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Paramashanti BA, Dibley MJ, Huda TM, Nugraheny E, Suparmi S, Nugraheni WP, Rahmawati W, Alam NA. Caregiver perceptions of complementary feeding in rural and urban Indonesia: A qualitative comparative study. Midwifery 2024; 138:104146. [PMID: 39182472 DOI: 10.1016/j.midw.2024.104146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 06/27/2024] [Accepted: 08/13/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVE To explore caregivers' perspectives on complementary feeding in rural and urban areas of Central Java, Indonesia. DESIGN A qualitative comparative study using in-depth interviews. We applied thematic analysis to identify themes and subthemes and presented representative quotes. SETTING Rural and urban villages in Central Java Province, Indonesia. PARTICIPANTS 46 mothers and grandmothers of 6- to 23-month-old children. FINDINGS We identified five themes: 1) timing of food introduction, 2) types of complementary foods, 3) meal preparations, 4) complementary food benefits, and 5) expectations toward complementary foods. While caregivers in urban areas had more favourable perceptions of complementary feeding, some misperceptions existed regarding complementary feeding in both areas. These misconceptions included the age of complementary food introduction, the delay in introducing animal-source foods, and the emphasis on any food the child preferred as long as they ate rather than on healthy food choices. KEY CONCLUSIONS There were similarities and differences in complementary feeding perspectives between caregivers in rural and urban areas. Therefore, policymakers and public health workers should design interventions to enhance complementary feeding practices by addressing the contextual issues in specific settings.
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Affiliation(s)
- Bunga A Paramashanti
- Research Center for Public Health and Nutrition, National Research and Innovation Agency (BRIN), Bogor, West Java 16911, Indonesia.
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
| | - Esti Nugraheny
- Research Center for Public Health and Nutrition, National Research and Innovation Agency (BRIN), Bogor, West Java 16911, Indonesia
| | - Suparmi Suparmi
- Research Center for Public Health and Nutrition, National Research and Innovation Agency (BRIN), Bogor, West Java 16911, Indonesia
| | - Wahyu Pudji Nugraheni
- Research Center for Public Health and Nutrition, National Research and Innovation Agency (BRIN), Bogor, West Java 16911, Indonesia
| | - Widya Rahmawati
- Department of Nutrition Science, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, New South Wales 2006, Australia
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Tesfie TK, Endalew B, Birhanu MY, Haimanot AB, Mneneh AL, Mengie MG, Mazengia EM, Simegn MB, Agimas MC, Derseh NM, Argaw GS, Tilahun WM. Spatial distribution of inadequate meal frequency and its associated factors among children aged 6-23 months in Ethiopia: Multilevel and spatial analysis. PLoS One 2024; 19:e0306646. [PMID: 38985748 PMCID: PMC11236183 DOI: 10.1371/journal.pone.0306646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 06/20/2024] [Indexed: 07/12/2024] Open
Abstract
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.
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Affiliation(s)
- Tigabu Kidie Tesfie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bekalu Endalew
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Molla Yigzaw Birhanu
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Aysheshim Belaineh Haimanot
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Anteneh Lamesgen Mneneh
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Muluye Gebrie Mengie
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Elyas Melaku Mazengia
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Mulat Belay Simegn
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Muluken Chanie Agimas
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girum Shibeshi Argaw
- Department of Nursing, College of Medicine & Health Sciences, Jigjiga University, Jigjiga, Ethiopia
| | - Werkneh Melkie Tilahun
- Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Tekeba B, Gonete AT, Dessie MT, Zegeye AF, Tamir TT. Spatial Variation and Determinants of Inadequate Minimum Meal Frequency among Children Aged 6-23 Months in Ethiopia: Spatial and multilevel analysis using Ethiopian Mini Demographic and Health Survey (EMDHS) 2019. Ann Glob Health 2024; 90:37. [PMID: 38947310 PMCID: PMC11212785 DOI: 10.5334/aogh.4448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 06/01/2024] [Indexed: 07/02/2024] Open
Abstract
