Dietary diversity and meal frequency among infant and young children: a community based study

The Role of Complementary Feeding Practices in Addressing the Double Burden of Malnutrition among Children Aged 6-23 Months: Insight from the Vietnamese General Nutrition Survey 2020

Background/Objectives: Optimal infant and young child feeding (IYCF) practices are crucial to addressing the double burden of malnutrition (DBM), encompassing undernutrition (including micronutrient deficiencies) and overnutrition. This study examined the demographic and socioeconomic determinants of IYCF practices, and their impacts on the DBM among 2039 Vietnamese children aged 6-23 months from the General Nutrition Survey 2020. Methods: Thirteen IYCF indicators recommended by the WHO/UNICEF were evaluated. Associations between IYCF indicators and outcome variables were assessed using logistic regressions. Results: The prevalence of stunting, underweight, and overweight subjects was 10.9%, 5.6%, and 3.1%, respectively. Low serum zinc affected 56.7% of children, while 14.3% had low serum retinol, 31.2% had anemia, and 34.6% had iron deficiency (ID). Only 36.7% of children achieved minimum dietary diversity (MDD), and 29.0% achieved the minimum acceptable diet (MAD). Children from the younger age group (6-11 months), ethnic minorities, those living in rural/mountainous regions, and poorer wealth quintiles had reduced odds of meeting IYCF criteria, including MDD and MAD. Infants meeting MDD had reduced odds of stunting [adjusted odds ratio (95% confidence intervals): 0.61 (0.41, 0.92)], and ID [0.69 (0.54, 0.88)]. Children meeting MAD had reduced odds of anemia [0.72 (0.57, 0.91)], ID [0.66 (0.52, 0.84)], and low serum retinol [0.63 (0.41, 0.99)]. Continued breastfeeding (12-23 months) reduced the odds of being underweight [0.50 (0.27, 0.92)] and of having low serum zinc [0.70 (0.52, 0.96)]. Adequate minimum milk feeding frequency had increased odds of being overweight [3.33 (1.01, 11.09)]. Conclusions: Suboptimal IYCF practices were significant predictors of the DBM among Vietnamese children, with evident age-specific, geographical, and socioeconomic disparities.

Nutritional status and its associated factors among infants and young children aged 6-23 months in Addis Ababa, Central Ethiopia, 2021: a cross-sectional study

The aim of this study is to assess nutritional status and associated factors among infants and young children aged 6-23 months in Yeka sub-city, Ethiopia, 2021. An institution-based cross-sectional study was conducted in selected health centres found in the Yeka sub-city from May 2021 to July 2021. In total, 396 systematically selected infants and young children aged 6-23 months attended the selected health centres were included in the study. Data were collected by using a structured questionnaire and anthropometric measurements. A multinomial logistic regression model was used. The overall magnitude of undernutrition and overnutrition among infants and young children were 24.7% and 5.5%, respectively. Dietary diversity score (DDS) ((adjusted odd ratio (AOR) = 5.65; 95% CI = 2.301, 10.87; P value = 0.003), minimum meal frequency (MMF) (AOR = 5.435; 95% CI = 2.097, 11.09; P value = 0.0052), and diarrhoea (AOR = 2.52; 95% CI = 1.007, 6.310; P value = 0.002) were statistically significantly associated factors for nutritional status among infants and young children. Malnutrition (undernutrition and overnutrition) is a public health problem among infants and young children in Yeka sub-city, Ethiopia. DDS, MMF, and diarrhoeal disease were associated with higher odds of undernutrition.

Minimum acceptable diet use and its associated factors among children aged 6-23 in Ghana: a mixed effect analysis using Ghana Demographic and Health Survey

Introduction

Inappropriate feeding practices are a major contributor to child malnutrition. To monitor the feeding practices of young children, current and frequent studies are required. However, as far as our searches are concerned, there is a scarcity of up-to-date information on attainment of the minimum acceptable diet and its predictors in the study area. Therefore, this study aimed to assess the magnitude of attainment of the minimum acceptable diet and its associated factors among children aged 6-23 in Ghana by using the most recent data.

Methods

Secondary data analysis was conducted based on the demographic and health survey data conducted in Ghana in 2022. A total weighted sample of 2,621 children aged 6-23 months in the 5 years preceding the survey was included in this study. A multi-level logistic regression model was used to identify the determinants of the minimum acceptable diet. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant.

Results

The national prevalence of the attainment of the minimum acceptable diet in Ghana was 26.40% (95% CI: 24.82-28.06). Child from mother with higher education (AOR = 1.96; 95% CI: 1.56-3.31) and father with higher education (AOR = 1.59; 95% CI: 1.04-2.41), Children having postnatal visit (AOR = 1.29; 95% CI: 1.03-1.62), being in the child age of 9-11 months (AOR = 2.09; 95% CI: 1.42-5.03) and 12-23 months (AOR = 3.62; 95% CI: 2.61-5.03), being in a middle (AOR = 1.66; 95% CI: 1.14-3.06), and rich wealth quintile (AOR = 2.06; 95% CI: 1.37-3.10), breastfed children (AOR = 3.30; 95% CI: 2.38-4.56), being in a high-community poverty (AOR = 0.65; 95% CI: 0.44-0.96), and being in the Savannah region (AOR = 0.32; 95% CI: 0.16-0.67) were factors significantly associated with the minimum acceptable diet use.

Conclusion

Many children are still far behind in meeting the minimum acceptable diet in Ghana as per 90% of WHO-recommended coverage. Measures should be taken to optimize the minimum acceptable diet attainment in the country. Thus, policymakers, the government, and other relevant authorities should focus on the early initiation of complementary feeding, the Savannah region, further empowering women, and enhancing breast-feeding and household wealth status.

Trend and determinants of minimum dietary diversity consumption change among children aged 6-23 months in Ethiopia from 2011 to 2019: A multivariate decomposition analysis

BACKGROUND

Sustainable Development Goals 2 target 2.2 aimed to end all forms of malnutrition by 2030. However, the prevalence of inadequate minimum dietary diversity (MDD) is high in Ethiopia and the evidence of trends and determinants of MDD consumption change among children over time is limited. Therefore, this study aimed to determine trends and determinants of MDD consumption change among children aged 6 to 23 months in Ethiopia from 2011-2019 Demographic and Health Survey (DHS) data.

METHOD

The study used the data on nationally representative weighted samples of 6,971, 7,467, and 3,154 children aged 6-23 months from the 2011, 2016, and 2019 rounds of the DHS. Trend and Multivariate Decomposition analysis was conducted to determine MDD consumption change from 2011-2016, and 2016-2019 into two components: one that was explained by differences in the level of the determinants (endowment), and the other component was explained by differences in the effect of the covariates on the outcome (coefficient effects).

RESULT

The trends analysis showed that adequate MDD consumption significantly increased from 2% to 10.41% from 2011 to 2016 but decreased from 10.41% to 7.11% from 2016 to 2019 in Ethiopia. The compositional and behavioral change factors like maternal age, occupational status of parents, sex of the household head, wealth index, residence, and sex of child statistically contributed to changes in MDD consumption from 2011 to 2016, and from 2016 to 2019 at p-value <0.05.

CONCLUSION

The trend of minimum dietary diversity consumption among children aged 6 to 23 months in Ethiopia increased from 2011-2016 and decreased from 2016-2019 in the last decade. The study revealed that the changes in behavioral response and population composition contributed to MDD consumption change among children in Ethiopia. The finding highlights the urgent need for targeted interventions and policies to address the issue of MDD consumption change among young children due to population structure changes like wealth status, residence, and behavioral response related to employment, household head, and sex of the child in Ethiopia. Therefore, efforts should be geared to reduce poverty and improve maternal employment status, particularly for women, by producing equitable economic opportunities.

Spatial distribution of inadequate meal frequency and its associated factors among children aged 6-23 months in Ethiopia: Multilevel and spatial analysis

INTRODUCTION

More than two-third of global child death is occurred due to inappropriate feeding practice that happened during early childhood period. Evidence on meal frequency status among infant and young children at national level can be used to design appropriate interventions to improve the recommended feeding frequency. Therefore, this study was aimed to explore the spatial distribution and identify associated factors of inadequate meal frequency among children aged 6-23 months in Ethiopia.

METHODS

Secondary data analysis was conducted using the 2019 mini Ethiopian Demographic and Health Survey data. A total weighted sample of 1,532 children aged 6-23 months were included. To identify significant factors associated with of inadequate meal frequency, multilevel binary logistic regression model was fitted. Variables with p-value < 0.25 from the bi-variable model were exported to multivariable analysis. In the multivariable model, variables with p-value < 0.05 were declared as significantly associated factors and adjusted odds ratio (AOR) with its 95% confidence interval were reported. Multilevel models were compared using deviance and log-likelihood. Spatial analysis tools were utilized to visualize the distribution of inadequate meal frequency. Bernoulli model was fitted using SaTScan V.9.6 to identify most likely clusters and ArcGIS V.10.8 was used to map the hotspot areas. Ordinary least square and geographic weighted regression models were used and compared using information criteria and adjusted-R2. Local coefficients of factors associated with hotspots of inadequate meal frequency were mapped.

RESULTS

The prevalence of inadequate meal frequency was 47.03% (95% CI: 44.54%, 49.53%) in Ethiopia. Age of the child, sex of the household head, timely initiation of breastfeeding, current breastfeeding status, number of antenatal care visit, maternal education, and region were significantly associated with inadequate meal frequency. The spatial distribution of inadequate meal frequency was showed significant variation across Ethiopia (Global Moran's I = 0.164, p-value <0.001). A total of 38 significant clusters were detected through SaTScan analysis, from these the 22 primary clusters were located in Somali and Harari.

