1
|
Sin MP, Forsberg BC, Peterson SS, Alfvén T. Assessment of Childhood Stunting Prevalence over Time and Risk Factors of Stunting in the Healthy Village Programme Areas in Bangladesh. CHILDREN (BASEL, SWITZERLAND) 2024; 11:650. [PMID: 38929230 PMCID: PMC11202057 DOI: 10.3390/children11060650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/14/2024] [Accepted: 05/20/2024] [Indexed: 06/28/2024]
Abstract
Childhood stunting is a significant public health concern in Bangladesh. This study analysed the data from the Healthy Village programme, which aims to address childhood stunting in southern coastal Bangladesh. The aim was to assess childhood stunting prevalence over time and explore the risk factors in the programme areas. A cross-sectional, secondary data analysis was conducted for point-prevalence estimates of stunting from 2018 to 2021, including 132,038 anthropometric measurements of under-five children. Multivariate logistic regression analyses were conducted for risk factor analysis (n = 20,174). Stunting prevalence decreased from 51% in 2018 to 25% in 2021. The risk of stunting increased in hardcore poor (aOR: 1.46, 95% CI: 1.27, 1.68) and poor (aOR: 1.50, 95% CI: 1.33, 1.70) versus rich households, children with mothers who were illiterate (aOR: 1.25, 95% CI: 1.09, 1.44) and could read and write (aOR: 1.35, 95% CI: 1.16, 1.56) versus mothers with higher education, and children aged 1-2 years compared with children under one year (aOR: 1.32, 95% CI: 1.20, 1.45). The stunting rate was halved over three years in programme areas, which is faster than the national trend. We recommend addressing socioeconomic inequalities when tackling stunting and providing targeted interventions to mothers during the early weaning period.
Collapse
Affiliation(s)
- May Phyu Sin
- Department of Orthopedics, Lund University, 221 85 Lund, Sweden;
| | - Birger C. Forsberg
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (S.S.P.); (T.A.)
| | - Stefan Swartling Peterson
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (S.S.P.); (T.A.)
| | - Tobias Alfvén
- Department of Global Public Health, Karolinska Institutet, 171 77 Stockholm, Sweden; (S.S.P.); (T.A.)
| |
Collapse
|
2
|
Belay DG, Wassie MM, Alemu MB, Merid MW, Norman R, Tessema GA. Socio-economic and spatial inequalities in animal sources of iron-rich foods consumption among children 6-23 months old in Ethiopia: A decomposition analysis. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003217. [PMID: 38753686 PMCID: PMC11098381 DOI: 10.1371/journal.pgph.0003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 04/16/2024] [Indexed: 05/18/2024]
Abstract
Iron deficiency anaemia is the most common type of anaemia in young children which can lead to long-term health consequences such as reduced immunity, impaired cognitive development, and school performance. As children experience rapid growth, they require a greater supply of iron from iron-rich foods to support their development. In addition to the low consumption of iron-rich foods in low- and lower-middle-income countries, there are also regional and socio-economic disparities. This study aimed to assess contributing factors of wealth-related inequality and geographic variations in animal sources of iron-rich food consumption among children aged 6-23 months in Ethiopia. We used data from the Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019, a national survey conducted using stratified sampling techniques. A total of 1,461 children of age 6-23 months were included in the study. Iron-rich animal sources of food consumption were regarded when parents/caregivers reported that a child took at least one of the four food items identified as iron-rich food: 1) eggs, 2) meat (beef, lamb, goat, or chicken), 3) fresh or dried fish or shellfish, and 4) organs meat such as heart or liver. Concentration indices and curves were used to assess wealth-related inequalities. A Wagstaff decomposition analysis was applied to identify the contributing factors for wealth-related inequality of iron-rich animal source foods consumption. We estimated the elasticity of wealth-related inequality for a percentage change in socioeconomic variables. A spatial analysis was then used to map the significant cluster areas of iron-rich animal source food consumption among children in Ethiopia. The proportion of children who were given iron-rich animal-source foods in Ethiopia is 24.2% (95% CI: 22.1%, 26.5%), with figures ranging from 0.3% in Dire Dawa to 37.8% in the Oromia