the minimum meal frequency indicator, 37·5 % met the minimum dietary diversity (MDD) and 34·4 % met the minimum adequate diet (MAD). The consumption of unhealthy food was observed amongst 48·9 % of children, with nearly 37 % consuming sweet beverages. Older maternal age and maternal overweight/obesity were associated with lower odds of meeting MDD and MAD, while child's age and partner's support for BF were associated with higher odds. CONCLUSIONS The results documented suboptimal IYCF practices amongst Lebanese children and identified a number of factors associated with these practices. Findings from this study will help guide the development of culture-specific programmes aimed at improving IYCF practices in Lebanon.
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Affiliation(s)
- Farah Naja
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
- Department of Clinical Nutrition and Dietetics, Research
Institute of Medical & Health Sciences (RIMHS), College of Health Sciences,
University of Sharjah, Sharjah, United
Arab Emirates
| | - Nahla Hwalla
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
| | - Fatima Al Zahraa Chokor
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
| | | | - Lara Nasreddine
- Department of Nutrition and Food Sciences, American
University of Beirut, P.O. Box 11-0236, Riad El-Solh, Beirut1107 2020, Lebanon
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Metwally AM, Sallam SF, Mawla MAA, Alian KM, Abdel-Latif GA, Hasanin HM, Kamal AN, Hanna C, Shebini SME, Ahmed NH, Mabrok HB, Mahmoud MH, Ismail AS, Boseila SAW, El-Alameey IR, Mahfouz NN, Shaaban FA, Ibrahim NA, Hassan NE, El-Masry SA, Naga MM, Khalil A. Promoting weaning practices and growth of Egyptian infants by using communication for behavioral development approach. BMC Pediatr 2022; 22:689. [DOI: https:/doi.org/10.1186/s12887-022-03741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/10/2022] [Indexed: 10/31/2023] Open
Abstract
AbstractBackgroundAccess to various affordable and nutritious foods is considered a challenging factor for households with limited resources affecting the proper weaning practices. In order to motivate communities to adhere to the right and proper weaning practices, the social aspect should be considered through close communication with the targeted communities. This study aimed to evaluate how impactful the use of the principles of Communication for Development (C4D) that respect parents’ beliefs and their cultural norms is in improving the weaning practices and growth of infants in an Egyptian village.MethodsAn interventional three-phase study was conducted for three years. The intervention targeted 464 mothers of infants up to 2 years of age. C4D interventions encouraged each mother to provide her baby with nutritious and varied options through age-appropriate introduction and diversification of nutrient-rich complementary foods under the slogan “ enjoy meals like a baby”. The effectiveness of the approach was measured by five essential weaning practices: Introduction of solid, semi-solid, or soft foods, Minimum dietary diversity, minimum meal frequency, Minimum acceptable diet, and consumption of iron-rich foods.ResultsThere was marked and significant improvement in the awareness and of the majority of the weaning practices’ indicators as a result of the interventions. This was noticed for the timely introduction of complementary foods which increased from 36.7% to 82.0%, the minimum meal frequency indicator (3–5) which increased from 25.3% to 67.3%, iron-rich or fortified food (68.0% to 82%) as well as a regular checkup for baby health at the health unit (71.3%). Indicators that were improved but failed to achieve the target were the “Minimum Dietary Diversity” (reached 32%) and the minimum acceptable diet (reached 22.0%). A significant effect on linear growth especially for females is evidenced by the remarkable decrease in wasting (from 31.5% to 11.1%) and obesity (from 12.0% to 0%) associated with a considerable decrease in underweight (from 40% to 16.7%).ConclusionTargeting caregivers through the C4D approach have succeeded in providing them with the support required for the provision of adequate nutrition for their infants that had significantly marked improvement in growth indices of their infants.
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15
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Metwally AM, Sallam SF, Mawla MAA, Alian KM, Abdel-Latif GA, Hasanin HM, Kamal AN, Hanna C, Shebini SME, Ahmed NH, Mabrok HB, Mahmoud MH, Ismail AS, Boseila SAW, El-Alameey IR, Mahfouz NN, Shaaban FA, Ibrahim NA, Hassan NE, El-Masry SA, Naga MM, Khalil A. Promoting weaning practices and growth of Egyptian infants by using communication for behavioral development approach. BMC Pediatr 2022; 22:689. [PMID: 36456920 PMCID: PMC9713754 DOI: 10.1186/s12887-022-03741-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Access to various affordable and nutritious foods is considered a challenging factor for households with limited resources affecting the proper weaning practices. In order to motivate communities to adhere to the right and proper weaning practices, the social aspect should be considered through close communication with the targeted communities. This study aimed to evaluate how impactful the use of the principles of Communication for Development (C4D) that respect parents' beliefs and their cultural norms is in improving the weaning practices and growth of infants in an Egyptian village. METHODS An interventional three-phase study was conducted for three years. The intervention targeted 464 mothers of infants up to 2 years of age. C4D interventions encouraged each mother to provide her baby with nutritious and varied options through age-appropriate introduction and diversification of nutrient-rich complementary foods under the slogan " enjoy meals like a baby". The effectiveness of the approach was measured by five essential weaning practices: Introduction of solid, semi-solid, or soft foods, Minimum dietary diversity, minimum meal frequency, Minimum acceptable diet, and consumption of iron-rich foods. RESULTS There was marked and significant improvement in the awareness and of the majority of the weaning practices' indicators as a result of the interventions. This was noticed for the timely introduction of complementary foods which increased from 36.7% to 82.0%, the minimum meal frequency indicator (3-5) which increased from 25.3% to 67.3%, iron-rich or fortified food (68.0% to 82%) as well as a regular checkup for baby health at the health unit (71.3%). Indicators that were improved but failed to achieve the target were the "Minimum Dietary Diversity" (reached 32%) and the minimum acceptable diet (reached 22.0%). A significant effect on linear growth especially for females is evidenced by the remarkable decrease in wasting (from 31.5% to 11.1%) and obesity (from 12.0% to 0%) associated with a considerable decrease in underweight (from 40% to 16.7%). CONCLUSION Targeting caregivers through the C4D approach have succeeded in providing them with the support required for the provision of adequate nutrition for their infants that had significantly marked improvement in growth indices of their infants.
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Affiliation(s)
- Ammal M. Metwally
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Sara F. Sallam
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Mohamed A. Abdel Mawla
- grid.419725.c0000 0001 2151 8157Pediatrics Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Khadija M. Alian
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Ghada A. Abdel-Latif
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Hasanin M. Hasanin
- grid.419725.c0000 0001 2151 8157Pediatrics Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Ayat N. Kamal
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Carine Hanna
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Salwa M. El Shebini
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Nihad H. Ahmed
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Hoda B. Mabrok
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Maha H. Mahmoud
- grid.419725.c0000 0001 2151 8157Nutrition and Food Science Department, Food Technology and Nutrition Research Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Ahmed S. Ismail
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Samia A. W. Boseila
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Inas R. El-Alameey
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt ,Faculty of Applied Medical Sciences, Clinical Nutrition Department, Taibahu University, Almadina almunawara, Saudi Arabia
| | - Nermine N. Mahfouz
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Fatma A. Shaaban
- grid.419725.c0000 0001 2151 8157Child Health Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Nihad A. Ibrahim
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Nayera E. Hassan
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Sahar A. El-Masry
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Maie M. Naga
- grid.419725.c0000 0001 2151 8157Community Medicine Research Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
| | - Aya Khalil
- grid.419725.c0000 0001 2151 8157Biological Anthropology Department, Medical Research and Clinical Studies Institute, National Research Centre, Dokki, Cairo, 60014618 Egypt
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Educational intervention and livestock ownership successfully improved the intake of animal source foods in 6-23 months old children in rural communities of Northern Ethiopia: Quasi-experimental study. PLoS One 2022; 17:e0277240. [PMID: 36331965 PMCID: PMC9635712 DOI: 10.1371/journal.pone.0277240] [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: 02/20/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Animal source foods (ASFs) are rich in high-quality proteins, including essential amino acids and highly bioavailable micronutrients vital for child growth and cognitive development. But, the daily consumption of ASFs among 6–23 months old children is very low in Tigray, Northern Ethiopia. Objective The study aimed to assess the effectiveness of nutrition education intervention to improve the consumption of ASFs among 6–23 months old children from rural communities with strict religious fasting traditions of avoiding intake of ASFs in Northern Ethiopia. Methods A quasi-experimental study was conducted in two food insecure districts namely Samre Seharti (intervention) and Tanqua Abergele (comparison). The mother-child pairs in the intervention group (n = 140) received nutrition education based on the barriers and available resources for optimal consumption of ASFs among children and followed up for nine months. The mother-child pairs in the comparison group (n = 153) received routine nutrition education. The data were collected using a pre-tested structured questionnaire. The baseline and endline data assessment included interviews on socio-demographic and socio-economic status, dietary intake, and child feeding practices. The effectiveness of the intervention was measured using the difference-in-difference (DID) analysis model. Results At endline, the consumption of ASFs among children was 19.5 percentage points higher in the intervention group compared with the comparison group (p = 0.008). In addition, there was a significant increase in egg consumption among children in the intervention group (DID of 16.9, p = 0.012) from the comparison group. No child was consuming meat at baseline in both the intervention and comparison arms and it was very low at endline (5.2% vs. 7.9%). Overall, the proportion of children that consumed eggs in the intervention group was higher than in the comparison group in households that owned sheep and goats (4.8% vs. 21.4%, p = 0.050) and chicken (6.3% vs. 43.8%, p = 0.002) after education interventions. However, no statistically significant difference was observed between cow ownership and milk consumption among children (p>0.05). Conclusions Age-appropriate educational interventions for mothers and owning small livestock in the household can improve the consumption of ASFs and eventually the minimum diet diversity of children in communities with strict religious traditions of avoiding ASFs during the fasting seasons.