Introduction: Minimum meal frequency is the number of times children eat in a day. Without adequate meal frequency, infants and young children are prone to malnutrition. There is little information on the spatial distribution and determinants of inadequate meal frequency at the national level. Therefore, we aimed to investigate the spatial distribution and determinants of inadequate meal frequency among young children in Ethiopia. Methods: The most recent Ethiopian demographic and health survey data was used. The analysis was conducted using a weighted sample of 1,610 children aged 6-23 months old. The Global Moran's I was estimated to assess the regional variation in minimum meal frequency. Further, a multivariable multilevel logistic regression model was fitted to identify factors associated with inadequate meal frequency. The AOR (adjusted odds ratio) at 95% CI (confidence interval) was computed to assess the strength and significance of the relationship between explanatory variables and the outcome variable. Factors with a p-value of <0.05 are declared statistically significant. Results: This study revealed that the prevalence of inadequate meal frequency was found to be 30.56% (95% CI: 28.33-32.88). We identified statistically significant clusters of high inadequate meal frequency, notably observed in Somalia, northern Amhara, the eastern part of southern nations and nationalities, and the southwestern Oromia regions. Child age, antenatal care (ANC) visit, marital status, and community level illiteracy were significant factors that were associated with inadequate meal frequency. Conclusion: According to the study findings, the proportion of inadequate meal frequency among young children in Ethiopia was higher and also distributed non-randomly across Ethiopian regions. As a result, policymakers and other concerned bodies should prioritize risky areas in designing intervention. Thus, special attention should be given to the Somalia region, the northern part of Amhara, the eastern part of Southern nations and nationalities, and southwestern Oromia.
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Affiliation(s)
- Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tilahun Dessie
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Gonete KA, Angaw DA, Gezie LD. Minimum acceptable diet and associated factors among children aged 6-23 months in Ethiopia: a systematic review and meta-analysis. BMC Pediatr 2024; 24:151. [PMID: 38424574 PMCID: PMC10903031 DOI: 10.1186/s12887-024-04635-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/09/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND To ensure a child's full growth, health, and development during infancy and the early years, adequate nutrition is crucial. A crucial window of opportunity for ensuring children's proper growth and development through adequate eating exists during the first two years of life. According to the evidence of the efficacy of interventions, achieving universal coverage of optimal breastfeeding could prevent 13% of deaths in children under the age of 5 worldwide, and using complementary feeding methods appropriately would lead to an additional 6% decrease in under-five mortality. METHODS From several electronic databases, all published, unpublished, and gray literature was extracted and exported into EndNote version X20. For further analysis of the review, the retrieved data from the excel sheet were imported into the statistical software program Stata version. Metanalysis was used to determine the prevalence of MAD, and a random effects model was used to estimate the pooled prevalence of MAD. The DerSimonian-Laird Random effects model (REM) was used to combine the determinant factors from all qualifying papers for the meta-analysis, and the heterogeneity was independently assessed using a χ2 test, Q statistics, and matching I2 statistics. To retrieve the extent of publication bias, funnel plots were scattered and tested for asymmetry and, additionally, Egger's test was computed with the user-written "meta bias" command in Stata (version 11) software. To end, sensitivity analyses with trim and fill were performed. RESULTS The pooled estimate of the overall prevalence of minimum acceptable diet in 16 studies in Ethiopia was 22% with (95% CI: 16, 28%) with a random effect model. However, eight papers were filled during trim and fill in order to counteract the small study effect. The overall filled pooled estimate was 7.9% with (95%CI: 11, 14.8%). Maternal education (primary and secondary) is 1.714 (95% CI 1.244,2.363) and 2.150(95% CI: 1.449,3.190), respectively, Ages of children with range of 12-17 months (2.158 (95% CI 1. 9,3.006) and 18-23 months 2.948(95% CI: 1.675,5.190)), Nutrition information ((1.883 (95% CI 1.169,3.032)) media exposure (1.778(95% CI: 1.396,2.265), and maternal knowledge (2.449 (95% CI 1.232, 5.027) were significantly associated with MAD. CONCLUSION The pooled estimate of the overall prevalence of minimum acceptable diet in 16 studies in Ethiopia were low. Maternal education (primary and secondary), ages of child with range of 12-17 month and 18-23 months, mothers having nutrition information, mothers who have media exposure,and mothers having good knowledge were significantly associated with Minimum acceptable diet. The government, NGO, and other stakeholders should focus on improving Minimum acceptable diet among 6 to 23 months of children through promoting with mass media, focuses on nutrition council during critical contact point in health facility, and doing capacity building for the mothers/caregivers.