CONCLUSION AND RECOMMENDATION

The prevalence of inadequate meal frequency was high in Ethiopia and had significant clustering patter. Significant hotspot clusters were located in Somali, northern Afar, Harari, Amhara, Gambela, and eastern South nation nationalities and peoples' region. Therefore, public health interventions which enhance breastfeeding practice, optimal number of antenatal care visits, educational empowerments should target hotspot areas to decrease inadequate meal frequency practice.

A systematic review of dietary data collection methodologies for diet diversity indicators

The purpose of the current study was to critically assess the gaps in the existing methodologies of dietary data collection for diet diversity indicators. The study proposed the importance of smartphone application to overcome the drawbacks. The review paper identified and assessed the conventional methodologies used in diet diversity indicators including Minimum Dietary Diversity for Women (MDD-W), Minimum Dietary Diversity of Infant and Young Child Feeding Practices (IYCF-MDD), and Household Dietary Diversity Score (HDDS). The 80 research studies from 38 countries were critically assessed on the basis of their research aim, study design, target audience, dietary data collection methodology, sample size, dietary data type, dietary data collection frequency, and location point of dietary data collection. Results indicated that most studies employed interviewer-administered 24-h recall assessing the dietary diversity. The review paper concluded that smartphone application had potential to overcome the identified limitations of conventional methodologies including recall bias, social-desirability bias, interviewer training, and cost-time constraints.

Association of food consumption patterns and nutritional status of children under 5 years from rural households in Northern regions, Namibia

BACKGROUND

Many developing countries, Namibia included, have a high prevalence of malnutrition among children, especially in rural subsistence farming areas where inadequate food supply is common. Poor diets in children under 5 years may result in negative health impacts. This study determined the association of food consumption patterns and nutritional status of children under 5 years from rural households in Oshana and Oshikoto regions in Namibia.

METHOD

Employing a cross-sectional descriptive design, 377 children under 5 years participated in this study using purposive sampling. Validated dietary diversity and food frequency questionnaires were used to obtain information on demographic characteristics, commonly consumed food per week, and meal frequencies for the recruited children. Anthropometric measurements were obtained to assess nutritional status of children using Emergency Nutrition Assessment (ENA) software. Descriptive and inferential statistics were computed using the IBM® SPSS® Statistics (Statistical Package for Social Sciences) version 27.

RESULTS

Staple foods, mostly grains, roots and tubers, along with flesh foods, legumes and nuts were commonly consumed. Vitamin A-rich fruits and vegetables were solely consumed in Oshana region (10.7%) and not in Oshikoto. Oshana exhibited a lower dietary diversity score (4±1 SD) compared to Oshikoto (5±1 SD). The prevalence of adequate feeding practices varied, with Oshana having 38.8% meeting minimum milk feeding frequency (MMFF), 55.6% minimum dietary diversity (MDD), 69.8% minimum meal frequency (MMF), and 27% minimum acceptable diet (MAD). In Oshikoto, these figures were lower at 2%, 7%, 32%, and 0.5%, respectively. Stunting, underweight, wasting, and overweight were also documented, with slight differences between the two regions. The study did not find association between nutritional status and MMFF, MDD and MAD. However, significant associations were found between specific food types, amount of food, breastfeeding length, MMF and malnutrition indicators in both regions (p<0.05).

CONCLUSION

Most study participants consumed locally available staple foods. Stunting, underweight, and wasting were prevalent among children in the two regions which were significantly associated to the amount of food consumed, MMF and/ some food types. Improving food environments and eliminating access barriers to diversified diets can mitigate high prevalence of malnutrition among rural children.

Minimum acceptable diet and associated factors among children aged 6-23 months in Jig-Jiga, Somali region, eastern Ethiopia, 2022

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.

Minimum meal frequency practice and associated factors among children aged 6-23 months old in The Gambia: a multilevel mixed effect analysis

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.

Gender disparity in minimum dietary diversity failure among currently breastfed children aged 6-23 months in Bangladesh: evidence from Bangladesh Multiple Indicator Cluster Survey, 2019

Research on children's dietary diversity plays a crucial role in designing effective health interventions. Thus, this study aimed to identify the factors contributing to minimum dietary diversity failure (MDDF) among male and female children aged 6-23 months in Bangladesh. The data for this study was obtained from the Bangladesh Multiple Indicator Cluster Survey, 2019, which included children currently breastfed within a specific age range. Multivariable binary logistic regression was employed to assess the strength and significance of the association. The findings revealed that approximately 59⋅4 % of children in Bangladesh experienced MDDF, with 57⋅8 % of male children and 61 % of female children affected. Proportion test uncovered a significant gender disparity (χ2=6⋅58, P-value = 0⋅01) among children aged 6-23 months. However, the multivariable binary logistic regression analysis revealed that both male and female children shared common risk factors for MDDF, which included child age, maternal educational status, wealth status, number of antenatal care visits, and division. In our study, we observed varied spatial patterns in minimal dietary diversity. Sherpur, Netrokona, Sunamganj, and Sylhet districts showed the highest failure rates. Notably, all are flood-affected areas, impacting food availability and diversity. For targeted regional development programmes, district mapping results may offer valuable insights to policymakers, especially in areas with a high prevalence of dietary diversity failure. By understanding these risk factors, policymakers and stakeholders can implement targeted strategies to improve dietary diversity among children, promoting better health and well-being for the young population in Bangladesh.

Infant and young child feeding practices and associated socioeconomic and demographic factors among children aged 6-23 months in Ghana: Findings from Ghana Multiple Indicator Cluster Survey, 2017-2018

BACKGROUND

Association between poor infant and young child feeding (IYCF) practices and malnutrition in infants and young children (IYC) is well established. Furthermore, appropriate IYCF practices are important during the first 1,000 days of life to ensure optimal health and development. Understanding IYCF practices and associated socioeconomic and demographic factors will inform interventions to achieve the UN 2030 Sustainable Development Goal (SDG) target to end malnutrition in all forms.

OBJECTIVE

This study estimates the prevalence of Minimum Dietary Diversity (MDD), Minimum Meal Frequency (MMF), and Minimum Acceptable Diet (MAD), and examines their association with socioeconomic and demographic characteristics among children aged 6-23 months in Ghana.

METHOD

We used data from the Ghana Multiple Indicator Cluster Survey 6 (GMICS6) conducted in 2017-18. Participants were recruited through multi-stage stratified cluster sampling. Information on caregiver's self-reported breastfeeding status and 24-hour dietary recall of foods IYC were fed with were collected through face-to-face interviews. We estimated the prevalence of MDD, MMF and MAD with a 95% confidence interval (CI). We investigated the socioeconomic and demographic determinants of MDD, MMF and MAD using univariate and multivariable logistic regression analyses.

FINDINGS

Among 2,585 IYC aged 6-23 months, MDD, MMF and MAD were estimated as 25.46%, 32.82% and 11.72% respectively. Age of the IYC, educational status of the mothers/primary caregivers, and resident regions were found to have positive associations with MDD, MMF and MAD. In addition, the richest household wealth index and urban area of residence were found to have significant positive associations with MDD.

CONCLUSION

We report a low prevalence of MDD, MMF and MAD. Efforts to improve IYCF practices among children aged 6-23 months in Ghana should focus on multi-sectorial approaches including increasing access to formal education, income-generating activities and addressing regional and rural-urban inequity.

Minimum Dietary Diversity Among Children Aged 6-59 Months in East Africa Countries: A Multilevel Analysis

Objective: To find out the determinants of minimum dietary diversity (MDD) among under-five children in East Africa based on the 2017 revised indicator. Methods: Secondary data from the demographic and health survey (DHS) of eight countries in East Africa were combined. A total of 27,223 weighted samples of children aged 6-59 months were included. Multi-level logistic regression analysis was employed to identify the determinants of dietary diversity. Results: The magnitude of adequate MDD in East Africa was found to be 10.47% with 95% CI (10.12-10.84) with the lowest and highest magnitude in Ethiopia and Rwanda respectively. Having a mother in the age group of 35-49, having a mother with higher educational attainment, and having a post-natal check-up within 2 months were significant factors in determining adequate MDD. Conclusion: The magnitude of adequate MDD intake among children aged 6-59 months in East Africa is relatively low. Therefore, strengthening interventions focused on improving the economic status of households, the educational status of mothers, and diversified food consumption of children aged 6-59 months should get priority to improve the recommended feeding practice of children.

Factors associated with diet diversity among infants and young children in the Eastern and Southern Africa region

This study explores common factors associated with not meeting minimum dietary diversity (MDD) among 27,072 children aged 6-23 months in Eastern and Southern Africa using data from nine Demographic and Health Surveys from 2013 to 2016. MDD was defined as consumption of more than or equals to five of eight food groups including breast milk in the past 24 h. Equity gaps were calculated as the difference in MDD prevalence between the top and bottom wealth quintiles. Logistic regression was conducted to identify common factors for not meeting MDD at the household, maternal and child levels across two or more countries to inform regional policies to improve children's diets. Kenya had the highest MDD wealth equity gap (40.4 pts), and South Africa had the smallest (14.4 pts). Equity gaps for flesh foods or eggs (up to 39.8 pp) were larger than for grain or legumes (up to 20 pp). Common risk factors for not reaching MDD included younger child age (6-11 months) (n = 9 countries), no formal maternal occupation (n = 6), not receiving vitamin-A supplementation (n = 3), younger maternal age (n = 3), lower maternal education (n = 3), no media (n = 3) or newspaper (n = 3) exposure, lower household wealth quintile (n = 3), use of nonefficient cooking fuel (n = 2), longer time to get to the water source (n = 2), not listening to the radio (n = 2) and higher birth order (n = 2). Priorities for improving MDD in the region include introducing diverse foods at a young age from 6 months with early nutrition counselling, promoting higher maternal education, increasing food purchasing power and ensuring the support of younger mothers.