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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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Are processed fruits and vegetables able to reduce diet costs and address micronutrient deficiencies? Evidence from rural Tanzania. Public Health Nutr 2022; 25:2637-2650. [PMID: 35465867 PMCID: PMC9991728 DOI: 10.1017/s1368980022000982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess the impact of integrating processed fruits and vegetables (FV) into diets in terms of diet cost reduction and ensuring nutritional adequacy year-round. DESIGN Market surveys were conducted to record foods. Focus group discussions (FGD) and 24-h dietary assessments - from children and women - were carried out to determine culturally accepted dietary habits. Six processed FV were considered for addition to diets. Using the Cost of Diet linear programming tool, standards diets were first modelled, and subsequently, the processed FV were included to analyse their impact. SETTING Rural Tanzania: Mtwara and Morogoro. PARTICIPANTS Market survey: 50 traders; FGD: 40 women; 24-h recalls: 36 infants aged 6-23 months, 52 children aged 6-13 years and 292 women. RESULTS The standard diet costs between TZS 232 and 2368 (USD 0·3-3) daily for infants. For children aged 6-13 years, it costs between TZS 1711 and 7199 (USD 2·2-9·1) daily and the cost for the women was between TZS 2793 and 10 449 (USD 3·5-13·2). Addition of the processed FV reduced diet costs by up to 61 %, 48 % and 49 % for children aged 12-23 months, children aged 6-13 years and women, respectively. However, for infants aged 6-11 months, costs rose by up to 127 %. The processed FV addressed all micronutrient gaps in the diets except for infants aged 6-11 months, where some micronutrient intakes were unfulfilled. CONCLUSIONS Processed FV could provide a feasible option to ensure availability of nutritious but cheap diets year-round. Hence, interventions to process FV into nutritious and affordable products should extensively be pursued.
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Broadbent E, McConkie M, Aleson E, Kim L, Stewart R, Mulokozi G, Dearden KA, Linehan M, Cherian D, Torres S, Crookston BT, Hall PC, West JH. Promoting Caregiver Early Childhood Development Behaviors through Social and Behavioral Change Communication Program in Tanzania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095149. [PMID: 35564545 PMCID: PMC9103222 DOI: 10.3390/ijerph19095149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 12/04/2022]
Abstract
Objectives: Stunting remains a prevalent issue in Tanzania. The consequences of stunting include reduced height, greater susceptibility to disease, and diminished cognitive ability throughout the lifespan. Lack of psychosocial stimulation is associated with increased stunting, particularly in terms of its cognitive impact. The Addressing Stunting in Tanzania Early (ASTUTE) program was a large social and behavior change communication (SBCC) intervention that aimed to reduce childhood stunting in the region by targeting early childhood development (ECD) behaviors. The purpose of this study is to report on the extent to which exposure to ASTUTE might be related to ECD behaviors. Methods: ASTUTE disseminated program messages via a mass media campaign and interpersonal communication (IPC). Logistic regression models were used to explore the relationship between exposure to TV, radio, IPC messages, and key ECD behaviors of female primary caregivers and male heads of household. Results: Among primary caregivers, IPC was positively associated with all ECD behaviors measured. Radio was associated with all behaviors except drawing with their child. TV was associated with all behaviors except playing with their child. Among heads of household, only the radio was positively associated with the ECD behaviors measured. Conclusions for practice: Findings indicate that SBCC interventions that include mass media and IPC components may be effective at promoting parental engagement in ECD behaviors. Significance: We know that ECD is important for a child’s development. We know that parents play a critical role in promoting ECD behaviors. We are still exploring ways to influence parents so that they are more involved in ECD behaviors. The results presented here provide evidence for successful mass media and IPC efforts to improve parents’ ECD behaviors. We hope this study will add more evidence for large interventions such as these to the literature, and we are very hopeful that governments and large international NGOs will prioritize SBCC approaches in the future, especially in locations where face-to-face interventions may be challenging.
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Affiliation(s)
- Eliza Broadbent
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - McKayla McConkie
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Emily Aleson
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Lily Kim
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Rebekah Stewart
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | | | - Kirk A. Dearden
- Corus International, Washington, DC 20036, USA; (K.A.D.); (M.L.); (D.C.)
| | - Mary Linehan
- Corus International, Washington, DC 20036, USA; (K.A.D.); (M.L.); (D.C.)
| | - Dennis Cherian
- Corus International, Washington, DC 20036, USA; (K.A.D.); (M.L.); (D.C.)
| | | | - Ben T. Crookston
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Parley C. Hall
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
| | - Joshua H. West
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA; (E.B.); (M.M.); (E.A.); (L.K.); (R.S.); (B.T.C.); (P.C.H.)
- Correspondence: ; Tel.: +1-801-422-3444
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Ketema B, Bosha T, Feleke FW. Effect of maternal employment on child nutritional status in Bale Robe Town, Ethiopia: a comparative cross-sectional analysis. J Nutr Sci 2022; 11:e28. [PMID: 35573460 PMCID: PMC9066325 DOI: 10.1017/jns.2022.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/07/2022] Open
Abstract
Adequate nutrition is essential for early childhood to ensure healthy growth, proper organ formation, and function, a strong immune system, neurological and cognitive development. The main aim of the present study was to assess the effect of maternal employment on nutritional status among children aged 6-23 months in the town of Bale Robe, Ethiopia. A community-based comparative cross-sectional study was conducted on about 597 (293 unemployed and 304 employed) having children aged 6-23-month-old children sampled were employed with a multistage sampling technique. A face-to-face interview was conducted using a structured pretested questionnaire. Descriptive statistics, binary and multivariable logistic regression analyses were used for the statistical analysis. The magnitude of stunting (39.9 %), underweight (39⋅9 %) and wasting (22⋅2 %) was greater in 6-23-month-old children born to employed mothers than their counterparts in unemployed ones [stunted (31⋅3 %), underweight (24⋅0 %) and wasted (11⋅8 %)]. Being a girl [AOR 0⋅31; 95 % CI (0⋅17, 0⋅54)] in employed mothers and [AOR 0⋅29; 95 % CI (0⋅16, 0⋅51)] in unemployed people significantly protected stunting. This study demonstrated that the nutritional status of 6-23-month-old children is better among unemployed mothers than among employed mothers. Therefore, concerted efforts may decrease child undernutrition in a study area.
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Key Words
- Bale Robe
- EBF, Exclusive Breastfeeding
- Ethiopia
- HAZ, Height-for-Age Z-score
- Infant and young child
- MAD, Minimum Acceptable Diet
- MDD, Minimum Diet Diversity
- MMF, Minimum Meal Frequency
- MUAC, Mid-upper arm circumference
- MUACAZ, Mid-upper arm circumference-for-age Z-score
- PCA, Principal Component Analysis
- PI, Principal Investigator
- SPSS, Statistical Product and Service Solutions
- Stunting
- UNICEF, United Nations Children's Fund
- Underweight
- WAZ, Weight-for-Age Z-score
- WHO, World Health Organization
- WHZ, Weight-for-Height Z-Score
- Wasting
- sd, Standard Deviation
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Affiliation(s)
- Bezawit Ketema
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Tafese Bosha
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
| | - Fentaw Wassie Feleke
- College of Agriculture, Hawassa University, P.O. Box 05, Hawassa, Ethiopia
- College of Health Science, Woldia University, P.O. Box 400, Woldia, Ethiopia
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Complementary Feeding Practices and Household Food Insecurity Status of Children Aged 6–23 Months in Shashemene City West Arsi Zone, Oromia, Ethiopia. Nurs Res Pract 2022; 2022:9387031. [PMID: 35463294 PMCID: PMC9019450 DOI: 10.1155/2022/9387031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 02/27/2022] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction Appropriate infant feeding practices are critical to a child's growth, health, and development during the first 1000 days of life. One in every six children worldwide receives a minimum acceptable diet. According to the EDHS 2016, the status of the minimum acceptable diet was 7 percent among children aged 6–23 months in Ethiopia. The study sought to ascertain the relationship between complementary feeding (CF) indicators and household food insecurity in children aged 6–23 months. Methods A systematic sampling method was used to conduct a cross-sectional study of 536 mother-child pairs aged 6–23 months. The 24-hour dietary recall was used to collect data on CF practices using face-to-face interviews with socioeconomic and food security questionnaires. The relationship between complementary feeding indicators and household food insecurity was investigated using logistic regression analysis. The relationship between independent variables and complementary feeding indicators was determined using multivariate logistic regression. Results Overall, a total of 67.9% of children received timely introduction of CF and Minimum Meal Frequency (MMF), Minimum Dietary Diversity (MDD), and Minimum Acceptable Diet were met by 61.7%, 42.5%, and 41.7%, respectively. Result of multivariate logistic regression showed there is significant association between household food security with MMF, MDD, and MAD [AOR: 2.02, 95% CI: (1.25–3.24); AOR: 1.55, 95% CI: (1.02–2.36); and AOR: 1.62, 9595% CI: (1.06–2.47)], respectively, while there was no association with introduction of CF [AOR = 0.87, 95% CI: (0.55–1.39)]. Conclusion This study revealed that the rates of MMF, MDD, and MAD remained low in this study setting. Household socioeconomic status (wealth index, food security status, household income) and child age were found to be among the factors statistically significantly associated with complementary feeding practices indicators.