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Affiliation(s)
- Kedir Abdela Gonete
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia.
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
| | - Lemma Derseh Gezie
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box 196, Gondar, Ethiopia
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Aboagye RG, Seidu AA, Ahinkorah BO, Cadri A, Frimpong JB, Dadzie LK, Budu E, Eyawo O, Yaya S. Prevalence and predictors of infant and young child feeding practices in sub-Saharan Africa. Int Health 2024; 16:68-82. [PMID: 37042267 PMCID: PMC10759300 DOI: 10.1093/inthealth/ihad022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 03/02/2023] [Accepted: 03/15/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND This study assessed the prevalence and predictors of minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) in sub-Saharan Africa (SSA). METHODS A sample of 87 672 mother-child pairs from the 2010-2020 Demographic and Health Surveys of 32 countries in SSA was used. Multilevel binary logistic regression analysis was carried out to examine the predictors of MDD, MMF, and MAD. Percentages and adjusted odds ratios (aORs) with a 95% confidence interval (CI) were used to present the findings. RESULTS The prevalence of MDD, MMF, and MAD in SSA were 25.3% (95% CI 21.7 to 28.9), 41.2% (95% CI 38.8 to 43.6), and 13.3% (95% CI 11.6 to 15.0), respectively. Children aged 18-23 months were more likely to have MDD and MAD but less likely to have MMF. Children of mothers with higher education levels were more likely to have MDD, MMF, and MAD. Children who were delivered in a health facility were more likely to have MDD and MAD but less likely to have MMF. CONCLUSIONS Following the poor state of complementary feeding practices for infants and young children, the study recommends that regional and national policies on food and nutrition security and maternal and child nutrition and health should follow the internationally recommended guidelines in promoting, protecting, and supporting age-appropriate complementary foods and feeding practices for infants and young children.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Australia
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Abdul Cadri
- Department of Social and Behavioural Science, School of Public Health, University of Ghana, Legon, Ghana
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Department of Kinesiology, New Mexico State University, Las Cruces, NM, USA
| | - Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Oghenowede Eyawo
- School of Global Health, Faculty of Health, York University, Toronto, ON, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada
- George Institute for Global Health, Imperial College London, London, UK
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Lacerda EMDA, Bertoni N, Alves-Santos NH, Carneiro LBV, Schincaglia RM, Boccolini CS, Castro IRRD, Anjos LAD, Berti TL, Kac G, Rodrigues Farias D, de Freitas MB, Normando P, Andrade PG. Minimum dietary diversity and consumption of ultra-processed foods among Brazilian children 6-23 months of age. CAD SAUDE PUBLICA 2023; 39:e00081422. [PMID: 37878864 PMCID: PMC10599228 DOI: 10.1590/0102-311xen081422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 04/03/2023] [Accepted: 05/04/2023] [Indexed: 10/27/2023] Open
Abstract
The study aimed to estimate the prevalence of minimum dietary diversity (MDD) and consumption of ultra-processed foods in children 6-23 months of age according to sociodemographic variables. Three indicators of complementary feeding of 4,354 children from the Brazilian National Survey on Child Nutrition (ENANI-2019) were built based on a questionnaire about food consumption on the day before the interview: MDD, consumption of ultra-processed foods, and MDD without the consumption of ultra-processed foods. The prevalence and 95%CI were calculated, stratified by macroregion; race/skin color, education and work status of the mother or caregiver; enrollment in the Brazilian Income Transfer Program; household food security; sanitation; and child enrollment in daycare/school. The overall prevalence of MDD was 63.4%, with lower prevalences among children who lived in the North Region (54.8%), whose mothers or caregivers had 0-7 years of education (50.6%), and lived under moderate or severe food insecurity (52.6%). Ultra-processed foods were consumed by 80.5% of the children, with the highest prevalence in the North Region (84.5%). The prevalence of MDD without ultra-processed foods was 8.4% and less prevalent among children with black mothers or caregivers (3.6%) and among those whose mother or caregiver had 8-10 years of education (3.6%). The most frequently consumed food groups from the MDD indicator were grains, roots and tubers (90.2%), dairy products (81%) and those from ultra-processed food were sweet or salty cookies/crackers (51.3%) and instant flours (41.4%). The ubiquitous presence of ultra-processed foods in the diets of Brazilian children and the low frequency of diversified foods, especially among the most vulnerable populations, indicate the need to strengthen policies and programs to ensure adequate and healthy infant nutrition.