Dietary Diversity, Household Food Insecurity and Stunting among Children Aged 12 to 59 Months in N'Djamena-Chad

BACKGROUND

Household food insecurity is increasingly recognized as a global health problem, particularly in sub-Saharan Africa. This study aimed to contextualize the associations between household food insecurity, dietary diversity and stunting in N'Djamena.

METHODS

This study is a community-based cross-sectional study, and the SMART (Standardized Monitoring and Assessment of Relief and Transitions) methodology was used to calculate the sample size. A total of 881 households were selected for the survey. A 24-h recall evaluated the dietary diversity score (DDS), the Household Food Insecurity Access Scale (HFIAS) made it possible to assess household food insecurity (HFI), and stunting among children aged 12 to 59 months was assessed by anthropometric measurements. Logistic regression was constructed to determine the association between household food insecurity, dietary diversity, and stunting. The study was conducted from January to March 2022.

RESULTS

The prevalence of severe food insecurity was 16.6%, and that of stunting was 25.3%. The mean DDS was 6.5 ± 1.6. Severe food insecurity (OR 2.505, CI: 1.670-3.756) was significantly associated with stunting. The association between DDS and stunting was not significant.

CONCLUSIONS

This study's prevalence of household food insecurity and stunting was very high. Household food insecurity and household size were significantly associated with stunting.

Contribution of socio-economic and demographic factors to the trend of adequate dietary diversity intake among children (6-23 months): evidence from a cross-sectional survey in India

BACKGROUND

The present study aims to estimate the factors contributing to the change adequate diversified dietary intake (ADDI) from 2005-06 to 2015-16 among children aged 6-23 months in India.

METHODS

A cross-sectional study was conducted using a large representative survey data. Data from the National Family Health Survey 2005-06 and 2015-16 was used. The effective sample size for the present study was 14,422 and 74,132 children aged 6-23 months in 2005-06 and 2015-16, respectively. The outcome variable was minimum adequate dietary diversity intake. Binary logistic regression was used to evaluate the factors associated with ADDI. Additionally, the Fairlie method of decomposition was used, which allows quantifying the total contribution of factors explaining the decadal change in the probability of ADDI among children aged 6-23 months in India.

RESULTS

There was a significant increase in ADDI from 2005-06 to 2015-16 (6.2%; p < 0.001). Additionally, compared to the 2005-06 years, children were more likely to have ADDI [AOR; 1.29, CI: 1.22-1.35] in 2015-16. Mother's education explained nearly one-fourth of the ADDI change among children. Further, the regional level contribution of 62.3% showed that the gap was widening across regions between the year 2005-06 and 2015-16 in ADDI among children. The child's age explained 5.2% with a positive sign that means it widened the gaps. Whereas the household wealth quintile negatively contributed and explained by -5.2%, that means between the years the gaps has reduced in ADDI among children aged 6-23 months.

CONCLUSION

Our findings indicate that increasing awareness of the use of mass media and improving the education levels of mothers would be beneficial for adequate dietary diversity intake among children aged 6-23 months. Investments should support interventions to improve overall infant and young children feeding practices in India.

Factors associated with complementary feeding practices among children aged 6-23 months in Indonesia

BACKGROUND

Complementary foods with breastfeeding are foods or drinks given to children aged 6-23 months to meet their nutritional needs. The non-optimal provision of complementary feeding influences malnutrition in children of this age.

AIMS

To analyze the factors associated with complementary feeding practices among children aged 6-23 months in Indonesia.

METHODS

A cross-sectional design was employed using data from the 2017 Indonesia Demographic and Health Survey. A total of 502,800 mothers with children aged 6-23 months were recruited through multistage cluster sampling. Data were analyzed using a logistic regression test to determine the correlation between predisposing, enabling, and reinforcing factors and complementary feeding practices.

RESULTS

A prevalence values of analysis showed that approximately 71.14%, 53.95%, and 28.13% of the children met MMF, MMD, and MAD, respectively. The probability of achieving minimum dietary diversity (MDD) was high in the following: children aged 18-23 months (odds ratio [OR] = 9.58; 95% confidence interval [CI] = 7.29-12.58), children of mothers with higher education (OR = 5.95; 95% CI = 2.17-16.34), children from households with upper wealth index (OR = 2.53; 95% CI = 1.85-3.48), children of mothers who received childbirth assistance by professionals (OR = 1.63; 95% CI = 1.20-2.20), and children of mothers who had access to the Internet (OR = 1.26; 95% CI = 1.06-1.50). Moreover, children from households with the upper wealth index (OR = 1.40; 95% CI = 1.03-1.91), children whose mothers were employed (OR = 1.19; 95% CI = 1.02-1.39) living in urban areas (OR = 1.28; 95% CI = 1.06-1.54) and children of mothers who received childbirth assistance by professionals (OR = 1.33; 95% CI = 0.98-1.82) were more likely to meet Minimum Meal Frequency (MMF). Finally, children aged 18-23 months (OR = 2.40; 95% CI = 1.81-3.17), of mothers with higher education (OR = 3.15; 95% CI = 0.94-10.60), from households with upper wealth index (OR = 1.41; 95% CI = 1.05-2.90) and born with professional childbirth assistance (OR = 1.82; 95% CI = 1.21-2.75) were significantly associated with minimum acceptable diet (MAD).

CONCLUSIONS

The findings revealed that the prevalence of MDD and MAD in Indonesia was low. Strategies such as improving health services, economic conditions, and education level of mothers are needed to improve infant and young child feeding in Indonesia.

Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis

This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.

Correlates of dietary diversity among children aged 6-23 months of head porters in Ghana

Objective

In many developing countries, most children cannot meet minimum dietary diversity (MDD), defined as the consumption of four or more of the seven food groups. In Ghana, only 35% of children met MDD nationwide in 2017, but rates are worse among the rural poor and resource-constrained individuals like Head Porters (HPs). The current study investigated the correlates of MDD in children of HPs aged 6-23 months old in Ghana.

Methods and materials

A cross-sectional survey was carried out in 2021 among 423 HPs selected purposively from eight market centers in two commercial cities. A multi-stage sampling method was used in obtaining the sample, while a structured interview guide was used to collect data from the caregivers. Stata version 15.1 and descriptive and inferential statistics like frequency, percentage, chi-square and logistic regression were used to analyze the data. All results were deemed significant if the p-value was < 0.05 and the odds ratios with a 95% confidence interval.

Results

The children had a mean age of 14.3 (±4.9) months, while half of the caregivers (48.2%) were between 15 and 25 years. Approximately 59% (251) had good knowledge of infant and young child feeding practices (IYCF). About 45% of the children consumed a diversified diet. The number of postnatal care (PNC) visits, delivery in a health facility, meeting minimum meal frequency (MMF), and the child's age was independently associated with MDD at the multivariate level.

Conclusion

Over a third of the caregivers had poor knowledge of IYCF practices. Furthermore, less than half of the children achieved MDD reflecting the need for more education by the stakeholders. Regular PNC visits and delivery in health facilities were independently associated with MDD; therefore, interventions to combat low MDD should prioritize the relevance of these predictors.

Dietary diversity and its determinants among children aged 6-23 months in Ethiopia: evidence from the 2016 Demographic and Health Survey

Dietary diversity in children may be influenced not only by individual circumstances but also by the features of the community in which they live. Our study aimed to assess community and individual-level determinants of minimum dietary diversity among children aged 6-23 months in Ethiopia. We included 2960 children aged 6-23 months from the recent Ethiopia Demographic and Health Survey. A minimum dietary diversity was defined as the consumption of at least five food groups out of the eight reference food groups within 24 h by children aged 6-23 months. Multilevel logistic regression was used to investigate the drivers of minimum dietary diversity in Ethiopian children aged 6-23 months. About 12⋅5 % of children met the bare minimum of dietary diversification. Age of the child (9-11 months AOR, 3⋅3 (95 % CI 1⋅8, 5⋅6), 12-17 months AOR, 4⋅0 (95 % CI 2⋅4, 6⋅7), 18-23 months AOR, 3⋅5 (95 % CI 2⋅0, 5⋅8)), caregiver listening radio at least once a week AOR, 1⋅6 (95 % CI 1⋅1, 2⋅4) and wealth quantiles (Second AOR, 1⋅8 (95 % CI 1⋅1, 3⋅1), Fourth AOR, 2⋅9 (95 % CI 1⋅6, 5⋅2) and Highest AOR, 2⋅2 (95 % CI 1⋅1, 4⋅2)) were individual characteristics associated with dietary diversity. Place of residence was the only community-level characteristic associated with children's dietary diversity (Rural AOR, 0⋅4 (95 % CI 0⋅2, 0⋅6)). The minimum dietary diversity among Ethiopian children is suboptimal. Nutrition programmes aimed at enhancing dietary diversity should be strengthened in this population, particularly for those from poor families and residing in rural areas.

Gender-common and gender-specific determinants of child dietary diversity in eight Asia Pacific countries

Background

Optimal child feeding practices contribute to reducing child undernutrition in low- and middle-income countries. Minimum dietary diversity (MDD) is a key indicator of complementary feeding quality for children aged 6-23 months. We aimed to examine the gender-common and gender-specific factors associated with the failure to meet MDD in eight Asia Pacific countries.