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Abstract
Consuming wildmeat may protect against iron-deficiency anemia, a serious public health problem globally. Contributing to debates on the linkages between wildmeat and the health of forest-proximate people, we investigate whether wildmeat consumption is associated with hemoglobin concentration in rural and urban children (< 5 years old) in central Brazilian Amazonia. Because dietary practices mediate the potential nutritional benefits of wildmeat, we also examined whether its introduction into children's diets is influenced by rural/urban location or household socio-economic characteristics. Sampling 610 children, we found that wildmeat consumption is associated with higher hemoglobin concentration among the rural children most vulnerable to poverty, but not in the least vulnerable rural, or urban children. Rural caregivers share wildmeat with children earlier-in-life than urban caregivers, potentially because of cultural differences, lower access to domesticated meat, and higher wildmeat consumption by rural households (four times the urban average). If wildmeat becomes unavailable through stricter regulations or over-harvesting, we predict a ~ 10% increased prevalence of anemia among extremely poor rural children. This modest protective effect indicates that ensuring wildmeat access is, alone, insufficient to control anemia. Sustainable wildlife management could enhance the nutritional benefits of wildlife for vulnerable Amazonians, but reducing multidimensional poverty and improving access to quality healthcare are paramount.
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Ahmed JA, Sadeta KK, Lenbo KH. Magnitude and factors associated with appropriate complementary feeding practice among mothers of children 6-23 months age in Shashemene town, Oromia- Ethiopia: Community based cross sectional study. PLoS One 2022; 17:e0265716. [PMID: 35349586 PMCID: PMC8963544 DOI: 10.1371/journal.pone.0265716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 03/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Inadequate complementary feeding is a major cause of childhood malnutrition. Malnutrition caused by insufficient complementary feeding accounts for more than one-third of all under-five mortality whereas appropriate feeding practices are critical for improving nutritional status and ensuring child survival. Thus, the objective of this study was to assess the prevalence of appropriate complementary feeding practices among mothers having 6-23 months children, from Feb.-march 2020 and associated factors in Shashemene Town, Oromia, Ethiopia. METHODS From February to March of 2020, a community-based cross-sectional survey was conducted. 536 mothers with children aged 6 to 23 months were chosen for the study using a two-stage sampling procedure. Data was collected by Face-to-face interviews during home-to-home visits with mothers who had children aged 6-23 months, using a structured questionnaire on the main complementary feeding indicators. The Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Logistic regression was used to identify factors associated with appropriate complementary feeding practice, with statistical significance set at probability value < 0.05. RESULTS The proportion of children aged 6-23 months who met the criteria for complementary food introduction, minimum meal frequency, minimum dietary diversity, minimum acceptable diet, and appropriate complementary feeding practices was 67.9 percent, 61.7 percent, 42.5 percent, 41.7 percent, and 30 percent, respectively. Child age 12-17 and 18-23 months were the independent factors associated with appropriate complementary feed practice [adjusted odd ratio (AOR): 2.32, 95 percent confidence interval (CI): (1.40-3.82)]. ** 1.91 (1.10-3.32) **. Socioeconomic status: mothers in the wealth index of the household, second, third, and fourth, [AOR: 4.27,95 percent, CI (1.8-10.22) ** 4.02(2.23-9.94) ** 7.02(3.27-15.1) **], number of antenatal care visits greater than or equal to four [AOR: 2.57,95 percent, CI: (1.3-5.05)] **, information sources [AOR: 3.5,95 percent, CI: (1.45-8.26) **]. CONCLUSION This study found that children aged 6-23 months had a low level of appropriate complementary feeding practice. Mothers with children aged 6-11 months, the number of antenatal care (ANC) visits, socioeconomic status, sources of information, mothers' knowledge, and positive attitude were all associated with appropriate feeding practices. As a result, nutritional education/counseling intervention on child feeding practices was suggested.
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Affiliation(s)
| | - Kebede Kumsa Sadeta
- School of Public Health Shashamene Campus of Madda Walabu University, Shashemene, Ethiopia
| | - Kelil Hussein Lenbo
- School of Nursing Shashamene Campus of Madda Walabu University, Shashemene, Ethiopia
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Farzana FD, Choudhury N, Haque MA, Ali M, Raihan MJ, Tanvir Ahmed SM, Rahman SS, Siddiqua TJ, Naz F, Faruque A, Ahmed T. Type of terrain and infant and young child feeding practices: cross-sectional study findings on children below 2 years of age from northern Bangladesh. BMJ Open 2022; 12:e056593. [PMID: 35135778 PMCID: PMC8830239 DOI: 10.1136/bmjopen-2021-056593] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Optimal feeding practices are vital for the subsistence, adequate nutrition, physical growth and mental development of infants and young children. This study aimed to examine the prevalence of core infant and young child feeding (IYCF) indicators and their associations with the type of terrain, that is, geographical area or zone among the beneficiaries of a large-scale nutrition programme, Suchana, being carried out in the northern part of rural Bangladesh. METHODOLOGY A cross-sectional study was conducted from November 2016 to February 2017 in Sylhet and Moulvibazar districts of Sylhet Division, Bangladesh. Data pertaining to 5440 children aged below 24 months were analysed for this study. Univariate analysis was carried out to establish the prevalence of the indicators; selected variables were subjected to multiple regression model to identify independent relationships between the IYCF indicators and the type of terrain stratified as plain land, hilly area, flash-flood prone area and haor (wetland). RESULTS In logistic regression analysis, flash-flood prone areas were significantly associated with higher exclusive breast feeding (1.92, 95% CI 1.12 to 3.30; p=0.019), minimum meal frequency (1.45, 95% CI 1.07 to 1.97; p=0.018) and minimum dietary diversity (1.63, 95% CI 1.01 to 2.63; p=0.046) compared with plain land. Moreover, hilly areas were associated with significantly lower introduction of solid, semisolid or soft foods (0.39, 95% CI 0.18 to 0.82; p=0.013) compared with plain land. CONCLUSION The observed prevalence of the indicators can be set as benchmark while prioritising interventions aimed at improving IYCF practices among underprivileged families residing in different types of rural setting in Bangladesh.
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Affiliation(s)
| | - Nuzhat Choudhury
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Md Ahshanul Haque
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Mohammad Ali
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | | | - S M Tanvir Ahmed
- Child Poverty Sector, Save the Children Bangladesh, Dhaka, Bangladesh
| | | | | | - Farina Naz
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Asg Faruque
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, icddr,b, Dhaka, Bangladesh
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Kassa Mekonnen C, Gizaw Demissie N, Kindie Abate H, Wako Beko Z. Infant feeding practices and its associated factors among HIV positive mothers attending public health institutions at Gondar Town, Northwest Ethiopia, 2019: An institutional based cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Yeshaneh A, Zebene M, Gashu M, Abebe H, Abate H. Complementary feeding practice and associated factors among internally displaced mothers of children aged 6-23 months in Amhara region, Northwest Ethiopia: a cross-sectional study. BMC Pediatr 2021; 21:583. [PMID: 34930219 PMCID: PMC8686606 DOI: 10.1186/s12887-021-03050-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 12/03/2021] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND Internally displaced populations are susceptible to food deprivation. Specifically, children aged 6-23 are commonly vulnerable to poor complementary feeding. Proper complementary feeding is of paramount importance to the healthy growth and survival of a children. Therefore, this study aimed to assess the level of appropriate complementary feeding practices and associated factors among internally displaced children aged 6-23 months in northwest Ethiopia, 2020. METHODS A community-based cross-sectional study was conducted from June to July 2020 among 264 internally displaced mothers of children 6-23 months in northwest Ethiopia. A systematic random sampling technique was used to reach the study subjects and data were collected using a structured and pre-tested interviewer-administered questionnaire. Data were entered into the Epi Data version 4.1 and analyzed using SPSS version 23. Binary and multivariable analyses with a 95% confidence level were performed. In the final model, variables with P < 0.05 were considered statistically significant. RESULTS The overall level of appropriate complementary feeding practice was 26.8%. Only 14% of the mothers provided a diversified diet for their 6-23 months children. Child aged 6-11 months (AOR = 0.11, 95%; CI: 0.04-0.27), 12-17 months (AOR = 0.35, 95%; 95% CI: 0.17-0.70) and not having harmful culture on complementary feeding (AOR = 2.04; 95% CI: 1.06-3.96) were independent predictors of appropriate complementary feeding practices. CONCLUSION The level of appropriate complementary feeding practice was found to be low, which would have negative implications on the health and nutritional status of infants and young children. Additional rations for breastfeeding mothers and children aged 6-23 months at refugee camps and nutritional counseling on child feeding practices are recommended.