region. Children in poor households disproportionately consume less iron-rich animal-source foods than those in wealthy households, leading to a pro-rich wealth concentration index (C) = 0.25 (95% CI: 0.12, 0.37). The decomposition model explained approximately 70% of the estimated socio-economic inequality. About 21% of the wealth-related inequalities in iron-rich animal source food consumption in children can be explained by having primary or above education status of women. Mother's antenatal care (ANC) visits (14.6%), living in the large central and metropolitan regions (12%), household wealth index (10%), and being in the older age group (12-23 months) (2.4%) also contribute to the wealth-related inequalities. Regions such as Afar, Eastern parts of Amhara, and Somali were geographic clusters with low iron-rich animal source food consumption. There is a low level of iron-rich animal source food consumption among children, and it is disproportionately concentrated in the rich households (pro-rich distribution) in Ethiopia. Maternal educational status, having ANC visits, children being in the older age group (12-23 months), and living in large central and metropolitan regions were significant contributors to these wealth-related inequalities in iron-rich animal source foods consumption. Certain parts of Ethiopia such as, Afar, Eastern parts of Amhara, and Somali should be considered priority areas for nutritional interventions to increase children's iron-rich animal source foods consumption.
Collapse
Affiliation(s)
- Daniel G. Belay
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Molla M. Wassie
- Flinders University, College of Medicine and Public Health, Flinders Health and Medical Research Institute, Adelaide, South Australia
| | - Melaku Birhanu Alemu
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mehari Woldemariam Merid
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Richard Norman
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Gizachew A. Tessema
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| |
Collapse
|
3
|
Dwijayanti I, Al Mamun A, Setiarsih D, Sulistyowati M, Mahmudiono T. Exploring global mothers' knowledge, attitudes, and practice of complementary feeding: A scoping review. Nutrition 2024; 120:112335. [PMID: 38271760 DOI: 10.1016/j.nut.2023.112335] [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: 08/25/2023] [Revised: 12/15/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024]
Abstract
Complementary feeding refers to the practice of providing solid foods and liquids in addition to breast milk when a baby reaches 6 mo of age. This becomes necessary to meet a baby's nutritional needs because of the potential nutrient insufficiency of breast milk alone. This review serves as an effective means to comprehensively understand the intricate and evolving nature of complementary feeding practices, often influenced by cultural, regional, and parental factors, from a literature perspective that acknowledges the dynamic aspects of complementary feeding. The data in this study were extracted and presented according to the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews, as guidelines. The studies were conducted using digital databases such as PubMed, Springer Link, and Science Direct from 2014 to 2022. A total of 1205 eligible studies were retrieved from the three databases searched, with 17 articles finally reviewed for data extraction. Overall, there remains a gap between mothers' knowledge, attitudes, and practices regarding complementary feeding. Addressing these disparities within and between countries necessitates targeted interventions and educational programs to enhance mothers' understanding, align attitudes with guidelines, and promote healthier practices for the well-being of children.
Collapse
Affiliation(s)
- Ira Dwijayanti
- Doctorate Degree Program in Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia; Department of Nutrition, Faculty of Health, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia.
| | - Abdullah Al Mamun
- Doctorate Degree Program in Public Health, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
| | - Dini Setiarsih
- Department of Nutrition, Faculty of Health, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia.
| | - Muji Sulistyowati
- Department of Health Promotion and Behavioral Sciences, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
| | - Trias Mahmudiono
- Department of Nutrition, Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia.