Methods

The study used data of children aged 6-23 months from the Demographic and Health Surveys (DHS) conducted in Afghanistan (n = 8410), Bangladesh (n = 2371), Nepal (n = 1478), Pakistan (n = 3490), Cambodia (n = 2182), Indonesia (n = 5133), Myanmar (n = 1379), and Timor-Leste (n = 2115). A total of 41 household, maternal, and child-level variables were examined for association with MDD using univariate and multivariable logistic regressions. All analyses accounted for the survey design and sampling weights.

Results

Being aged 6-11 months, not receiving Vitamin A supplementation, low maternal education, belonging to a low wealth quintile, and having two or more young children in the household were factors related to the failure to meet MDD among both male and female children. Mothers’ not watching TV or not being exposed to media at least once a week, delivery at home, young age, and engagement to non-agricultural work were only significant risk factors among female children. Non-professional delivery assistance, unsafe disposal of children’s stool, tolerant attitudes towards domestic violence, and rural residence were significant factors only among male children.

Conclusions

It is possible that male and female children in the region may consume food in various ways, because the factors for meeting MDD are not the same for different genders of children. It is advised to enhance dietary diversity in child nutrition programmes through gender-specific activities.

Minimum acceptable diet and associated factors among children aged 6-23 months during fasting days of orthodox Christian mothers in Gondar city, North West Ethiopia

Background

Nutritional improvement through appropriate feeding practices is critical for young children's healthy growth and development. Even if children are exempted from fasting, their diets are influenced by the widespread fasting practices of their Orthodox Christian mothers. However, scientific evidence on a minimum acceptable diet (MAD) among children aged 6–23 months during the fasting period was limited. Therefore, this study aimed to assess the minimum acceptable diet and associated factors among children aged 6–23 months during the fasting period among Orthodox Christian mothers in Gondar city, Northwest Ethiopia.

Method

A community-based cross-sectional study was conducted during the fasting season (Lent) from March 8, 20,121 to April 8, 2021. A total of 738 Orthodox Christian mothers with their children were selected by multistage sampling. A structured questionnaire was used to collect data among mothers to assess children’s MAD status. The degree of association between independent and dependent variables was assessed by using an odds ratio with a 95% confidence interval. Those variables with a p-value of less than 0.05 in the multivariable analysis were considered as a significant factor for MAD among children aged 6–23 months. Data were presented using texts, tables and figures.

Results

The overall prevalence of MAD among children aged 6–23 months was 19.4% (95% CI: 16.40%-22.20). Having household wealth index of rich and middle (AOR = 4.39, 95% CI: 2.26,8.50) and (AOR = 3.25, 95% CI: 1.69,6.22), respectively, children aged from 12–17 months (AOR = 2.66, 95% CI: 1.43,4.92) and 18–23 months (AOR = 5.39, 95% CI: 2.93,9.95) respectively, Children who lived with a family member who consumed any time without keeping the fasting time(AOR = 1.79, 95% CI: 1.13,2.83) and mothers of young children who were married (AOR = 4.13, 95% CI: 1.29,13.23) have significant association with MAD.

Conclusion

The practice of minimum acceptable diet was inadequate. Age of child, wealth status, marital status, and presence of family member who fed without keeping fasting time were significantly associated factors for MAD among children aged 6–23 months. Advocacy for appropriate feeding practice and meeting the MAD for children aged 6–23 months during the fasting period should also be strengthened targeting the unmarried women and those with poor households and giving awareness for mothers in collaboration with the respective religious leaders is highly recommended.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40795-022-00558-z.

Spatial variation and determinates of dietary diversity among children aged 6-23 months in Ethiopia: spatial and multilevel analysis using Ethiopian Demography Health Survey (EDHS) 2019

BACKGROUND

Minimum dietary diversity is the consumption of five or more food groups from the eight World Health Organization recommended food groups. Adequately diversified diet, in terms of amount and composition, is critical for optimal growth, development, and long-term health outcomes in the first 2 years. Understanding the regional variation of dietary diversity and the underlying factors is crucial for developing and implementing interventions. However, the use of spatial approaches in dietary studies has not been widely established. Therefore, this study aimed to explore the spatial patterns and determinates of minimum dietary diversity practice among 6-23 months children in Ethiopia.

METHODS

Secondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 1578 children aged 6-23 months was included for this study. The Global Moran's I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariable multilevel logistic regression was used for factor analyses. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association.

RESULTS

Overall, 87.4% (95% CI: 85.7 to 88.9%) of children in 2019 had inadequate Minimum dietary diversity. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) notably observed in Somali, Afar, Eastern and western Amhara, western Tigray, Benishangul, and Northeastern and western parts of the southern nations, nationality and peoples' regions. Inadequate dietary diversity was significantly higher among young children, uneducated mother, married women, younger mother, no postnatal check, community with higher level of poverty and community level uneducated woman.

CONCLUSION

According to the findings of this study inadequate Minimum dietary diversity for children as measured by World Health Organization dietary assessment shows high. Children's dietary diversity was distributed non-randomly in different districts across Ethiopia's regions. The findings of the study provided critical evidence about dietary diversity and associated factors. Hence, policy should focused on improve education status of Mother, boosting economic status of the community, increased maternal continuum of care and focused on young children nutrition may advance dietary diversity.

Trends and determinants of minimum acceptable diet intake among infant and young children aged 6-23 months in Ethiopia: a multilevel analysis of Ethiopian demographic and health survey

BACKGROUND

The minimum acceptable diet (MAD) has been used globally as one of the main indicators to assess the adequacy of feeding practices. More than half of the causes of under-five child mortality in developing countries including Ethiopia are attributed to malnutrition. With the exception of anecdotal information on the subject, progress overtime and how it influences the MAD has not been studied or well understood. Thus, this study aimed to determine the trends and determinants of MAD intake among infants and young children aged 6-23 months in Ethiopia.

METHODS

A community-based national survey dataset from the Ethiopian demographic and health survey (EDHS) 2019 were to identify predictors of MAD. In addition, the 2011, 2016, and 2019 EDHS data was used for trend analysis. The World Health Organization indicators were used to measure MAD. A weighted sample of 1457 infants and young children aged 6-23 months. A mixed-effects multi-level logistic regression model was employed using STATA version 16.0.

RESULTS

The proportions of infants and young children who received the MADs in Ethiopia were 4.1%, 7.3%, and 11.3% during the survey periods of 2011, 2016, and 2019, respectively. Having mothers who attended primary education [adjusted odds ratio (aOR) =2.33 (95% C.I 1.25 to 4.35)], secondary education [aOR = 2.49 (95% C.I 1.03 to 6.45)], or higher education [aOR = 4.02 (95% C.I 1.53 to 10.54)] compared to those who never attended formal education. Being in a medium househoold wealth [aOR = 4.06 (95% C.I 1.41 to 11.72)], higher-level wealth [aOR = 4.91 (95% C.I 1.49 to 16.13)] compared to those in the lowest househoold wealth. Being in 12-18 months age group [aOR = 2.12 (95% C.I 1.25 to 3.58)] and in 18-23 months age category [aOR = 2.23 (1.29 to 3.82)] compared to 6-11 months age group; and having postnatal check-ups [aOR = 2.16 (95% C.I 1.31 to 3.55)] compared to their counterparts. Moreover, residing in urban [aOR = 3.40 (95% C.I 1.73 to 6.68)]; living in a communities' where majority had a media exposure [aOR 1.80 (95% C.1.17 to 2.77)] were found to be significantly influenc consumption of the MAD.

CONCLUSIONS

The trends of MAD among children of 6-23 months was steady in Ethiopia. Sociodemographic and socioeconomic factors such as maternal education, child age, household wealth; and health system related factors such as maternal postnatal check-ups had a significant influence on infants' and young children's MAD feeding. Indeed, commnity-level factors such as place of residence, and media exposure affect the MAD of infants and young children. Thus, behavioral change communication interventions are recommended to improve dietary practices in infants and young children.

Infant Young Child Feeding Practices in an Indian Maternal-Child Birth Cohort in Belagavi, Karnataka

Poor infant young child feeding (IYCF) practices result in malnutrition, poor psychosocial development, poor school performance and less productivity in later life, thereby perpetuating a vicious cycle. The current study aims to characterize the IYCF practices during the first year of life in a maternal–child birth cohort (DHANI) in Belagavi, Karnataka, India. We collected data from the dyad at birth, 6 and 12 months postpartum. We examined dietary diversity among these infants at 12 months using WHO criteria. A total of 902 live births were recorded, and 878 mother–child pairs completed the 12-month follow up. The overall prevalence of early (within 1 h of delivery) initiation of breastfeeding (EIBF) was 77.9%, and that of exclusive breastfeeding (EBF) at 6 months was 52.4%. At 12 months, most (90%) infants were breastfed, while 39% also received formula. The large majority (94.4%) of infants met minimum meal frequency (MMF), but only 55% of infants were receiving a minimum acceptable diet (MAD). The mean dietary diversity (DD) score was 4.7 ± 1.1. Only 21.9% of infants consumed egg and/or flesh food. A large proportion (33.8%) of infants received no vegetables and/or fruits till 12 months of age. Consumption of sweet beverage was 4.8%, but consumption of ultra-processed foods high in trans-fats, sugars and salt was high (85.8%). High-quality, sustainable and scalable interventions to enhance knowledge and support positive behaviour change for adopting and implementing better IYCF practices may be urgently needed in low- and middle-income group settings to improve diet diversity and overall nutritional intake amongst young children.