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Affiliation(s)
- Alex Yeshaneh
- Department of Midwifery, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.
| | - Meron Zebene
- Ethiopian Federal Ministry of Health, Addis Ababa, Ethiopia
| | - Molla Gashu
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Haimanot Abebe
- Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Habtemariam Abate
- Federal Food, Medicine, and Health care Administration and Control Authority, Addis Ababa, Ethiopia
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Keno S, Bikila H, Shibiru T, Etafa W. Dietary diversity and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia. BMC Pediatr 2021; 21:565. [PMID: 34895180 PMCID: PMC8665635 DOI: 10.1186/s12887-021-03040-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although minimum dietary diversity (MDD) is one of the core indicators of a high-quality diet for infants and young children, meeting this dietary diversity standard remains a challenge in Ethiopia. Therefore, adequate information on the status and factors affecting minimum dietary diversity is essential to identify potential strategic interventions. This study to study is to assess DD and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia. METHODS A community-based cross-sectional study was conducted in the seven kebeles of Chelia District from 12th April to April 30th, 2020. Kebele is the smallest administrative unit in Ethiopia. Multistage sampling was used to select 631 participants who had a child aged 6 to 23 months. Data was entered into the Epi data version 3.1 and analyzed using Statistical Package for Social Science (SPSS) version 24. A binary logistic regression was fitted to identify significant factors associated with met MDD at 95% CI and a p-value < 0.05. RESULTS Less than one-quarter (17.32%) of infants and young children aged 6 to 23 months had met MDD. The dominant group of foods consumed was composed of grains, roots, and tubers. Children aged18-23 months (AOR = 3.26, 1.36-7.79), mothers aged 35-44 years (AOR = 3.25, 1.38-7.45), housewives as household heads (AOR = 3.41, 1.56-2.37), children of smaller family size (AOR = 3.89, 1.18-12.78), and caregivers who studied grade 9-12 (AOR = 9.98, 5.66-17.10), who received information about food diversity during ANC (AOR = 1.48, 2.21-11.23) and PNC (AOR = 3.94, 2.04-7.63) visit, who travels less than one hour to reach the market (AOR = 2.94, 1.24-6.91) and who had high family income (AOR = 4.12, 1.90-8.19) were significantly associated with meeting MDD. CONCLUSION Dietary diversity among children aged 6 to 23 months in Chelia District is low. It is proposed that caregivers on MDD be educated/trained and encouraged to share information during health service in order to increase the diverse diet and achieve a better dietary diversity score for infants and younger children.
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Affiliation(s)
- Shambel Keno
- West Shoa Zone Health Bureau, Oromia Region, Ethiopia
| | - Haile Bikila
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tesfaye Shibiru
- School of Medicine, Department of Pediatrics and Child Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Werku Etafa
- Department of Pediatrics and Neonatal Nursing, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
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Zebadia E, Mahmudiono T, Atmaka DR, Dewi M, Helmyati S, Yuniar CT. Factors Associated with Minimum Acceptable Diet in 6–11-Month-Old Indonesian Children Using the 2017 IDHS. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Inadequate complementary feeding practices are known to contribute to children’s nutritional status. A minimum acceptable diet (MAD) is one of the simple, valid, and reliable indicators to assess complementary feeding practices in 6–23-month-old children on food diversity and meal frequency. Based on the UNICEF data, the MAD of 6–11 months in Indonesia was 26.3% in 2017 and the lowest compared to other groups. Hence, this study research question is posing toward several factors associated with the low MAD among 6–11 months infant.
AIM: This study aimed to determine factors associated with MAD in 6–11-month-old children in Indonesia.
METHODS: This study was a secondary analysis using the 2017 Indonesia Demographic and Health Survey. This is a cross-sectional study involving 17,848 children in Indonesia. Final sample to be analyzed were 1,441 children of 6–11-month-old. Logistic regression model was applied to identify the significant risk factors associated with MAD.
RESULTS: The result showed that the prevalence of MAD in this study is 29%. From the multivariate logistic regression, wealth index, television ownership, and mother’s occupation were significantly associated with MAD of 6–11-month-old children in Indonesia.
CONCLUSION: In conclusion, factors associated with MAD among 6–11-month-old children were wealth index, television ownership, and mother’s occupation.
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Shagaro SS, Mulugeta BT, Kale TD. Complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia: Secondary data analysis of Ethiopian mini demographic and health survey 2019. Arch Public Health 2021; 79:205. [PMID: 34809724 PMCID: PMC8607675 DOI: 10.1186/s13690-021-00725-x] [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: 08/23/2021] [Accepted: 10/30/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Optimal nutrition in early child's life plays a vital role in improving mental and motor development, reduces the possibility of contracting various infectious diseases and related deaths, decreases the risk of obesity, and fosters better overall development. However, 45% of deaths in children under five years of age that occur globally is attributed to nutrition-related factors and the majority of these deaths occur in low-and middle-income countries. Therefore, this study aims to assess complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia. METHOD The study used the Ethiopian mini demographic and health survey 2019 data. A two-stage stratified cluster sampling technique was used to select 1465 mothers of children aged 6-23 months in Ethiopia. Two-level multilevel mixed-effects logistic regression model analysis was computed, and variables with p-value of less than 5% and an adjusted odds ratio with a 95% confidence interval in the final model were reported as statistically significant factors with appropriate complementary feeding practice. RESULT The overall prevalence of appropriate complementary feeding practice among mothers of children aged 6-23 months was 9.76%. In our study, mothers who attended primary[AOR = 2.72; 95%CI: 1.47-5.01], secondary[AOR = 2.64; 95%CI: 1.18-5.92] and higher school[AOR = 5.39; 95%CI: 2.29-12.64], being from medium income household[AOR = 2.89; 95%CI: 1.41-5.92], attended 1-3 times ANC visits in index pregnancy[AOR = 0.41; 95%CI: 0.18-0.89], mothers who have 12-17 months[AOR = 1.96; 95%CI: 1.16-3.33] and 18-23 months old children[AOR = 2.61; 95%CI: 1.49-4.54], currently breastfeeding mothers[AOR = 3.69; 95%CI: 1.73-7.91], mothers from pastoralist contextual regions[AOR = 0.29; 95%CI: 0.09-0.91], and mothers who have resided in rural areas[AOR = 0.49; 95%CI: 0.25-0.97] were factors significantly associated with appropriate complementary feeding practice. CONCLUSION This study showed low prevalence of appropriate complementary feeding practice. Therefore, the concerned health authorities need to strengthen the existing approaches designed for provision of nutrition education particularly targeting mothers who are unschooled, who have 6-11 months old children, live in pastoralist regions and reside in rural parts of the country, and create strategies that improve maternal job opportunities.