| |
Collapse
|
4
|
Bukuku DD, Prasopkittikun T, Payakkaraung S, Lenwari C. Factors influencing Tanzanian mothers' feeding practices for toddlers: A predictive correlational study. BELITUNG NURSING JOURNAL 2023; 9:603-610. [PMID: 38130674 PMCID: PMC10731432 DOI: 10.33546/bnj.2974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/20/2023] [Accepted: 11/25/2023] [Indexed: 12/23/2023] Open
Abstract
Background Feeding practices are crucial in ensuring toddlers receive an appropriate and varied diet to support their growth and development. In Tanzania, maternal feeding practices for young children are inadequate, and there is limited research on the influencing factors. Objective This study aimed to examine the factors influencing Tanzanian mothers' feeding practices for toddlers, utilizing the health promotion model as the theoretical framework. Methods A predictive correlational design was employed, with a random sample of 399 mothers who brought their toddlers for health supervision at a tertiary care hospital in the United Republic of Tanzania. Data on personal information, depression, perceived benefits, perceived barriers, perceived self-efficacy, social support, situational influences, and maternal feeding practices were collected using self-administered questionnaires between September 2021 and November 2021. Descriptive statistics, correlations, and multiple regression analysis were employed for the analysis. Results All the factors examined in the study accounted for 18.9% of the variance explained in maternal feeding practices. Significantly, only two factors, perceived self-efficacy (β = 0.32, p <0.001) and situational influences (β = 0.24, p <0.001), could predict maternal feeding practices. Conclusion Perceived self-efficacy and situational influences emerged as the primary influencing factors on maternal feeding practices for toddlers. Pediatric nurses should address these modifiable factors when developing nursing interventions and strategies to promote a healthy nutritional status in toddlers.
Collapse
|
5
|
Tadesse M, Ali Dawed Y, Fentaw Z, Endawike A, Adamu K. Determinants of inappropriate complementary feeding among children 6-23 months of age in Dessie City Northeast Ethiopia: a case-control study. BMC Nutr 2023; 9:124. [PMID: 37924096 PMCID: PMC10625273 DOI: 10.1186/s40795-023-00779-w] [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: 03/17/2022] [Accepted: 10/11/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Inappropriate complementary feeding is one of the leading causes of malnutrition among children 6-23 months old and delays children's growth milestone. The determinants of inappropriate complementary feeding practice have diverse natures, so that many of the previous studies fail to generate adequate evidence on it. This study aim to address the determinants of in appropriate complementary feedings at community level. METHODS A community-based unmatched case-control study design was carried out among children 6-23 months of age in Dessie City from April 13, 2021 to May 13, 2021. Nine kebeles were selected by simple random sampling method. One month prior to the data collection time survey was conducted and 482 samples were taken from the preliminary survey data; 241 cases and 241 controls by computer generated random numbers. Interviewer administered questionnaire was used to investigate potential determinants of inappropriate complementary feeding practice. Binary logistics regression was used to identify independent determinants. RESULTS Part working situation of mother [AOR = 0.21 CI: 0.08, 0.52] was negatively associated with inappropriate complementary feeding. Having no post-natal care visit [AOR = 4.062 CI:2.35,7.02], poor wealth status [AOR = 2.7 CI:1.09,6.68], food in-security [AOR = 4.49 CI:1.94,10.37], home delivery [AOR = 4.33 CI:1.43,13.15], having poor knowledge on infant and young child feeding [AOR = 5.94 CI:2.8,12.6], having no health education on complementary feeding [AOR = 2.54 CI:1.28,5.06] and father's job [AOR = 2.2 CI:1.17,4.1] were found to be positively associated with inappropriate complementary feeding. CONCLUSION Mothers' work situation, fathers' job, wealth index, food security, mothers' knowledge on infant feeding, post-natal care, health education on infant feeding and place of delivery were independent determinants for inappropriate complementary feeding. Thus, interventions shall effectively address those factors to alleviate the problem.