Levels of dietary diversity and its associated factors among children aged 6–23 months in West Shoa, Ethiopia: a comparative cross-sectional study

Dietary diversity is one of the eight core indicators of infant and young child feeding (IYCF) practices. It is also a proxy for nutrient adequacy of the diet of individuals. There are minimal studies showing the level of dietary practice in urban and rural settings comparably. Hence, the present study intended to assess and compare differences in the level of dietary diversity and its contributing factors in urban and rural settings of the West Shoa zone of Oromia, Ethiopia. A community-based comparative cross-sectional study was conducted among 674 pairs of mothers/caregivers and children aged 6–23 months using a multistage sampling technique. Data were analysed and descriptive summaries were presented with tables, charts and graphs. A linear regression analysis was used to identify factors that were associated with the level of dietary diversity. The dietary diversity score (DDS) was 26⋅1 % (95 % CI 22⋅8, 29⋅5) both in urban and rural (P < 0⋅001), and also the minimum meal frequency was 56⋅5 % (95 % CI 52⋅7, 60⋅2) (P < 0⋅038). Child from merchant mother, own production of foods at the household level and frequent advice of IYCF practices during Post natal care (PNC) visit in urban residents, maternal secondary educational level, living with caregiver only, having a merchant father, advice of IYCF practice during PNC visit and utilisation of horse as a means of transportation in rural were positively associated with the level of dietary diversity. Generally, infant and young children who received the recommended dietary diversity and the minimum meal frequency were low in the study area both in the urban and rural settings.

The effect of mothers and caregivers’ fasting status on the dietary diversity of children 6-23 months: A longitudinal study in Debrebirhan, Ethiopia

Background

There are various religions in Ethiopia, of which the Orthodox Tewahido Christian accounts for 44% of the population. According to the Ethiopian Orthodox Tewahido practice close to 200 days annually are dedicated to fasting. During this time, all followers who are above seven years old are expected to abstain from all types of food, including animal source foods and water for up to some hours daily. It is possible that such practice by mothers or caregivers could affect children’s dietary practice. However, whether mothers/caregivers’ fasting status influences dietary diversity of children during these periods remained uninvestigated.

Methods

A community-based longitudinal study was conducted in Debrebirhan, North Shewa Zone, Ethiopia in seven randomly selected kebeles. We collected data in a sample of 218 mothers/caregivers, from January 29 to February 25, 2019 in the pre-fasting period and from March 18 to April 10, 2019, during fasting period on same participants. Data was entered on Epi-Data version 4.4.2.1 and analyzed using STATA 15 software. Children’s dietary diversity was measured using the World Health Organization (WHO) standardized questionnaire for infant and young child feeding. The McNemar paired test was used for comparison of baseline and end line measurements. Statistical significance was set at p<0.05.

Result

A total of 218 and 216 mothers/caregivers with children 6–23 months participated in the study before and during fasting season with a response rate of 100.0% and 99.0% respectively. The median age of children was 14 months. The proportion of children who met the minimum dietary diversity before the fasting season was significantly higher (23.4%) compared to during the fasting period (5.5%). (P<0.001). The proportion of children who consumed dairy product was significantly higher (55.5%) before the fasting period compared to consumption during the fasting period (42.6%) (p<0.001). Similarly, consumption of flesh food was significantly higher before the fasting period (17.9%) compared to consumption during the fasting period (0.46%) (P<0.001).

Conclusion

The study revealed that mothers/caregivers’ fasting status negatively affect the dietary diversity of children aged 6–23 months in the household by decreasing their consumption of animal source food. Intervention strategies in promoting children’s dietary diversity should be designed in a way that considers Ethiopian Orthodox Tewahido Christian mothers/caregivers’ fasting practice.

Dietary diversity and associated factors among children (6-23 months) in Gedeo zone, Ethiopia: cross - sectional study

INTRODUCTION

Different foods and food groups are good sources for various macro- and micronutrients. Diversified diet play an important role in both physical and mental growth and development of children. However, meeting minimum standards of dietary diversity for children is a challenge in many developing countries including Ethiopia.

OBJECTIVE

To assess dietary diversity and associated factors among children (6-23 months) in Gedieo Zone, Ethiopia.

METHOD

Community based cross-sectional study was carried out at Gedieo Zone, Ethiopia, from January to March 15, 2019. Multi-stage sampling technique was used to get a total of 665 children with the age of between 6 and 23 months from their kebeles. Data was collected by using face-to-face interview with structured questionnaire. Data was entered into Epidata version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for analyses. Variables having p < 0.25 at bivariate analysis were fitted to multivariable analysis. Multivariable logistic regression model was used at 95% confidence interval and with P-Value < 0.05. Bivariate.

RESULT

A total of 665 children were participated with response rate of 96.2%. Only 199(29.9%) of children were met the minimum requirements for dietary diversity. Age of children [AOR 4.237(1.743-10.295))], Educational status [AOR 2.864(1.156-7.094)], Number of families [AOR 2.865(1.776-4.619))] and household wealth index [AOR4.390(2.300-8.380)] were significantly associated with Dietary Diversity of children.

CONCLUSION

Only, one out of four children aged of 6-23 months attained the minimum dietary diversity score. Children from low socioeconomic status and mothers with no formal educational attainment need special attention to improve the practice of appropriate feeding of children.

Dietary diversity and associated factors among children aged 6 to 23 months in Chelia District, Ethiopia

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.

Minimum acceptable diet and associated factors among children aged 6-23 months in Ethiopia

INTRODUCTION

The health and growth of children less than two years of age can be affected by the poor quality of complementary foods and poor feeding practices even with optimal breastfeeding. In Ethiopia, empirical evidence on the minimum acceptable diet and its associated factors is limited. Therefore, this study was aimed to assess the level of minimum acceptable diet and its associated factors among children aged 6-23 months in Addis Ababa Ethiopia.

METHODS

An institution-based Cross-sectional study was conducted among a total of 575 mother-child pairs. A simple random sampling technique was used to recruit participants. For infant and young child feeding practices, the data collection tools were adapted from world health organizations' standardized questionnaire which is developed in 2007. Data entry and analysis were performed using EPI data version 3.1 and SPSS version 20 respectively. Bivariable and multivariable logistic regression analyses were performed to determine predictor variables. Statistical significance was declared at p-value < 0.05.

RESULT

In this study, the level of minimum acceptable diet was found to be 74.6%.. About 90.6 and 80.2% of the children received minimum meal frequency and dietary diversity respectively. Having a husband secondary and above educational level [AOR = 4.789(95%CI:1.917-11.967)], being a housewife [AOR = 0.351(95% CI: 0.150-0.819)], having a history of more than three postnatal follow-ups [AOR = 2.616(95%CI:1.120-6.111], Having mothers age between 25 and 34 years [AOR = 2.051(95%CI:1.267-3.320)], being male child [AOR = 1.585(95%CI:1.052-2.388)] and having children age between 18 and 23 months [AOR = 3.026(95%CI:1.786-5.128)] were some of the factors significantly associated with a minimum acceptable diet.

CONCLUSION

In this study, the minimum acceptable diet among children aged 6-23 months was significantly associated with the educational status of the husband, mother's occupation, history of postnatal follow-up, age of the mother, sex of the child, and age of the child. Thus, attention should be given to educating the father, empowering mothers to have a job, promoting gender equality of feeding, and counseling on the benefit of postnatal care visits. In addition, the ministry of health should work on educating and advocating the benefit of feeding the recommended minimum acceptable diet to break the intergenerational cycle of malnutrition.

The High Burden and Predictors of Anemia Among Infants Aged 6 to 12 Months in Dar es Salaam, Tanzania

BACKGROUND

Despite several interventions, the prevalence of anemia and related complications remains high among infants in Tanzania.

OBJECTIVE

We sought to determine the predictors of iron-deficiency anemia (IDA) among infants of HIV-negative women in Dar es Salaam, Tanzania.

METHODS

Cross-sectional analysis of 2826 mother-infant pairs who participated in a trial of vitamins and perinatal outcomes in Dar es Salaam, Tanzania. Hemoglobin and mean corpuscular volume were used to determine the prevalence of anemia among infants at 6 and 12 months. Multiple logistic regression was used to determine the maternal and infant risk factors for anemia during infancy.

RESULTS

We found high prevalence of anemia (90%) and IDA (44.2%) among infants. Higher maternal education (odds ratio [OR] = 0.52), maternal normal hemoglobin at enrollment (OR = 0.68) and during the early postpartum period reduced the odds of IDA at 6 months (OR = 0.56). The odds of IDA at 6 months were higher among males (OR = 1.65), wealth score below median (OR = 1.35), low birth weight (LBW; OR = 1.75), and small for gestational age (SGA) infants below the third centile (OR = 1.95) or third to less than fifth centile (OR = 2.29). Higher maternal education lowered the odds of IDA at 12 months (OR = 0.25). Wealth score below median (OR = 1.44), preterm delivery (OR = 1.94), SGA (less than third centile; OR = 2.40), and LBW (OR = 2.89) increased the odds of IDA during infancy in the study population. Dietary diversity was low for infants and women in the study sample.

CONCLUSION

Interventions to reduce the risk of infant IDA should address women's education, improvement of wealth status, and optimal care for premature, SGA, and LBW infants.

Women empowerment and minimum daily meal frequency among infants and young children in Ghana: analysis of Ghana demographic and health survey

Background

The nutritional quality of food has an important impact on the health and well-being of families, especially children whose bodies need to grow, develop and reach their full physical and mental potential. Traditionally, women in Ghana provide care and nourishment for their children and families if they have the means to do so or if they are financially, legally and socially empowered. Women’s empowerment is not only important for women’s human rights, but also improves nutrition and health outcomes of both mothers and their children. Women’s empowerment is concerned with increasing ability to make strategic life choices in situations where the ability was hitherto denied. This study sought to investigate the association between women’s empowerment and minimum daily meal frequency (minimum number of meals to be consumed in a day) in Ghana.