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Affiliation(s)
- Sewunet Sako Shagaro
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Be'emnet Tekabe Mulugeta
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Dileba Kale
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Akalu Y, Yeshaw Y, Tesema GA, Demissie GD, Molla MD, Muche A, Diress M, Tiruneh SA. Iron-rich food consumption and associated factors among children aged 6-23 months in sub-Saharan Africa: A multilevel analysis of Demographic and Health Surveys. PLoS One 2021; 16:e0253221. [PMID: 34138916 PMCID: PMC8211154 DOI: 10.1371/journal.pone.0253221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 05/31/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Anemia remains a major public health problem for children in sub-Saharan Africa (SSA). Iron-rich foods consumption has a determinant role on the anemia status. Hence, this study aimed to determine the prevalence of good consumption of iron-rich foods and its associated factors among children aged 6-23 months in SSA. MATERIALS AND METHODS The recent Demographic and Health Survey data sets of thirty-five SSA countries were used. Data were analyzed using STATA/MP version 16.0 and all statistical analyses were done after weighting the data. A generalized linear mixed model using Poisson regression with robust error variance was used to determine factors associated with good consumption of iron-rich food. Association of variables was declared at a p-value of ≤0.05 and adjusted prevalence ratio (aPR) ratio with its 95% confidence interval (CI) was calculated for each variable. RESULTS The total weighted samples of 77,001 children aged 6-23 months were included. The prevalence of consumption of iron rich foods was 42.1% (95% CI: 41.78-42.48). Children with age of 12-17 (adjusted prevalence ratio (aPR) = 1.96, 95% CI: 1.89-2.04) and 18-23 months (aPR = 2.05, 95% CI: 1.97-2.14), who took drugs for intestinal parasites (aPR = 1.30, 95% CI: 1.26-1.34), with postnatal check within 2 months (aPR = 1.09, 95% CI: 1.06-1.13), and children from women with ANC visit of 1-3 (aPR = 1.31, 95% CI: 1.24-1.37) and ≥4 (aPR = 1.41, 95% CI: 1.34-1.48) had higher prevalence of good consumption of iron rich foods. Moreover, the prevalence of consumptions of iron rich foods was higher among children from; family with rich (aPR = 1.36, 95%CI: 1.30-1.42) and middle (aPR = 1.14 95% CI: 1.09-1.19) wealth index, and mother with media exposure (aPR = 1.26, 95%CI: 1.22-1.31). CONCLUSION The prevalence of good consumption of iron-rich foods among children aged 6-23 months in SSA countries is low. Child factors, family factors, and community-level factors were significantly associated with consumption of iron rich foods. Strategies to increase the consumption of iron-rich foods during this critical stage of growth and development should be designed in SSA.
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Affiliation(s)
- Yonas Akalu
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Yigizie Yeshaw
- Department of Physiology, School of Medicine, 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
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getu Debalkie Demissie
- Department of Health Education and Behavioral Sciences, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebe Muche
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Kemboi S, Mungiria-Mituki D, Ramkat R, Termote C, Covic N, Cheserek MJ. Variation in the Factors Associated With Diet Quality of Children Aged 6 to 23 Months in Low and High Agroecological Zones of Rongai Subcounty, Kenya. Food Nutr Bull 2021; 41:186-199. [PMID: 32522128 DOI: 10.1177/0379572120912875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adequate quality complementary diets and appropriate feeding practices are important for proper growth and development of young children. OBJECTIVE To assess factors associated with diet diversity, meal frequency, and acceptable diet of children aged 6 to 23 months in two agroecological zones of Rongai subcounty, Kenya. METHODS A cross-sectional study was conducted among 384 mothers/caregivers with children aged 6 to 23 months. A structured questionnaire was used to assess sociodemographic characteristics and child feeding practices. Diet diversity, meal frequency, and acceptable diet were derived from a 24-hour recall of child's food intake. Factors associated with diet quality were determined using binary logistic regression. RESULTS Mean child diet diversity score was 3.54 ± 1.0 of 7 food groups, with 56.8% of the children achieving minimum dietary diversity. A majority of the children (81.8%) received minimum meal frequency (MMF), with significant (P < .05) difference between low (91.1%) and high (75.2%) agricultural potential areas. Children who received minimum acceptable diet (MAD) were only 34.1%. Mother/caregiver education level positively (P < .05) associated with minimum diet diversity in low potential area (adjusted odds ratio [AOR] = 3.79, 95% CI: 1.47-9.75) and with MAD in high potential area (AOR = 1.87, 95% CI: 1.01-3.46). Other factors associated with MDD, MMF, and MAD included household income and slow feeding in low potential area, and child gender and active feeding in high potential area. CONCLUSION There is a variation in factors associated with diet quality and child feeding practices in different agroecological zones. Therefore, nutrition education and behavior change communication interventions aimed at improving child nutrition should be context-specific.
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Affiliation(s)
| | | | | | | | - Namukolo Covic
- International Food Policy Research Institute, Addis Ababa, Ethiopia
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Mothers' perceptions on and learning from infant and young child-feeding videos displayed in Mother and Child Health Centers in Kenya: a qualitative and quantitative approach. Public Health Nutr 2021; 24:3845-3858. [PMID: 34034846 DOI: 10.1017/s1368980021002342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective was to explore mothers’ perceptions on educational videos on infant and young child-feeding practices, and to assess whether viewing frequencies would influence maternal knowledge, attitudes and feeding practices (KAP). DESIGN A set of forty-seven videos were displayed in health centres for 6 months. At 3 months, we conducted focus group discussions (FGD) with mothers and, at 6 months, administered KAP-questionnaire-based interviews to mothers. Using a quasi-experimental design, we compared groups according to video viewing frequencies. SETTING The study was conducted in a slum in Nairobi and a rural area in Machakos, Kenya. We installed TV screens in waiting rooms of six Mother and Child Health Centers, where mothers could choose to watch them. PARTICIPANTS Forty-three mothers with children aged 0–48 months participated in six FGD and 547 mothers of children aged 0–23 months in KAP interviews. RESULTS The mothers from the FGD found the videos acceptable and beneficial. Videos enhanced mothers’ learning and empowered them to support others in learning. The KAP data showed that after adjustments, breast-feeding (P = 0·06), complementary feeding knowledge (P = 0·01), complementary feeding attitudes (P = 0·08) and hygiene knowledge and practices (P = 0·003) were better among mothers who had seen videos three to four times, or five or more times, compared with mothers who had seen the videos once or twice. CONCLUSIONS Videos were an accepted form of education and were beneficial when watched repeatedly. The videos could be a good addition to current infant and young child-feeding education efforts in Kenya.
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Minimum acceptable diet among children aged 6-23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study. BMC Pediatr 2021; 21:239. [PMID: 34011304 PMCID: PMC8132412 DOI: 10.1186/s12887-021-02713-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02713-0.
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Molla A, Egata G, Getacher L, Kebede B, Sayih A, Arega M, Bante A. Minimum acceptable diet and associated factors among infants and young children aged 6-23 months in Amhara region, Central Ethiopia: community-based cross-sectional study. BMJ Open 2021; 11:e044284. [PMID: 33972337 PMCID: PMC8112428 DOI: 10.1136/bmjopen-2020-044284] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE The main objective of this study was to assess the prevalence of a minimum acceptable diet (MAD) and associated factors. DESIGN Community-based cross-sectional study SETTING: Debre Berhan Town, Ethiopia. PARTICIPANTS An aggregate of 531 infants and young children mother/caregiver pairs participated in this study. A one-stage cluster sampling method was used to select study participants and clusters were selected using a lottery method. Descriptive statistics were calculated for all study variables. Statistical analysis was performed on data to determine which variables are associated with MAD and the results of the adjusted OR with 95% CI. P value of <0.05 considered statistically significant. PRIMARY OUTCOME Prevalence of MAD and associated factors RESULTS: The overall prevalence of MAD was 31.6% (95% CI: 27.7 to 35.2). Having mother attending secondary (adjusted OR, AOR=4.9, 95% CI: 1.3 to 18.9) and college education (AOR=6.4, 95% CI: 1.5 to 26.6), paternal primary education (AOR=1.3, 95% CI: 1.5 to 2.4), grouped in the aged group of 12-17 months (AOR=1.8, 95% CI: (1.0 to 3.4) and 18-23 months (AOR=2.2, 95% CI: 1.2 to 3.9), having four antenatal care (ANC) visits (AOR=2.0, 95% CI: 1.0 to 3.9), utilising growth monitoring (AOR=1.8, 95% CI: 1.1 to 2.9), no history of illness 2 weeks before the survey (AOR=2.9, 95% CI: 1.5 to 6.0) and living in the household with home garden (AOR=2.5, 95% CI: 1.5 to 4.3) were positively associated with increase the odds of MAD. CONCLUSION Generally, the result of this study showed that the prevalence of minimum acceptable was very low. Parent educational status, ANC visits, infant and young child feeding advice, child growth monitoring practice, age of a child, a child has no history of illness 2 weeks before the survey, and home gardening practice were the predictors of MAD. Therefore, comprehensive intervention strategies suitable to the local context are required to improve the provision of MAD.