Collapse
Affiliation(s)
- Meron Tadesse
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, 1145, Ethiopia
| | - Yeshimebet Ali Dawed
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, 1145, Ethiopia
| | - Zinabu Fentaw
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Abel Endawike
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kidist Adamu
- Department of Health System Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
| |
Collapse
|
6
|
Irenso AA, Zheng M, Campbell KJ, Chamberlain D, Laws R. The influence of household structure and composition on the introduction of solid, semisolid and soft foods among children aged 6-8 months: An analysis based on Ethiopia Demographic and Health Surveys. MATERNAL & CHILD NUTRITION 2022; 19:e13429. [PMID: 36148628 PMCID: PMC9749599 DOI: 10.1111/mcn.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 12/15/2022]
Abstract
The early and late introduction of complementary food, both prevalent in Ethiopia, are associated with morbidities, growth faltering and developmental risks in children. The interhousehold network around the primary caregiver's intrahousehold network is critical in influencing the age of introducing complementary foods. This study examined the influence of household composition and structures on complementary food introduction. This is a secondary data analysis of four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. The household structure and composition variables were calculated from household members' kinship status and attribute, respectively. The introduction of solid, semisolid or soft foods was dichotomised as whether the children within 6 to 8 months have been given complementary foods. Multivariable logistic regression with adjustment for the primary caregiver and household characteristics was run to examine the associations between household structure and composition variables and the introduction of complementary foods. The marginal effects (ME) were calculated to facilitate the practical interpretation of the study findings. Large households (>3 nonredundant contacts) with extended family or unrelated people (high effective size, ME = 6.01%, 95% confidence interval [CI]: -8.53, -3.49) lowered the proportion of children starting food within the recommended 6-8 months. Households with close kins (high constraint) (ME = 7.22%, 95% CI: -13.65, 28.09) and greater age diversity (ME = 0.65%, 95% CI: 0.15, 1.15) increased the proportion of children receiving complementary food at an appropriate age. This study revealed that interhousehold structure and composition influence the age of introduction of complementary foods. These factors, therefore, need to be considered in designing interventions to improve age at the introduction of complementary foods.
Collapse
Affiliation(s)
- Asnake Ararsa Irenso
- School of Public HealthAmbo UniversityAmboEthiopia,School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Miaobing Zheng
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Karen J. Campbell
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Dan Chamberlain
- Centre for Social Impact UNSWUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rachel Laws
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| |
Collapse
|
7
|
Irenso AA, Letta S, Chemeda AS, Asfaw A, Egata G, Assefa N, Campbell KJ, Laws R. Maternal Time Use Drives Suboptimal Complementary Feeding Practices in the El Niño-Affected Eastern Ethiopia Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073937. [PMID: 35409616 PMCID: PMC8997821 DOI: 10.3390/ijerph19073937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 11/30/2022]
Abstract
Ethiopia is affected by recurrent drought and food-insecurity crises, including El Niño. El Niño started in mid-2014, worsened in 2015, and continued in 2016, leading to a widespread food-insecurity emergency resulting in a surge in the rate of acute malnutrition in infants due to suboptimal feeding practices. This study explored how El Niño influenced complementary feeding practices in the eastern Ethiopia community from March to September 2016. It was an exploratory qualitative study with a basic interpretative qualitative approach. A general inductive approach was used for the analysis. The study involved 11 focus group discussions (FGD) with a total of 76 people, including three with mothers, three with Health Development Army (HDA) leaders, two with fathers, two with traditional birth attendants, and one with religious leaders. El Niño resulted in failed crops and loss of livestock, resulting in reduced dietary diversity and meal frequency. El Niño resulted in suboptimal complementary feeding practices by reducing food access and altering livelihood and coping strategies, reducing the time mothers allocated to child feeding, keeping them away from home, and stressing community health services. The maternal suboptimal time allocation is central to the poor complementary feeding practices. Thus, the women should be supported with climate-resilient livelihood options in their villages, allowing them to feed their children and attend education sessions with HDA leaders.
Collapse
Affiliation(s)
- Asnake Ararsa Irenso
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (K.J.C.); (R.L.)