Methods

The study used data from the 2014 Ghana Demographic and Health Survey (GDHS). A sample of 1640 mother-child dyad was used. Mothers ages ranged from 15 to 49 while children’s ages ranged from 6 to 23 months. Univariate and multiple linear regression techniques were applied to identify women empowerment (economic, socio-familial and legal) and sociodemographic factors associated with minimum daily meal frequency scores. Data was analyzed by the STATA statistical package software version 13.0. Statistical significance level was set at P < 0.10.

Results

Data from decisions on large household purchases (β = 0.351, p < 0.01) family visits (β = 0.743, p < 0.01), home ownership (β = − 0.245, p < 0.10), age of child (β = 1.387, p < 0.01), mother’s educational attainment (β = 0.496, p < 0.10) and place of residence (β = − 0.298, p < 0.10) showed significant positive association with minimum daily meal frequency in Ghana.

Conclusion

Minimum daily meal frequency was largely influenced by economic and socio-familial factors that contribute to empowerment of women. as decisions on large household purchases and family visits showed significant positive association with minimum daily meal frequency. Interventional programs should target households and mothers with lower socio-demographic characteristics such as lower educational levels and low economic status to improve minimal daily meal frequency in their children thereby ensuring better child health and well-being.

Minimum daily meal frequency is influenced by various dimensions of empowerment of women such as economic and socio-familial empowerment.

There is the need for improved advocacy for women to be involved in decision-making on family visits and large household purchases as these activities promote frequent meal attainment of children

Interventional programs should target households and mothers with lower socio-demographics characteristics such as lower educational level, lower income and those residing in rural areas to improve feeding at least the minimum daily meal frequency to children for their better health and well-being.

Nutrition Education Programs Aimed at African Mothers of Infant Children: A Systematic Review

BACKGROUND

Child malnutrition is a major epidemiological problem in developing countries, especially in African countries. Nutrition education for mothers can alleviate this malnutrition in their young children. The objective of this study was to make a systematic review to assess the effect of intervention programs in nutrition education for African mothers on the nutritional status of their infants.

METHODS

A bibliographic search was carried out in the PubMed database for clinical trials between November 2012 and 2021. The studies should contain educational programs to evaluate the impact on the infant's nutritional indicators in children under 5 years (food consumption, anthropometry and/or knowledge of nutrition in caretakers).

RESULTS

A total of 20 articles were selected, of which 53% evaluated infant's food consumption, 82% anthropometric measurements and 30% nutritional knowledge. In general, nutritional education programs are accredited with some significant improvements in food and nutrient consumption, knowledge and dietary practices in complementary feeding, but only those studies that implemented strategies in agriculture, educational workshops and supplementation obtained reductions in chronic malnutrition figures.

LIMITATIONS

There is high heterogeneity in the articles included, since the intervention programs have different approaches.

CONCLUSIONS

Programs that implemented actions of national agriculture or nutritional supplementation reap the greatest benefits in curbing infant malnutrition.

Prevalence of Minimum Meal Frequency Practice and Its Associated Factors among Children Aged 6 to 23 Months in Ethiopia: A Systematic Review and Meta-analysis

Background. Inappropriate complementary feeding practices are amongst the key causes of child undernutrition. It rises the risk of undernutrition, illness, and mortality among children. Objectives. This study was aimed to determine the pooled prevalence of MMF practice and associated factors among children aged 6 to 23 months in Ethiopia. Methods. The search was conducted by using the following electronic databases; PubMed/MEDLINE, HINARI, EMBASE, Google Scholar, Web of Science, Scopus, African journals, and Google for grey literature. The publication bias was determined by using a funnel plot and Egger's test. The heterogeneity between the studies was checked by using I ² statistic. The subgroup analysis was done by sample size, region, and year of publication. Result. A total of 20 studies with 12 656 study participants were included in the present systematic review and meta-analysis. The pooled prevalence of MMF practice among children aged 6 to 23 months in Ethiopia was estimated to be 63.80% (95%CI: 56.59, 71.01). PNC visit (AOR = 1.90, 95%CI [1.31, 2.49]), wealth index (AOR = 2.11, 95%CI [1.42, 2.81]) and age of child (AOR = 5.75, 95%CI [4.25, 7.26]) were factors significantly associated with MMF among children aged 6 to 23 months. Conclusion. The findings showed that the pooled prevalence of MMF among children aged 6 to 23 months in Ethiopia was relatively low. PNC visit, wealth index and age of child were factors significantly associated with MMF among children aged 6 to 23 months. Therefore, community-based health education concerning the recommended MMF among children aged 6 to 23 months is required to take place.

Dietary Diversity Feeding Practice and Its Associated Factors among Infants and Young Children Aged between 6 and 23 Months in Birbir Town, Southern Ethiopia

A significant proportion of infant and young child mortality can be prevented by the provision of a diverse diet. Globally, an estimated 45% of deaths of children under the age of 5 are because of malnutrition. More than two-thirds of these deaths are associated with inappropriate child-feeding practices. This situation is the worst in Ethiopia. Thus, the objective of this study was to determine the status of dietary diversity and identify relevant variables. A community-based cross-sectional study was conducted with 335 randomly selected mothers/caregivers who had infants and young children aged between 6 and 23 months. Data were collected by interview with a structured questionnaire. The data were analyzed using SPSS Version 23. A multivariable logistic regression model was fitted to identify factors associated with dietary diversity practices and statistical significance was declared at p < 0.05. Only 12.6% (95% CI; 9.2, 16.6) of children aged 6 to 23 months had adequate dietary diversity. Having a backyard garden and primary education were associated with adequate dietary diversity practices. In this study, the status of adequate dietary diversity feeding practice is low. Therefore, interventions targeting dietary diversity should encourage households to have backyard gardens, and strengthening counseling of mothers/caregivers attending antenatal care and postnatal care is proposed for achieving adequate dietary diversity practices.

The effect of maternal depressive symptoms on infant feeding practices in rural Ethiopia: community based birth cohort study

BACKGROUND

Maternal depression and other psychosocial factors have been shown to have adverse consequences on infant feeding practices. This study explored the longitudinal relationship of maternal depressive symptoms and other selected psychosocial factors with infant feeding practices (IFPs) in rural Ethiopia using summary IFP index.

METHODS

This study uses existing data from the ENGINE birth cohort study, conducted from March 2014 to March 2016 in three districts in the southwest of Ethiopia. A total of 4680 pregnant women were recruited and data were collected once during pregnancy (twice for those in the first trimester), at birth, and then every 3 months until the child was 12 months old. A standardized questionnaire was used to collect data on IFPs, maternal depressive symptoms, household food insecurity, intimate partner violence (IPV), maternal social support, active social participation, and other sociodemographic variables. A composite measure of IFP index was computed using 14 WHO recommended infant and young child feeding (IYCF) practice indicators. High IFP index indicated best practice. Prenatal and postnatal maternal depressive symptoms were assessed using the patient health questionnaire (PHQ-9). Linear multilevel mixed effects model was fitted to assess longitudinal relationship of IFPs with maternal depression and other psychosocial factors.

RESULTS

Reports of higher postnatal depressive symptoms (ß = - 1.03, P = 0.001) and IPV (ß = - 0.21, P = 0.001) were associated with lower scores on the IFP index. Whereas, reports of better maternal social support (ß = 0.11, P = 0.002) and active social participation (ß = 0.55, P < 0.001) were associated with higher scores on the IFP index. Contrary to expectations, moderate household food insecurity (ß = 0.84, P = 0.003), severe household food insecurity (ß = 1.03, P = 0.01) and infant morbidity episodes (ß = 0.63, P = 0.013) were associated with higher scores on the IFP index.

CONCLUSIONS

Overall, a multitude of factors are related to IFPs and hence coordinated, multi-sectoral and multi-stakeholder interventions including maternal depressive symptoms screening and management are needed to improve infant feeding practices.

Use of Technology to Access Health Information/Services and Subsequent Association With WASH (Water Access, Sanitation, and Hygiene) Knowledge and Behaviors Among Women With Children Under 2 Years of Age in Indonesia: Cross-sectional Study

BACKGROUND

Water access, sanitation, and hygiene (WASH) remain a public health concern in Indonesia. Proper WASH practices can decrease risk of stunting, wasting, and disease in children under the age of 2.

OBJECTIVE

The purpose of our study is to examine if using technology to access health information and services among Indonesian women affects knowledge and behaviors regarding handwashing and defecation practices.

METHODS

Our study is an interview-based cross-sectional survey. Participants included 1734 mothers of children under 2 years of age. These women were randomly selected and interviewed as part of a 3-stage cluster sampling technique. Our study uses data regarding WASH knowledge which includes benefits of handwashing with soap, 5 critical times of handwashing, risks of open defecation, media of disease transmission, defecation locations, and risks of open defecation. Data regarding WASH behaviors were also included: handwashing with soap, type of latrine used at home, and where defecation took place. This investigation used adjusted and unadjusted logistic and linear regression models to determine differences in WASH outcomes between those who use technology to access health information and services and those who did not.

RESULTS

One result is that Indonesian women with children under 2 years of age who use technology to access health information and services are more likely to know the advantages of proper handwashing (odds ratio [OR] 2.603, 95% CI 1.666-4.067) and know the 5 critical times of handwashing (OR 1.217, 95% CI 0.969-1.528). Women who use technology to access health information are also more likely to know the risks of open defecation (OR 1.627, 95% CI 1.170-2.264) and use a type of toilet (such as a gooseneck or squat toilet) that limits risk (OR 3.858, 95% CI 2.628-5.665) compared to women who did not use technology to access health information.

