An exploration of cultural influencing factors on dietary diversity in Malagasy children aged 6-59 months

Evaluation of nutritional status using the minimum dietary diversity for women of reproductive age (MDD-W) tool in breastfeeding mothers in Madagascar

OBJECTIVES

Women of reproductive age in low-income countries are especially nutritionally vulnerable given the strain that pregnancy and lactation places on the body. The aim of this study was to identify dietary diversity and its associated factors among mothers with young children.

METHODS

It is a cross-sectional study conducted in Ampefy, Madagascar from 1 November 2022 to 31 March 2023. Dietary diversity was determined using the minimum dietary diversity for women of reproductive age tool. Data were collected through face-to-face interviews using validated structured questionnaires, and anthropometric status was examined. Frequencies and percentages were calculated, and the comparison of variables was performed between mothers with acceptable and unacceptable dietary diversity using the chi-square test for qualitative variables. A logistic regression analysis was also conducted.

RESULTS

A total of 437 mothers with young children participated in the study, resulting in a response rate of 95.0%. The mean age of the participants was 25.84 years (SD = 6.30). The study revealed that 32.95% of participants had unacceptable dietary diversity scores and the associated profile included low education, no transport, homebirth not by personal choice, not breastfeeding within the first hour of birth, not breastfeed exclusively for 6 months, no dietary changes during pregnancy or lactation, and no use of folic acid supplements.

CONCLUSION

This study's findings underscore the importance of providing nutrition information to women, in order to improve dietary diversity and overall maternal and child health.

Incorrect Feeding Practices, Dietary Diversity Determinants and Nutritional Status in Children Aged 6-23 Months: An Observational Study in Rural Angola

BACKGROUND

More than a quarter of children who are affected by severe acute undernutrition reside in Sub-Saharan Africa. Incorrect feeding practices have a negative impact on a child's health in both the short and the long term, and the interval from conception to two years is the most critical for the development of undernutrition-related complications. These first 1000 days of life also represent an "opportunity window" for early interventions, hence, having a clear insight into dietary habits and the determinants of diet quality is fundamental to improving nutritional counseling practices.

OBJECTIVES

To investigate incorrect feeding practices, dietary diversity determinants and nutritional status in children aged 6-23 months.

METHODS

Prospective quali-quantitative observational study conducted at the Missionary Catholic Hospital of Chiulo (Angola) from March to April 2023.

RESULTS

Of 250 children, global acute malnutrition affected 25.2% and was associated with starting complementary feeding at <4 months of age (p = 0.007) and not achieving the minimum meal frequency (p < 0.0001). Minimum dietary diversity was found in 11.2%, minimum meal frequency was experienced by 72.8%, and the minimum acceptable diet was found in 11.2% of participants. The minimum dietary diversity was reached only by households with access to food from five or more major food groups (p = 0.007) or the money to buy food from five or more major food groups (p = 0.008) and was higher in households where the householder had a higher educational level (p = 0.002). Regarding the determinants linked to family traditions and beliefs, the main religion-associated beliefs concerned the impurity of pork (n = 25) and fish (n = 8), while eggs (n = 19) and cow milk (n = 8) were the main food types that were deemed harmful for children.

CONCLUSIONS

Although some factors (economic and religious) may be difficult to overcome, other factors linked to erroneous beliefs (dangerous foods) or incorrect feeding practices (early weaning and an incorrect frequency of meals) can be targeted, to improve the effectiveness of nutritional counseling practices.