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Affiliation(s)
| | - Neilane Bertoni
- Divisão de Pesquisa Populacional, Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil
| | - Nadya Helena Alves-Santos
- Instituto de Estudos em Saúde e Biológicas, Universidade Federal do Sul e Sudeste do Pará, Belém, Brasil
| | | | | | - Cristiano Siqueira Boccolini
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | - Talita Lelis Berti
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Gilberto Kac
- Instituto de Nutrição Josué de Castro, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil
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Semagn BE, Abubakari A. Zero fruits/vegetables consumption and associated factors among Children aged 6-23 months in Ethiopia: Mixed effect logistic regression analysis. PLoS One 2023; 18:e0288732. [PMID: 37450483 PMCID: PMC10348598 DOI: 10.1371/journal.pone.0288732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The first two years of life is a vital period for promoting optimal growth, development and health. The lifelong nutritional habit and overall health of children is influenced by their early age feeding practice. Ethiopia is among the top five countries in Sub-Saharan Africa with the highest burden of zero fruits/vegetables consumption. This study aims to access factors associated with zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia. METHODS The study analyzed Ethiopian Mini Demographic and Health Survey 2019 dataset with a total weighted sample of 1459 young children aged between 6-23 months and who were living with their mothers. Data cleaning, coding and labeling were done using STATA version 14 software. Multilevel mixed effect logistic regression model was employed to identify associated factors. RESULTS Exactly 69.3% of children aged 6-23 months in Ethiopia had zero fruits/vegetables consumption. In the multivariable multilevel binary logistic regression analysis a child from household with middle (AOR = 0.55, 95% CI: 0.35, 0.86) and rich (AOR = 0.37, 95% CI: 0.23, 0.60) wealth index, mothers who aged between 25-34 years old (AOR = 0.44; 95%CI = 0.29-0.69), mothers who were married/living with partner (AOR = 3.21; 95%CI: 1.58-6.52), children of mothers who follow Islamic religion (AOR = 0.34, 95% CI: 0.19, 0.61), mothers who had more than four ANC visits during their most recent pregnancy (AOR = 0.57; 95%CI: 0.39-0.83), children in age group of 12-18 month(AOR = 0.41, 95% CI: 0.28, 0.59), and 19-23 months (AOR = 0.26, 95% CI: 0.17, 0.40), health facility delivery (AOR = 1.52, 95% CI; 1.00-2.30), and small peripheral regions (AOR = 4.40, 95% CI; 1.39-13.97) were found to be significant factors associated with children's zero fruits /vegetables consumption. The Interclass correlation coefficient (ICC) value in the null model was 0.34, which indicates that 34% of the variation in children's zero fruits /vegetables consumption was attributed to the variation between clusters. CONCLUSION This study found that zero fruits/vegetables consumption among children aged 6-23 months in Ethiopia is high. Therefore, efforts should be made by stakeholders who are concerned about optimal diet and health of children to improve fruits/vegetables consumption of children particularly those from poor households, young mothers (15-24), and peripheral regions of Ethiopia. This could be done during ANC follow up visits and during nutrition counseling.