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Affiliation(s)
- Abebaw Molla
- School of Public Health, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Gudina Egata
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Lemma Getacher
- Department of Public Health, Institute of Health Sciences Debre Birhan University, Debre Birhan, Ethiopia
| | - Bezie Kebede
- School of Pharmacy, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Alemayehu Sayih
- Department of Nursing, College of Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Mikyas Arega
- Department of Public Health, Institute of Health Sciences Debre Birhan University, Debre Birhan, Ethiopia
| | - Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences Arba Minch University, Arba Minch, Ethiopia
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Mollay C, Kassim N, Stoltzfus R, Kimanya M. Complementary feeding in Kongwa, Tanzania: Findings to inform a mycotoxin mitigation trial. MATERNAL AND CHILD NUTRITION 2021; 17:e13188. [PMID: 33945210 PMCID: PMC8476443 DOI: 10.1111/mcn.13188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 11/27/2022]
Abstract
Complementary feeding of 6‐ to 24‐month‐old infants and young children with adequate, safe and developmentally appropriate food is essential to child health. Inappropriate complementary foods and feeding practices are linked to the high incidences of undernutrition among infant and young children in most developing countries, including Tanzania. Mycotoxin risk is an additional concern, given the documented presence of aflatoxin and fumonisin in food systems of Africa, especially maize and groundnut. In preparation for a trial of mycotoxin mitigation, we conducted focus group discussions and recipe trials to explore complementary foods and feeding practices in Kongwa, a rural district of central Tanzania. Sixty mothers of infants from 6 to 18 months of age in five villages across the district were purposefully sampled. During focus group discussions, mothers reported to mostly feed their children with cereal and groundnut‐based foods as thin or thick porridges. The most common porridge preparations contained cereal (mostly, maize) ranging from 66.7% to 80.0% by weight and groundnuts from 7.7% to 33.3%. The ratio of cereal to groundnut ranged from 3:1 to 4:1. For the recipe trial sessions, mothers chose similar ingredients reported during discussions to prepare complementary foods. The reliance on maize and groundnuts in complementary foods predisposes the children to undernutrition and exposure to aflatoxins and fumonisins. These formative research results suggest multiple intervention points to improve complementary feeding and reduce mycotoxin exposure in this population, including education messages package on feeding practices, mycotoxin control practices and complementary food formulation.
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Affiliation(s)
- Clara Mollay
- Department of Food Biotechnology and Nutritional Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Neema Kassim
- Department of Food Biotechnology and Nutritional Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | | | - Martin Kimanya
- Department of Food Biotechnology and Nutritional Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
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Waswa LM, Jordan I, Krawinkel MB, Keding GB. Seasonal Variations in Dietary Diversity and Nutrient Intakes of Women and Their Children (6-23 Months) in Western Kenya. Front Nutr 2021; 8:636872. [PMID: 33763444 PMCID: PMC7982591 DOI: 10.3389/fnut.2021.636872] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 02/12/2021] [Indexed: 01/09/2023] Open
Abstract
Seasonal variations in food availability and access contributes to inadequate nutrient intakes, particularly in low income countries. This study assessed the effect of seasonality on dietary diversity (DD) and nutrient intakes of women and children aged 6–23 months in a rural setting in Western Kenya. A longitudinal study was conducted among 426 mother-child pairs during the harvest and post-harvest seasons in 2012. Dietary intakes were assessed using 24-h dietary recalls and dietary diversity scores (DDS) and nutrient intakes calculated for both seasons. Effect of seasonality on women dietary diversity scores (WDDS) and children's dietary diversity scores (CDDS) were assessed using generalised linear mixed models (GLMM). The proportion of women consuming diets with high DDS (>4 out of 9 food groups) increased from 36.4 to 52.4% between the two seasons, with mean WDDS being significantly higher in November compared to July/August (4.62 ± 1.43 vs. 4.16 ± 1.14, P < 0.001). A significantly higher proportion of children consumed foods from ≥4 out of 7 food groups in November compared to July/August (62.4 vs. 52.6%, P = 0.004). Mean CDDS (3.91 vs. 3.61, P = 0.004) was low but significantly higher in November compared to July/August. Estimated marginal mean WDDS increased from 4.17 to 4.38, and decreased for CDDS from 3.73 to 3.60 between the seasons. Seasonality had a small but significant effect on WDDS, P = 0.008 but not on CDDS, P = 0.293. Increase in CDDS in November was due to age and not seasonal effect. Higher women education and household food security were associated with higher WDDS and CDDS. Intakes of iron, calcium and vitamin E were higher among women in November and significantly different between the seasons. Agro-ecological zone, ethnic group and home gardening influenced nutrient intakes of the women. Seasonality had an effect on the DD of women but not of children, thus other factors apart from food availability influence the quality of children's diets during the complementary feeding period. With increasing age and transition to family foods, children's DD is expected to be affected by seasonality. Integrated interventions to alleviate seasonal food insecurity and strengthen rural households' resilience against seasonal deterioration in diet quality are recommended.
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Affiliation(s)
- Lydiah M Waswa
- Department of Human Nutrition, Faculty of Health Sciences, Egerton University, Egerton, Kenya
| | - Irmgard Jordan
- Center for international Development and Environmental Research, Justus Liebig University Giessen, Giessen, Germany
| | - Michael B Krawinkel
- Institute of Nutritional Sciences-International Nutrition, Justus Liebig University Giessen, Giessen, Germany
| | - Gudrun B Keding
- Division of Quality of Plant Products, Department of Crop Sciences, Faculty of Agricultural Sciences, George August University Goettingen, Goettingen, Germany
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Hassen SL, Temesgen MM, Marefiaw TA, Ayalew BS, Abebe DD, Desalegn SA. Infant and Young Child Feeding Practice Status and Its Determinants in Kalu District, Northeast Ethiopia: Community-Based Cross-Sectional Study. NUTRITION AND DIETARY SUPPLEMENTS 2021. [DOI: 10.2147/nds.s294230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Sema A, Belay Y, Solomon Y, Desalew A, Misganaw A, Menberu T, Sintayehu Y, Getachew Y, Guta A, Tadesse D. Minimum Dietary Diversity Practice and Associated Factors among Children Aged 6 to 23 Months in Dire Dawa City, Eastern Ethiopia: A Community-Based Cross-Sectional Study. Glob Pediatr Health 2021; 8:2333794X21996630. [PMID: 33748344 PMCID: PMC7905725 DOI: 10.1177/2333794x21996630] [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] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 01/30/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: Malnutrition because of poor dietary diversity contributing to child morbidity and mortality. Two-thirds of child mortality occurs within the first 2 years. However, there is limited data related to dietary diversity among children aged 6 to 23 months in Ethiopia. Thus, this study aimed to assess dietary diversity and factors among children aged 6 to 23 months in the study setting. Methods: A community-based cross-sectional study conducted on 438 children aged 6 to 23 months in Dire Dawa, 1-30/02/2019. Simple random sampling was used to select study subjects. Data collected using a structured and pretested interview administered questionnaire. Data entered using EpiData 4.2 and analyzed with SPSS Version 22. Multivariable logistic regression was used to examine associated factors. Adjusted odd-ratio with 95% confidence interval (CI) used, and P-value <.05 considered statistically significant. Results: The overall minimum dietary diversity practice was 24.4% (95% CI: 20.3, 28.5). Maternal education [AOR 2.20; 95% CI: 1.08, 4.52], decision-making [AOR = 2.5; 95% CI: 1.19, 5.29], antenatal care [AOR = 2.19; 95% CI: 1.20, 3.99], postnatal care [AOR = 6.4; 95% CI: 2.78, 14.94] and facility delivery [AOR = 2.66; 95% CI: 1.35, 5.25] were maternal factors. Moreover, child’s age [AOR = 2.84; 95% CI: 1.39, 5.83], and child’s sex [AOR = 2.85; 95% CI: 1.64, 4.94] were infant factors. Conclusion: One-fourth of children practiced minimum dietary diversity. Child’s age, birth interval, postnatal care, antenatal care, child’s sex, mothers’ decision-making, mothers’ education, and place of delivery were significant predictors. Therefore, maternal education, empowering women, and improve maternal service utilization are crucial to improving dietary diversity.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Alemu Guta
- Dire Dawa University, Dire Dawa, Ethiopia
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Chilinda ZB, Wahlqvist ML, Lee MS, Huang YC. Optimal Household Water Access Fosters the Attainment of Minimum Dietary Diversity among Children Aged 6-23 Months in Malawi. Nutrients 2021; 13:nu13010178. [PMID: 33430102 PMCID: PMC7827850 DOI: 10.3390/nu13010178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/31/2020] [Accepted: 01/06/2021] [Indexed: 11/22/2022] Open
Abstract
Along with sanitation and hygiene, water is a well-known driver of child undernutrition. However, a more direct role of household (HH) water access in shaping dietary diversity remains unexplored. We assessed the association between HH water access and achievement of minimum dietary diversity (MDD) among young children. We utilized nationally-representative cross-sectional data from the 2015/16 Malawi Demographic and Health Survey, which included 4727 mother–child dyads, respectively, (26.8 ± 6.8 years, range 15–49 years) and (13.9 ± 4.9 months, range 6–23 months). HH water access was categorized as (1) basic or no access, (2) intermediate, or (3) optimal. MDD was defined as feeding a child, during the previous day, at least four of the food groups defined by the World Health Organization. Only 27.7% of the children achieved MDD standards; most of the children who achieved MDD were from HHs with optimal water access (58.4%, p < 0.001). However, only 5.9% of the mother–child dyads were from HHs with optimal water access. After adjusting for covariates, children from HHs with optimal water access had higher odds of achieving MDD than those from HHs with basic or no water access (aOR = 1.74, CI = 1.24–2.46). Our results highlight the need to incorporate water-based strategies into national nutritional policies to increase dietary diversity among Malawian infants and young children.