CONCLUSIONS

Using technology to access health information and services was associated with an increase in handwashing and defecation knowledge. In the future, promoting mothers of children under 2 years of age to access health information through technology might be used to increase handwashing and defecation knowledge as well as safe defecation practices. However, further research should be done to determine how technology may increase the frequency of recommended handwashing behaviors.

Water insecurity potentially undermines dietary diversity of children aged 6-23 months: Evidence from India

Dietary diversity is a crucial pathway to child nutrition; lack of diversity may deprive children of critical macro and micronutrients. Though water along with hygiene and sanitation is a known driver of child undernutrition, a more direct role of household water in shaping dietary diversity remains unexplored. Existing literature provides a sound theoretical basis to expect that water could affect dietary diversity among young children. Here, we test the proposition that suboptimal household access to water and low regional water availability associate with lower dietary diversity among young children. Using the nationally representative 2015-2016 India Demographic and Health Survey data, we conducted a probit analysis on the sample of 69,841 children aged 6-23 months to predict the probability that a child achieves minimum standards of dietary diversity (MDD). After controlling for relevant socioeconomic and gender-related covariates, we found that children in household with suboptimal household water access were two percentage points less likely to achieve MDD, when compared with those from households with optimal water access. Children in high water availability regions had nine percentage points greater probability of achieving MDD compared with children from low water availability regions, accounting for household water access. As dietary diversity is central to nutrition, establishing the role of water access in shaping early childhood dietary diversity broadens the framework on how household material poverty shapes child malnutrition-independent of sanitation and hygiene pathways. This provides additional window for nutrition planning and intervention wherein water-based strategies can be leveraged in multiple ways.

Individual-level predictors of practices of nutrition-specific and nutrition-sensitive interventions for infants and young children in West and Central Africa: a cross-sectional study

OBJECTIVES

To explore the role of individual-level and household-level characteristics for practice of nutrition-specific and nutrition-sensitive interventions.

DESIGN

Secondary data analysis (cross-sectional).

SETTING

West and Central Africa.

PARTICIPANTS

Data are from the Demographic and Health Surveys in the time period between 1986 and 2016. The final sample included between 116 325 and 272 238 observations depending on the outcome.

PRIMARY AND SECONDARY OUTCOME MEASURES

Nutrition-specific and nutrition-sensitive interventions were identified based on the UNICEF Conceptual Framework for child undernutrition. These were early breastfeeding initiation, minimum dietary diversity, full age-appropriate immunisation, iodised salt usage, vitamin A supplementation, iron supplementation, deworming in children aged 1 to 5, clean cooking fuel, safe drinking water and improved sanitation. Explanatory variables include household, mother and child characteristics. Linear probability models were fitted for each outcome, both unadjusted as well as fully adjusted including primary sampling unit fixed effects.

RESULTS

Prevalence of early breastfeeding initiation was 54.31% (95% CI: 53.22% to 55.41%), minimum dietary diversity 13.89% (95% CI: 13.19% to 14.59%), full age-appropriate immunisation 13.04% (95% CI: 12.49% to 13.59%), iodised salt usage 49.66% (95% CI: 46.79% to 52.53%), vitamin A supplementation 52.87% (95% CI: 51.41% to 54.33%), iron supplementation 10.73% (95% CI: 10.07% to 11.39%), deworming 31.33% (95% CI: 30.06% to 32.60%), clean cooking fuel usage 3.02% (95% CI: 2.66% to 3.38%), safe drinking water 57.85% (95% CI: 56.10% to 59.59%) and improved sanitation 42.49% (95% CI: 40.77% to 44.21%). There was a positive education and wealth gradient for the practices of all interventions except deworming. Higher birth order was positively associated with the practice of early breastfeeding initiation, minimum dietary diversity, vitamin A supplementation and negatively associated with full immunisation and improved sanitation.

CONCLUSIONS

Household, maternal, and child-level characteristics explain practices of nutrition-specific and nutrition-sensitive interventions beyond intervention delivery at the regional level.

Sustainable under nutrition reduction program and dietary diversity among children's aged 6-23 months, Northwest Ethiopia: Comparative cross-sectional study

INTRODUCTION

Adequate dietary diversity is vital for the survival, growth and development of infants and children. Inadequate dietary diversity is the major cause of micronutrient deficiency in Sub-saharan Africa, including Ethiopia, where only less than one-fourth of the children aged 6-23 months obtain adequate diversified diet. Thus country implemented a strategy known as the Sustainable Undernutrtion Reduction (SUR) programs to alleviate the problem. However, empirical evidences are scarce on the impact of the program on children aged 6-23 months. Therefore, this study aimed to compare the level of dietary diversity among children aged 6-23 months in districts covered and not covered by SURE program in West Gojjam zone.

METHODS

A community based comparative cross-sectional study was conducted in three districts of West Gojjam zone, Ethiopia, from February 29 to April 20, 2019. A total of 832 mother and child pairs were selected by the simple random sampling technique. A pretested and structured interviewer-administered questionnaire was used to collect data. A binary logistic regression model was fitted to identify factors associated with dietary diversity. Crude odds and adjusted odds ratios with 95% confidence intervals (CI) were calculated to assess the strength of associations and significance of the identified factors for dietary diversity score.

RESULT

The overall proportion of adequate dietary diversity among children aged 6-23 months was 29.9% (95% CI: 27.0-33.0), whereas in SURE covered and uncovered districts it was 33.4% (95%CI: 29.0-38.and 26.4%(95% CI: 22.0, 31.0), respectively. ANC (Antenatal care) (AOR = 1.7; 95% CI: 1.16, 2.55) and postnatal care services (AOR = 2.1; 95% CI: 1.38, 3.28), participating in food preparation programs (AOR = 1.9; 95% CI: 1.19, 2.96), GMP (AOR = 2.74,95%CI:1.80, 4.18), vitamin A supplementation (AOR = 2.10,95%CI:1.22, 3.61) and household visits by health extension workers (AOR = 2.0; 95% CI: 1.25, 3.21) were significantly associated with dietary diversity.

CONCLUSION

The proportion of adequate dietary diversity was higher among children in the program than those out of the program. ANC visits, PNC follow-ups, women's participating in food preparation programs and household visits by health extension workers were significantly associated with dietary diversity. Therefore, and strengthening and scaling up the program to non covered districts and providing health and nutrition counseling on Infant and Young Child Feeding (IYCF) during ANC and PNC services are recommended for achieving the recommended dietary diversity.

The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania

BACKGROUND

Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have been identified as the main causes for undernutrition. As dietary diversity is a major requirement if children are to get all essential nutrients, it can thus be used as one of the core indicators when assessing feeding practices and nutrition of children. Therefore, adequate information on the association between dietary diversity and undernutrition to identify potential strategies for the prevention of undernutrition is critical. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania.

METHODS

Using existing data from the Tanzania Demographic and Health Survey of 2015-2016, we carried out secondary data analysis. Stunting, Wasting and Underweight of the surveyed children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups eaten the previous day as reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight.

RESULTS

A total of 2960 children were enrolled in this study. The prevalence of stunting was 31%, wasting 6% and underweight 14%. Among all children, 51% were female and 49% male. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). The remaining food groups were reported to be consumed by a much lower proportion of children, including eggs (7%), meat and fish (36%), milk and dairy products (22%), as well as legumes and nuts (35%), and other vegetables (21%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a significantly higher likelihood of being stunted (AOR = 1.37, 95% CI; 1.13-1.65) and underweight (AOR = 1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children.

CONCLUSION

Consumption of a diverse diet is associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

Poor child complementary Feeding Practices in northwest Ethiopia: Finding from the Baseline Survey of Nutrition Project, 2016

Background

Improving infant and young child feeding practices is critical to improved nutrition, health, and development of children. Ethiopia adopted the WHO recommendations of child feeding practices and developed the national guideline. In spite of this fact, only few children start and received appropriate complementary feeding based on the recommendation. Therefore, the study aimed to determine dietary diversity score and its associated factors among under five children at Dabat Health and Demographic Surveillance System site (HDSS), northwest Ethiopia.

Methods

A cross-sectional community based study was carried out from February to June 2016. All children aged 6–59 months old who lived in HDSS site were included in the survey. Odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated to show the strength of association. Finally, variables with a P-value of < 0.05 were considered statistically significant..

Results

In this study, a total of 3433 children were included. About 34.87% (95%CI: 33.27, 36.49%) of the children received adequately diversified diet. The odds of receiving adequately diversified diet was higher among children whose mother had secondary and above education (AOR = 6.51; 95%CI: 4.95, 8.56), had antenatal care (AOR = 1.90; 95%CI: 1.60, 2.26) and postnatal care visits (AOR = 1.31; 95%CI: 1.00, 1, 72), and children who feed with their family (AOR = 1.39; 95%CI: 1.17, 1.65). However, a lower dietary diversity score was observed among younger children; 6–11 months old (AOR = 0.59; 95%CI: 0.41, 0.85), and children from food insecure household (AOR = 0.76; 95%CI: 0.63, 0.92).

Conclusions

Diversified diet feeding practice is low in Dabat HDSS site. Age of the child, maternal education, antenatal and postnatal care visits, and household food insecurity were significantly associated with dietary diversity of children. Hence, ensuring household food security and enhancing the coverage of maternal health care utilization are recommended to increase dietary diversity of children.