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Affiliation(s)
- Birhan Ewunu Semagn
- Department of Public Health, Asrat Weldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia
| | - Abdulai Abubakari
- Department of Global and International Health, School of Public Health, University for Development Studies, Tamale, Ghana
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Paramashanti BA, Dibley MJ, Alam A, Huda TM. Wealth- and education-related inequalities in minimum dietary diversity among Indonesian infants and young children: a decomposition analysis. Glob Health Action 2022; 15:2040152. [PMID: 35389332 PMCID: PMC9004518 DOI: 10.1080/16549716.2022.2040152] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background Over the last two decades, Indonesia has experienced remarkable economic growth. However, the percentage of infants and young children meeting the minimum dietary diversity (MDD) criteria has stagnated. Despite the growing body of evidence of the association between MDD and socioeconomic factors, there is little information about socioeconomic inequalities in MDD in Indonesia. Objectives The current study seeks to quantify the wealth- and education-related inequalities in MDD among infants and young children in Indonesia and determine the contribution of different factors to these disparities. Methods We included a total of 5038 children aged 6–23 months of the 2017 Indonesia Demographic and Health Survey. We measured wealth- and education-related inequalities using the concentration curve and Wagstaff normalised concentration index. Using a concentration index decomposition analysis, we then examined factors contributing to wealth- and education-related inequalities in MDD. Results The concentration indices by household wealth and maternal education were 0.220 (p < 0.001) and 0.192 (p < 0.001), respectively, indicating more concentration of inequalities among the advantaged population. The decomposition analysis revealed that household wealth (29.8%), antenatal care (ANC) visits (16.6%), paternal occupation (15.1%), and maternal education (11.8%) explained the pro-rich inequalities in MDD in Indonesia. Maternal education (26.1%), household wealth (19.1%), ANC visits (14.9%), and paternal occupation (10.9%) made the most considerable contribution to education-related inequalities in MDD. Conclusions There is substantial wealth- and education-related inequalities in MDD. Our findings suggest an urgent need to address the underlying causes of not reaching dietary diversity by promoting infant and young child feeding equity in Indonesia.
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Affiliation(s)
- Bunga A Paramashanti
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta, Indonesia
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Yunitasari E, Al Faisal AH, Efendi F, Kusumaningrum T, Yunita FC, Chong MC. Factors associated with complementary feeding practices among children aged 6-23 months in Indonesia. BMC Pediatr 2022; 22:727. [PMID: 36539759 PMCID: PMC9769005 DOI: 10.1186/s12887-022-03728-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 10/31/2022] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Esti Yunitasari
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ahmad Hisyam Al Faisal
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ferry Efendi
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Tiyas Kusumaningrum
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Fildzah Cindra Yunita
- grid.440745.60000 0001 0152 762XFaculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Mei Chan Chong
- grid.10347.310000 0001 2308 5949Department of Nursing, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Dessie G, Tsegaye GW, Mekonnen BA, Bayih MT, Nigussie ZM. Change in stunting and its associated factors among children aged less than 5 years in Ethiopia using Ethiopia Demographic and Health Survey data from 2005 to 2019: a multivariate decomposition analysis. BMJ Open 2022; 12:e061707. [PMID: 36368742 PMCID: PMC9660614 DOI: 10.1136/bmjopen-2022-061707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study is to assess change in stunting and its associated factors among children aged less than 5 years in Ethiopia using Ethiopia Demographic and Health Survey data from 2005 to 2019. DESIGN A community-based cross-sectional study was conducted. SETTING The study was conducted in Ethiopia. PARTICIPANTS In 2005, 4586 individuals were examined, followed by 10 282 in 2011, 9462 in 2016 and 4937 in 2019. PRIMARY AND SECONDARY OUTCOMES The primary outcome of the study was stunting, and the secondary outcome was factors associated with stunting and its change. A multilevel logistic regression model was fitted to identify individual and community-level factors associated with stunting among children aged less than 5 years. Multivariate decomposition analysis was also carried out to assess the role of compositional characteristics and behavioural change for decline in stunting among children aged less than 5 years in Ethiopia. RESULTS Over the study period, the prevalence rate of stunting in children aged less than 5 years decreased from 47% to 37% in 2019. Differences in behavioural change among children under the age of 5 years account for 76.69% of the overall decline in stunting prevalence rate in the years 2005-2011, 86.53% in the years 2005-2016, 98.9% in the years 2005-2019, 70.34% in the years 2011-2016 and 73.77% in the years 2011-2019. Behavioural adjustments among breastfed children, diet diversity, place of delivery, ANC follow-up and region have all had a major effect on stunting prevalence rate. The wealth index, parenteral education, child's age in months, length of breast feeding and area were among the compositional change factors. CONCLUSION A large percentage of children aged less than 5 years remains stunted in Ethiopia. Stunting was associated with alterations in the compositional and behavioural characteristics of children. Stimulating existing nutritional measures and improving the wealth index will make a significant difference in reducing stunting among Ethiopian children aged less than 5 years.