- School of Public Health, Haramaya University, Harar P.O. Box 235, Ethiopia
- Correspondence: ; Tel.: +61-420-974-834
| | - Shiferaw Letta
- School of Nursing, Haramaya University, Harar P.O. Box 235, Ethiopia; (S.L.); (A.A.); (N.A.)
| | - Addisu S. Chemeda
- Department of Food Process Engineering and Postharvest Technology, Ambo University, Ambo P.O. Box 19, Ethiopia;
| | - Abiyot Asfaw
- School of Nursing, Haramaya University, Harar P.O. Box 235, Ethiopia; (S.L.); (A.A.); (N.A.)
| | - Gudina Egata
- School of Public Health, Addis Ababa University, Addis Ababa P.O. Box 9086, Ethiopia;
| | - Nega Assefa
- School of Nursing, Haramaya University, Harar P.O. Box 235, Ethiopia; (S.L.); (A.A.); (N.A.)
| | - Karen J. Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (K.J.C.); (R.L.)
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Science, Deakin University, 221 Burwood Highway, Melbourne, VIC 3125, Australia; (K.J.C.); (R.L.)
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
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.
Collapse
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
| |
Collapse
|
10
|
Tiruneh SA, Ayele BA, Yitbarek GY, Asnakew DT, Engidaw MT, Gebremariam AD. Spatial distribution of iron rich foods consumption and its associated factors among children aged 6-23 months in Ethiopia: spatial and multilevel analysis of 2016 Ethiopian demographic and health survey. Nutr J 2020; 19:115. [PMID: 33032619 PMCID: PMC7545915 DOI: 10.1186/s12937-020-00635-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Micronutrient deficiencies are the most prevalent nutritional deficiencies that cause serious developmental problems in the globe. The aim of this study was to assess the spatial distribution of iron rich foods consumption and its associated factors among children aged 6-23 months in Ethiopia. METHODS The data retrieved from the standard Ethiopian Demographic and Health Survey 2016 dataset with a total sample size of 3055 children aged 6-23 months. Spatial scan statistics done using Kuldorff's SaTScan version 9.6 software. ArcGIS version 10.7 software used to visualize spatial distribution for poor consumption of iron rich foods. Multilevel mixed-effects logistic regression analysis employed to identify the associated factors for good consumption of iron-rich foods. Level of statistical significance was declared at a two-sided P-value < 0.05. RESULTS Overall, 21.41% (95% CI: 19.9-22.9) of children aged 6-23 months had good consumption of iron rich foods in Ethiopia. Poor consumption of iron rich foods highly clustered at Southern Afar, Southeastern Amhara and Tigray, and the Northern part of Somali Regional States of Ethiopia. In spatial scan statistics, children aged 6-23 months living in the most likely cluster were 21% more likely vulnerable to poor consumption of iron rich foods than those living outside the window (RR = 1.21, P-value < 0.001). Child aged 12-17 months (AOR = 1.90, 95% CI: 1.45-2.49) and 18-23 months (AOR = 2.05, 95% CI: 1.55-2.73), primary (AOR = 1.42, 95% CI:1.06-1.87) and secondary and above (AOR = 2.26, 95% CI: 1.47-3.46) mother's education level, rich (AOR = 1.49, 95% CI: 1.04-2.13) and middle (AOR = 1.83, 95% CI: 1.31-2.57) household wealth status, Amhara (AOR = 0.24, 95% CI: 0.09-0.60), Afar (AOR = 0.38, 95% CI: 0.17-0.84), and Harari (AOR = 2.11, 95% CI: 1.02-4.39) regional states of Ethiopia were statistically significant factors for good consumption of iron rich foods. CONCLUSION Overall, the consumption of iron rich foods was low and spatially non-random in Ethiopia. Federal Ministry of Health and other stakeholders should give prior attention to the identified hot spot areas to enhance the consumption of iron rich foods among children aged 6-23 months.
Collapse
Affiliation(s)
- Sofonyas Abebaw Tiruneh
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
| | | | - Getachew Yideg Yitbarek
- Department of Biomedical Sciences (Medical Physiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa Asnakew
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | |
Collapse
|