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Affiliation(s)
- Zizwani Brian Chilinda
- Graduate Institute of Public Health, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan;
| | - Mark L. Wahlqvist
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan;
- School of Public Health, National Defense Medical Center, No. 161, Section 6, Minquan East Road, Neihu District, Taipei City 11490, Taiwan;
- Institute of Population Health Sciences, National Health Research Institutes, 35 Keyan Road, Zhunan, Miaoli County 35053, Taiwan
- Monash Asia Institute, Monash University, 5th Floor, H Building, 900 Dandenong Road, Caulfield East, Melbourne, VIC 3145, Australia
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, No. 161, Section 6, Minquan East Road, Neihu District, Taipei City 11490, Taiwan;
| | - Yi-Chen Huang
- Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan;
- Correspondence: ; Tel.: +886-4-2205-3366 (ext. 7523)
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Hiruy AF, Teshome AA, Desta YT, Zuo X, He S, Assefa EG, Ying C. Dietary condition and feeding practices of children aged 6-23 months in Ethiopia: analysis of 2005-2016 demographic and health survey. Eur J Clin Nutr 2021; 75:1047-1059. [PMID: 33402739 DOI: 10.1038/s41430-020-00828-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 10/28/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Childhood malnutrition is well estimated as the major underlying risk factor for morbidity and mortality in children under 5 years. Feeding practices greatly influence the dietary condition of children aged 6-23 months in developing countries. Therefore, this study was performed to determine the association between infant young children feeding (IYCF) practices and the dietary conditions of children aged 6-23 months in Ethiopia. METHOD A cross-sectional study was conducted based on data on 5638 children aged 6-23 months from three Ethiopia Demographic and Health Surveys (EDHS) (2005, 2011, 2016). Multivariable logistic regression was performed to estimate the odd ratios (ORs) and 95% confidence intervals (CIs) of stunting and anaemia with IYCF practices. RESULT The prevalence of stunting among children aged 6-23 months in Ethiopia decreased greatly from 49% in 2005 to 32% in 2016. Among the IYCF practices, consumption of iron-rich foods, minimum dietary diversity (MDD), and minimum acceptable diet (MAD) were significant predictors of stunting. In addition, the prevalence of anaemia declined significantly from 26% in 2005 to 16% in 2011, but increased to 29% in 2016. Among the IYCF practices, breastfeeding and minimum meal frequency (MMF) had lower odds of childhood anaemia. CONCLUSIONS The present study showed that anaemia and stunting among children aged 6-23 months in Ethiopia is critical public health problems that need urgent attention.
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Affiliation(s)
- Aschalew Fikru Hiruy
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Anissa Abebe Teshome
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Yemane Tadesse Desta
- Department of Immunology, School of basic medical science, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Xuezhi Zuo
- Department of Clinical Nutrition, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, 430030, Hubei, China
| | - Shuiqing He
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Eskedar Getachew Assefa
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China
| | - Chenjiang Ying
- Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, Hubei, China. .,Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Dietary Diversity and Associated Factors Among Children Aged 6-23 Months in Indonesia. J Pediatr Nurs 2021; 56:30-34. [PMID: 33181370 DOI: 10.1016/j.pedn.2020.10.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/01/2020] [Accepted: 10/05/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Optimum feeding practice is the key to determine development and growth among infants and young children. Dietary diversity is considered an indicator to assess nutritional adequacy. OBJECTIVES This study aimed to determine the factors that associated with minimum dietary diversity types among children aged 6-23 months in Indonesia. METHODS Secondary data analysis was carried out for this study using the Indonesian Demographic and Health Survey (IDHS) 2017. The study was conducted with inclusion criteria in women of childbearing age with ages ranging from 15 to 49 years, having children aged 6-23 months, and living with respondents (n = 4861). Data obtained using a questionnaire with cross-sectional design approach. Chi-square test, and logistic regression test were used to measure the determinants of minimum dietary diversity. RESULTS The prevalence of children aged 6-23 months who received various foods was 3070 (63.15%) respondents. Age of child of 18-23 months [AOR = 5.88; 95% CI = 4.48-7.14], mother graduated from university level [AOR = 5.16; 95% CI = 2.07-12.89], access to maternal information on mass media (reading newspapers or magazines [AOR = 1.30; 95% CI = 1.10-1.55] and watching television [AOR = 1.56; 95% CI = 1.06-2.30]), and richest wealth quintile [AOR = 1.91; 95% CI = 1.32-2.75] significantly related to minimum dietary diversity in children aged 6-23 months in Indonesia. CONCLUSIONS The current study revealed that minimum dietary diversity among Indonesian children remain related to education, mass media and socio-economic level. PRACTICE IMPLICATIONS Pediatric nurses can play a critical role here by delivering the messages through educational outreach visits that focus on poor uneducated mother.
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Minimum dietary diversity and associated factors among young infants and children living in the most productive area of Amhara region, Addis Zemen town: A community-based cross-sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fanta M, Cherie HA. Magnitude and determinants of appropriate complementary feeding practice among mothers of children age 6-23 months in Western Ethiopia. PLoS One 2020; 15:e0244277. [PMID: 33382749 PMCID: PMC7774947 DOI: 10.1371/journal.pone.0244277] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 12/07/2020] [Indexed: 11/18/2022] Open
Abstract
Background Appropriate complementary feeding has the potential to prevent 6 percent of all under five deaths particularly in developing countries. However, infant and young child feeding practices in Ethiopia are suboptimal. Data on complementary feeding practices in Horro district are also lacking. Therefore, this study aimed to determine magnitude and determinants of appropriate complementary feeding practice among mothers of children age 6–23 months in Horro district, Western Ethiopia. Methods Community based cross sectional study was conducted from February to March 2016 in six kebeles of Horro district, Western Ethiopia. A total of 325 mothers of children age 6–23 months were included in the study. Data were collected using pre-tested interviewer administered structured questionnaire; entered into EPI-INFO version 3.5.4 and analyzed using SPSS version 20. Odds ratio was calculated with 95% CI to identify determinants of appropriate complementary feeding practice. P-values less than 0.05 were considered as statistically significant. Results The magnitude of appropriate complementary feeding practice in the study area was 9.91%. Lower age of child (6-11months) [AOR: 0.195, 95% CI: (0.045–0.846)], having no formal education [AOR = 0.115:95% CI: (0.002, 0.290)] and giving birth for the first time [AOR = 0.271:95% CI: (0.011, 0.463)] were factors negatively associated with appropriate complementary feeding practice. Conclusion Only one tenth of mothers practiced appropriate complementary feeding. This strongly calls for sustained nutrition education targeting uneducated mothers, mothers who gave birth for the first time and those with very young children to improve the practice.
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Affiliation(s)
- Marga Fanta
- Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar, Ethiopia
| | - Hirut Assaye Cherie
- Department of Applied Human Nutrition, Bahir Dar Institute of Technology, Bahir Dar, Ethiopia
- * E-mail:
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Rebouças AG, Bernardino ÍDM, Dutra ER, Imparato JCP, Duarte DA, Flório FM. Factors associated with feeding practices among Brazilian children aged 12 to 23 months old. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2020. [DOI: 10.1590/1806-93042020000400007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Abstract Objectives: a quantitative analytical cross-sectional study aimed to identify demographic characteristics to access health services and housing conditions in relation to inadequate feeding practices among Brazilian children from 12 to 23 months of age. Methods: the analysis of the feeding practices (consumption of recommended food groups) of 2541 Brazilian children (aged 12-23 months old) was performed using data from the Pesquisa Nacional de Saúde 2013 (National Health Survey). Descriptive and multivariate statistics used the Decision Tree Analysis based on CHAID (Chi-squared Automatic Interaction Detector) algorithm, as well as hierarchically adjusted Poisson regression analyses were performed. The variables were entered in a hierarchical model at distal (demographic), intermediate (access to health) and proximal (housing conditions) levels. Results: the results showed a high prevalence of sugar consumption (85.5%; CI95%=83.7-87.2) and highlighted inadequate feeding practices among non-white children (p=0.001), resident in the North (p<0.001) and Northeast (p=0.010) of Brazil and in towns in the countryside (p<0.001) presented feeding practices that were not recommended for consumption in the food groups. Conclusions: non-white children, who lived in the North and Northeast regions of Brazil and in the countryside, which are known to be more socioeconomically vulnerable, were more likely to experience inadequate feeding practices.