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Affiliation(s)
- Getenet Dessie
- Department of Epidemiology and Biostatistics, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
- Centre for Epidemiology and Population Health, Australian National University, Canberra, Capital of Australia, Australia
| | - Gebiyaw Wudie Tsegaye
- Epidemiology and Biostatistics, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
| | | | - Mulat Tirfie Bayih
- Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir Dar, Ethiopia
- Human Nutrition, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
| | - Zelalem Mehari Nigussie
- Epidemiology and Biostatistics, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
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Jalata DD, Asefa BG. Trends and Determinants of Dietary Diversity in Children Aged 6-59 Months in Ethiopia: Analysis of 2005-2016 Demographic and Health Survey. Curr Dev Nutr 2022; 6:nzac135. [PMID: 36475020 PMCID: PMC9718648 DOI: 10.1093/cdn/nzac135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/23/2022] [Accepted: 08/25/2022] [Indexed: 04/22/2024] Open
Abstract
Background Dietary diversity may be associated with health and optimum growth in children. Objectives In this study we analyzed the trends and determinants of minimum dietary diversity (MDD) among Ethiopian children aged 6 to 59 mo. Methods Ethiopian Demographic Health Survey (EDHS) data of 3 consecutive years (2005, 2011, and 2016) were analyzed. A total of n = 2396 (2005), n = 3385 (2011), and n = 3723 (2016) children aged 6 to 59 mo were included for measurement of trends and identification of the determinants of MDD. The associations between the study factors and MDD were investigated using multiple logistic regression analysis. Results The proportion of children who fulfilled the MDD decreased from 2.46% in 2005 to 1.57% in 2011 but sharply increased to 7.82% in 2016. Adjusted regression analysis revealed that exposure of mothers to media, particularly watching television, maternal education, and household wealth were associated with a greater likelihood of mothers providing diversified diets to their children across the 3 y of EDHS data. Conclusions A decrease in MDD was observed from the years 2005 to 2011, after which a sharp increase was noted in 2016. In all 3 y of the EDHS, media exposure, maternal education, and household wealth were the consistent factors positively affecting dietary diversity among children aged 6 to 59 mo. Future intervention programs to increase dietary diversity in children should emphasize improving access to media exposure, education, and antenatal care visits.
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Affiliation(s)
- Dassalegn Daraje Jalata
- Food Science and Nutrition Research Department, Ethiopian Institute of Agricultural Research, Addis Ababa, Ethiopia
| | - Bezuayehu Gutema Asefa
- Food Science and Nutrition Research Department, National Fishery and Aquatic Life Research Center, Ethiopian Institute of Agricultural Research, Sebeta, Ethiopia
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Irenso AA, Zheng M, Campbell KJ, Chamberlain D, Laws R. The influence of household structure and composition on the introduction of solid, semisolid and soft foods among children aged 6-8 months: An analysis based on Ethiopia Demographic and Health Surveys. MATERNAL & CHILD NUTRITION 2022; 19:e13429. [PMID: 36148628 PMCID: PMC9749599 DOI: 10.1111/mcn.13429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 12/15/2022]
Abstract
The early and late introduction of complementary food, both prevalent in Ethiopia, are associated with morbidities, growth faltering and developmental risks in children. The interhousehold network around the primary caregiver's intrahousehold network is critical in influencing the age of introducing complementary foods. This study examined the influence of household composition and structures on complementary food introduction. This is a secondary data analysis of four Ethiopian Demographic and Health Surveys conducted between 2000 and 2016. The household structure and composition variables were calculated from household members' kinship status and attribute, respectively. The introduction of solid, semisolid or soft foods was dichotomised as whether the children within 6 to 8 months have been given complementary foods. Multivariable logistic regression with adjustment for the primary caregiver and household characteristics was run to examine the associations between household structure and composition variables and the introduction of complementary foods. The marginal effects (ME) were calculated to facilitate the practical interpretation of the study findings. Large households (>3 nonredundant contacts) with extended family or unrelated people (high effective size, ME = 6.01%, 95% confidence interval [CI]: -8.53, -3.49) lowered the proportion of children starting food within the recommended 6-8 months. Households with close kins (high constraint) (ME = 7.22%, 95% CI: -13.65, 28.09) and greater age diversity (ME = 0.65%, 95% CI: 0.15, 1.15) increased the proportion of children receiving complementary food at an appropriate age. This study revealed that interhousehold structure and composition influence the age of introduction of complementary foods. These factors, therefore, need to be considered in designing interventions to improve age at the introduction of complementary foods.