Dietary Diversity and Meal Frequency Practices among Children Aged 6-23 Months in Agro Pastoral Communities in Afar Region, Ethiopia: A Cross-sectional Study

Introduction: Inappropriate infant and young child feeding practices in the first two years of life are among the major causes of childhood malnutrition in developing countries, including Ethiopia. Dietary diversity refers to increasing the consumption of a variety of foods across and within the food groups. Therefore, this study aimed to assess the minimum dietary diversity and minimum meal frequency practices among children aged 6-23 months in Agro pastoral communities, Afar Region, Ethiopia.Methods: A community-based cross-sectional study was conducted from December 1-30, 2018. A multi-stage stratified sampling followed by a systematic random sampling technique was used to select participants. An interviewer-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with minimum dietary diversity and meal frequency. The adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals (CI) were computed to see the association between the outcome and independent variables. The statistical significance was declared at p-value <0.05.Results: The proportion of children who met the minimum dietary diversity and meal frequency were 21.8% (95% CI: 19.0%-24.7%) and 43.8% (95% CI: 40.4%-47.2%) respectively. Maternal education (AOR = 2.5, 95% CI = 1.1-5.3 and AOR = 3.9, 95% CI = 1.3-11.5), maternal occupation (AOR = 4.2, 95% CI = 2.3-7.8), sex of child (AOR = 2.6, 95% CI = 1.5-4.5) and history of postnatal care visit (AOR = 1.8, 95% CI = 1.1-3.2) were independently associated with minimum dietary diversity. Similarly, age of child (AOR = 2.8, 95% CI = 1.4-5.5 and AOR = 5.3, 95% CI = 2.3-12.4), sex of child (AOR = 2.6, 95% CI = 1.4-4.6) and history of postnatal care visit (AOR = 2.2, 95% CI = 1.3-3.8) were the factors significantly associated with minimum meal frequency practices.Conclusions: The current study showed that the proportions of children who met the minimum dietary diversity and meal frequency were low. Increasing maternal education, being a housewife, being a male child and attending a postnatal care visit were independently associated with minimum dietary diversity. Likewise, increasing the age of a child, being a male child and attending a postnatal care visit were significantly associated with minimum meal frequency. Improving maternal education and health care utilization, health and nutrition counseling during postnatal care visits are highly recommended to improve infant and young child feeding practices.Abbreviations ANC: Ante Natal Care, DHS: Demographic and Health Surveys, EDHS: Ethiopian Demographic and Health Surveys, RERC: Research and Ethical Review Committee, IYCF: Infant and Young Child Feeding, MDD: Minimum Dietary Diversity, MMF: Minimum Meal Frequency, PNC: Post Natal Care, WHO: World Health Organization.

Factors associated with complementary feeding practices among children aged 6-23 mo in Malawi: an analysis of the Demographic and Health Survey 2015-2016

Background

Optimal child complementary feeding practices are crucial for nutritional status, growth, development and health, and ultimately affect child survival. This is the first population-based study in Malawi that aimed to examine factors associated with complementary feeding practices among children aged 6-23 mo.

Methods

Utilizing data from the 2015-16 Malawi Demographic and Health Survey (MDHS), 4732 children aged 6-23 mo and their mothers were analysed. The MDHS produced a nationally representative sample using a multistage cluster sampling design that included sampling weights. The impact of child, maternal, household, community and health service utilization factors on complementary feeding practices was examined using the generalized estimating equation logistic regression.

Results

After controlling for a wide range of covariates, children from mothers with secondary or post-secondary education and from mothers working in agriculture and living in the central region were significantly more likely to have timely introduction to solid, semi-solid or soft food. Surprisingly, being >1 y of age was associated with reduced odds of achieving minimum meal frequency. In addition, children >1 y of age from mothers older than 24 y and from mothers with primary, secondary and post-secondary education were significantly more likely to achieve minimum dietary diversity. Children from rich households were more likely to achieve both minimum dietary diversity and minimum acceptable diet. Finally, exposure to mass media was significantly associated with increased odds of achieving minimum meal frequency, minimum dietary diversity and minimum acceptable diet.

Conclusions

Public health strategies aimed at reducing childhood undernutrition should focus on children from poor households whose mothers have no formal education and are unemployed. In addition, exposure to mass media had a positive impact on the three complementary feeding indicators. Therefore behaviour change communication messages through mass media aimed at promoting child nutrition are necessary to achieve optimal child complementary feeding practices.

Feeding Practices and Undernutrition in 6⁻23-Month-Old Children of Orthodox Christian Mothers in Rural Tigray, Ethiopia: Longitudinal Study

Fasting period and fasting status affect the feeding practices and nutritional status of Ethiopian Orthodox mothers. Even if children are exempted from fasting, some mothers do not prepare their food from animal sources as it could contaminate utensils for cooking family foods. Therefore, the objective of this study was to assess feeding practices and undernutrition in 6⁻23-months old children whose mothers are Ethiopian Orthodox religion followers during lent fasting and non-fasting periods in rural Tigray, Northern Ethiopia, and to identify associated factors. A community-based longitudinal study was carried out in Ethiopian Orthodox lent fasting and non-fasting periods. Using a multi-stage systematic random sampling technique, 567 and 522 children aged 6⁻23 months old participated in the fasting and non-fasting assessments, respectively. Statistical analyses were done using logistic regression, an independent sample t-test, Wilcoxon signed-rank (WSRT) and McNemar's tests. The prevalences of stunting, underweight and wasting were 31.6⁻33.7%, 11.7⁻15.7% and 4.4⁻4.8%, respectively. The weight-for-height (WHZ) and height-for-age (HAZ) values for children of fasting mothers were significantly lower (p < 0.05) compared to those of non-fasting mothers. Likewise, the median weight-for-age (WAZ) and diet diversity score (DDS) of children of fasting mothers were also significantly higher in non-fasting than in fasting periods. A small proportion of children (2.3⁻6.7%) met the minimum acceptable diet (MAD) in the study population, but these measures were significantly increased (p < 0.001) in the children of non-fasting mothers. Mother's fasting during lactation period of the indexed child was amongst the independent factors common in child stunting, underweight and wasting. Nutritional status and feeding practices of 6⁻23-month-old children are affected by maternal fasting during the fasting period. Therefore, without involvement of religious institutions in the existing nutritional activities, reduction of undernutrition would not be successful and sustainable.

Complementary feeding and effect of spontaneous fermentation on anti-nutritional factors of selected cereal-based complementary foods

Background

Malnutrition has been responsible directly or indirectly for 10.9 million deaths worldwide annually among children under five. Childhood malnutrition is highly related to poor nutritional quality diet in developing countries where there is limited access to animal based foods. Most foods consumed by young children are cereal based which contain high amounts of anti-nutritional factors. Fermentation is thought to significantly lower the content of anti-nutrients in cereal grains. This study therefore, aimed to determine complementary feeding practices and effect of spontaneous fermentation on anti-nutritional factors and mineral contents of selected cereals.

Methods

Cross sectional survey was conducted in Ebinat district to determine complementary feeding practices among 324 lactating mothers. Laboratory analysis was carried out for teff and wheat cereal grains to determine the effect of spontaneous fermentation on anti-nutrients as well as mineral contents.

Results

Prevalence of appropriate complementary feeding practice was 1.5%. Fermentation of the sampled cereals for 12 h significantly (p < 0.05) reduced total phytate and total tannin. The reduction continued and most of the reduction of phytate and tannin contents occurred during the 72 h of fermentation for both cereal samples. However, the reduction for some fermentation times was not statistically significant. A significant (p < 0.05) variation was also noticed in the total amounts of calcium, iron and zinc in both sampled cereals within the 72 h of fermentation.

Conclusion

Prevalence of appropriate complementary feeding practice was very low. There were significant reductions of phytate and tannin contents with concomitant increments of minerals after fermentation of cereals. Phytate: mineral ratios were significantly decreased after fermentation for all the parameters examined. It is recommended to ferment cereals while preparing complementary foods for children so as to enhance their micronutrient uptake.

Dietary diversity feeding practice and its associated factors among children age 6-23 months in Ethiopia from 2011 up to 2018: a systematic review and meta-analysis

BACKGROUND

Globally Less than one fourth of children aged 6-23 months get the recommended minimum dietary diversity feeding practice. Despite this issue is common in Ethiopia, fragmented and inconsistent findings were found. Therefore the main objective of this meta-analysis was to estimate the pooled prevalence of dietary diversity feeding practice and to identify its associated factors among children aged 6-23 months in Ethiopia.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed. Articles were systematically searched through PubMed, Google scholar, Google, Hinari and Cochrane library. Newcastle-Ottawa Scale adapted for cross-sectional studies quality assessment tool was used to assess the quality of each study. A total of 14 studies were extracted and analyzed using STATA 14. Random effect model was used to estimate the pooled prevalence; whereas subgroup analysis and meta-regression was performed to identify the probable source of heterogeneity. Both egger's and begg's test were used to check publication bias. Furthermore, the effect between associated factor variables, and dietary diversity feeding practices were examined.

RESULTS

A total of 154 studies were retrieved and 14 studies were included in meta-analysis. The Meta analysis result showed that the pooled prevalence of dietary feeding practice among children age 6-23 months in Ethiopia was 23.25% with considerable heterogeneity (I2 = 98.8, p = 0.00). In the subgroup analysis, the lowest prevalence was observed in Amhara region (12.58%). Home delivery OR: 0.63, antenatal care follow up OR: 1.80, postnatal care visit OR: 2.61, mothers decision making status OR: 1.65, mothers media exposure status OR: 2.79 and being urban residence OR: 2.18 (1.26, 3.77) were significant factors for minimum dietary diversity feeding practice in Ethiopia.

CONCLUSIONS

The pooled prevalence of dietary diversity feeding practice among children aged 6-23 months in Ethiopia was low. Place of delivery, post natal care, antenatal care service, mothers decision making status, mothers media exposure status and being urban residence were found to be the significant factors.