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Leonez DGVR, Melhem ARDF, Vieira DG, de Mello DF, Saldan PC. COMPLEMENTARY FEEDING INDICATORS FOR CHILDREN AGED 6 TO 23 MONTHS ACCORDING TO BREASTFEEDING STATUS. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2020; 39:e2019408. [PMID: 33111770 PMCID: PMC7584029 DOI: 10.1590/1984-0462/2021/39/2019408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To verify if there are differences among the complementary feeding indicators of children aged 6-23 months according to the breastfeeding status. METHODS A cross-sectional study was carried out with 1,355 children aged 6-23 months in 2012 to evaluate five indicators proposed by the World Health Organization (WHO) and modified in accordance with Brazilian's recommendations "Ten steps to a healthy feeding: a feeding guide for children under two years old". The indicators used were: I. Introduction of solid, semi-solid or soft foods; II. Minimum dietary diversity; III. Minimum meal frequency; IV. Minimum acceptable diet, and V. Consumption of iron-rich foods. To verify differences between the complementary feeding indicators according to breastfeeding status, the F-statistic was used, with p≤0.05 meaning significant. RESULTS Indicators I, II, and V were similar among breastfed and non-breastfed children; however, indicators III and IV presented a higher proportion of adequacy for non-breastfed children, with 94.9% (CI95% 93.2-96.2) versus 40.3% (CI95% 33.2-47.9) for indicator III, and 57.3% (CI95% 53.2-61.2) versus 23.1% (CI95% 17.4-30.1) for indicator IV. CONCLUSIONS Non-breastfed children have better complementary feeding status, but the indicator III takes into account non-breast milk as a meal for non-breastfed children, which increased the number of dairy meals and influenced indicator IV (calculated from indicators II and III).
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Tariqujjaman M, Rahman M, Luies SK, Karmakar G, Ahmed T, Sarma H. Unintended consequences of programmatic changes to infant and young child feeding practices in Bangladesh. MATERNAL AND CHILD NUTRITION 2020; 17:e13077. [PMID: 33063946 PMCID: PMC7988846 DOI: 10.1111/mcn.13077] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/29/2022]
Abstract
BRAC, an international development organization, implemented a home-fortification programme from 2014 to 2018 in Bangladesh. This study aimed to understand the unintended consequences of programmatic changes that occurred during the implementation of the programme on the prevalence of good infant and young child feeding (IYCF) practices and other associated factors. We used pooled data from eight cross-sectional surveys and data from a series of qualitative investigations carried out as part of a mixed-methods evaluation approach. A total of 6,479 caregivers of children aged 6 to 23 months participated in the surveys. The prevalence of good IYCF practices increased from baseline (42.1%) to midline (45.3%), but it decreased at the endline survey (31.9%). Qualitative investigations identified several reasons for low IYCF practices at the programme level, such as the withdrawal of community health worker (CHW) incentives for promoting IYCF, providing incentives for the home-fortification of micronutrient powder (MNP) and changing the focus from IYCF promotion to MNP promotion. A multivariable generalized estimating equation model for pooled data revealed that caregivers were 28% (adjusted risk ratio [ARR]: 0.72, 95% CI [0.67, 0.78]) less likely to maintain good IYCF practices during the period when CHWs were not incentivized to promote IYCF compared to the period when CHWs were incentivized to promote it. The prevalence of good IYCF practices decreased from both baseline and midline to the endline survey due to the unintended consequences of the programmatic changes. An integrated intervention strategy to promote the home-fortification of MNP and IYCF could be helpful to avoid unintended negative consequences of programmatic changes.
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Affiliation(s)
- Md Tariqujjaman
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahfuzur Rahman
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Sharmin Khan Luies
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Gobinda Karmakar
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Tahmeed Ahmed
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Haribondhu Sarma
- Nutrition and Clinical Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.,Research School of Population Health, The Australian National University, Acton, Australia
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Gezahegn H, Tegegne M. <p>Magnitude and Its Predictors of Minimum Dietary Diversity Feeding Practice Among Mothers Having Children Aged 6–23 Months in Goba Town, Southeast Ethiopia, 2018: A Community-Based Cross-Sectional Study</p>. NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s243521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Hilemariam F, Ketema K, Endalifer ML. Complementary feeding practice and associated factors among children aged 6 to 12 months attending governmental health facilities in Addis Ababa: Ethiopia. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Inappropriate feeding practices, coupled with high rates of infectious diseases, are the proximate causes of malnutrition during the first two years of life. Around 10 million under-five children died annually of which over one-third were due to inappropriate complementary feeding. OBJECTIVE: To assess factors associated with timely initiation of complementary feeding among children aged 6 to 12 months in public health care facilities of Addis Ababa Ethiopia. METHODS: An institutional-based cross-sectional study design was conducted. Data was collected using a pretested structured questionnaire. Binary and multivariable logistic regressions analyses were performed. Variables with p-value ≤0.05 were considered as statistically significant. RESULTS: The proportion of timely initiation of complementary feeding was 65.2% (95% CI = 60.8, 69.5). Being married [AOR = 2.622, 95% CI: 1.182–5.817], belongs to 18–24 years age at first marriage [AOR = 1.671, 95% CI: 1.019–2.742], being grade 9 and above [AOR = 1.910, 95% CI: 1.401–2.258], average income > 1500 Ethiopian birr [AOR = 2.138, 95% CI: 1.762–2.347], and postnatal care follow up [AOR = 1.641, 95% CI:1.435–3.224] were significantly associated with complementary feeding. CONCLUSIONS: In this study, the magnitude of timely initiation complementary feeding was higher as compared to the country level figure. Implementing nutrition strategy which scales-up mother’s living standards improve complementary feedings practices.
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Affiliation(s)
| | - Kassahun Ketema
- College of Medicine and Health Science Debre Markos University, Debre Markos, Ethiopia
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Obstetrical care is associated with child's dietary diversity in Indonesia: analysis from Demographic and Health Survey 2017. Public Health Nutr 2020; 24:2640-2649. [PMID: 32933590 DOI: 10.1017/s1368980020002396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the influence of obstetrical care factors on dietary diversity and individual food group consumption in Indonesia. DESIGN Cross-sectional study to assess the association between pregnancy care factors and dietary diversity score, minimum dietary diversity (MDD) and consumption of seven food groups. SETTING Data from the Indonesia Demographic and Health Survey 2017. PARTICIPANTS A total of 5113 children aged 6-23 months. RESULTS Dietary diversity score was significantly higher for children whose mothers received four or more prenatal care visits, were delivered at a health facility, had a professionally trained delivery assistant and were delivered by C-section. Children born at a health facility and delivered by a health professional had higher odds of meeting MDD (adjusted OR (AOR) 1·45, 95 % CI 1·18, 1·79 and OR 2·10, 95 % CI 1·54, 2·87, respectively). Four or more antenatal visits, delivering at a health facility and having a professional delivery attendant were associated with higher odds of consumption of lentils (AOR 1·66, 95 % CI 1·23, 2·25, AOR 1·30, 95 % CI 1·02, 1·65 and AOR 1·79, 95 % CI 1·19, 2·69). Four or more antenatal visits, delivering at a health facility and having a professional delivery attendant had higher odds of consumption of other fruits and vegetables (AOR 1·70, 95 % CI 1·23, 2·35, OR 1·23, 95 % CI 1·03, 1·61 and OR 1·90, 95 % CI 1·29, 2·79). CONCLUSIONS Efforts focusing on providing nutritional education during antenatal care and delivery should be encouraged, especially for mothers seeking care outside of a health facility.
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Appiah CA, Mensah FO, Hayford FEA, Awuuh VA, Kpewou DE. Predictors of undernutrition and anemia among children aged 6–24 months in a low-resourced setting of Ghana: a baseline survey. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-05-2019-0095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe purpose of this study was to identify the predictors of child undernutrition and anemia among children 6–24 months old in the East Mamprusi district, Northern region, Ghana.Design/methodology/approachThis cross-sectional study recruited 153 children and their mothers. Weight, height and hemoglobin levels of the children were measured. A structured questionnaire based on the World Health Organization's indicators for assessing infant and young child feeding practices was used to collect data on parents' socioeconomic status, household characteristics, hygiene and sanitation practices, mothers' knowledge on feeding practices such as child's meal frequency and dietary diversity and child morbidity within the past two weeks. Predictors of child nutritional status were determined using multinomial logistic regression analysis.FindingsUnderweight in the children was significantly predicted by maternal knowledge on protein foods (AOR = 0.045, p = 0.008), time of initiation of complementary feeding (AOR = 0.222, p = 0.032) and maternal age (AOR = 9.455, p = 0.017). Feeding child from separate bowls (AOR = 0.239, p = 0.005), minimum meal frequency per child's age (AOR = 0.189, p = 0.007) and time of initiation of complementary feeding (AOR = 0.144, p = 0.009) were significant determinants of stunting among the children. Exclusive breast feeding (AOR = 7.975, p = 0.012) and child's past morbidity (AOR = 0.014, p = 0.001) significantly contributed to anemia among the children.Research limitations/implicationsThis is a cross-sectional study and cannot establish causality. The small sample size also limits the generalizability of study findings. However, findings of the study highlight factors which could potentially influence the high rate of child undernutrition in the study setting.Practical implicationsThis study identifies determinants of undernutrition in the East Mamprusi district, an underresourced area in Ghana. This information could inform the development/reformulation of locally sensitive key messages and targeted intervention strategies to curb the high levels of child undernutrition in the East Mamprusi district of Ghana.Originality/valueThis study identifies maternal care practices as key potential drivers of undernutrition in a low-resource setting known for high prevalence of child undernutrition. It suggests insight for large-scale studies on the predictors of child undernutrition in Northern Ghana and other resource-poor settings.
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