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Affiliation(s)
- Asnake Ararsa Irenso
- School of Public HealthAmbo UniversityAmboEthiopia,School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Miaobing Zheng
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Karen J. Campbell
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
| | - Dan Chamberlain
- Centre for Social Impact UNSWUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rachel Laws
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN)Deakin UniversityBurwoodVictoriaAustralia
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Pneumonia Prevalence and Associated Risk Factors among under-Five Children in Goncha Siso Enesie District, Northwest Ethiopia. ADVANCES IN PUBLIC HEALTH 2022. [DOI: 10.1155/2022/6497895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Pneumonia is one of the leading causes of morbidity and mortality among under-five children in various localities of Ethiopia. This study was aimed to assess the prevalence of pneumonia and its associated factors among under-five children who were visiting Ginde Woyin health center, Goncha Siso Enesie District, Northwest Ethiopia. Methods. A health center-based cross-sectional study was conducted among 403 participants by a systematic random sampling technique. Data were collected using questionnaires and sputum diagnosis. Data were analyzed using Statistical Package for Social Science (SPSS) version 26.0. Binary and multivariable logistic regressions were used to analyze the risk variables, and
values < 0.05 were considered statistically significant. Results. The overall prevalence of pneumonia among under-five children was 24.3% (95% CI: 20.1, 28.3). The significant predictors for under-five pneumonia identified were the use of wood as a source of fuel for cooking (AOR = 2.769;
), starting complementary food before six months of age (AOR = 2.080; P = 0.033), and mixed breastfeeding conditions (AOR = 5.229;
). The highest under-five pneumonia was observed among children of age below one year (33.6%), rural dwellers (30.4%), family sizes above five (31.8%), children from families with a monthly income of less than 1000 Ethiopian Birr (<19.03 USD) (27.8%), whose mothers were students (61.5%), houses where cooking took place in the living room (37.8%), homes that lacked windows in the kitchens (28.4%), homes that lacked windows (41.5%), and mixed breastfeeders (44.1%). Conclusion. The prevalence of under-five pneumonia in the present study was relatively high. The findings in the present study will help policy makers and program officers to design pneumonia-preventive interventions.
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Worku MG, Alamneh TS, Tesema GA, Alem AZ, Tessema ZT, Liyew AM, Yeshaw Y, Teshale AB. Minimum acceptable diet feeding practice and associated factors among children aged 6-23 months in east Africa: a multilevel binary logistic regression analysis of 2008-2018 demographic health survey data. Arch Public Health 2022; 80:127. [PMID: 35484576 PMCID: PMC9047376 DOI: 10.1186/s13690-022-00882-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite the proportion of receiving a minimum acceptable diet (minimum meal frequency and minimum dietary diversity) is lower in east Africa, there is limited evidence on minimum acceptable diet. Therefore, this study aimed to investigate the minimum acceptable diet and associated factors among children aged 6-23 months in east Africa. METHODS A secondary data analysis of the most recent Demographic and Health Survey (DHS) data of 12 east African countries was done. A total weighted sample of 34, 097 children aged 6-23 months were included. A multilevel binary logistic regression model was applied. The Intra-class Correlation Coefficient (ICC) and Median Odds Ratio (MOR) were calculated to assess the clustering effect. Besides, deviance was used for model comparison as the models are nested models. Both crude and adjusted Odds Ratio (OR) with a 95% Confidence Interval (CI) were reported as potential predictors of minimum acceptable diet feeding practice. RESULTS The prevalence of minimum acceptable diet feeding practice among children in east Africa was 11.56%; [95%CI; 11.22%, 11.90%]. In the multilevel analysis; child age of 12-17 month (AOR = 1.33: 95%CI; 1.20, 1.48), maternal primary (AOR = 1.21: 95%CI; 1.08, 1.35), secondary (AOR = 1.63: 95%CI; 1.44, 1.86) higher (AOR = 2.97: 95%CI; 2.30, 3.38) education level, media exposure (AOR = 1.38, 95%CI; 1.26, 1.51), household wealth statues (AOR = 1.28, 95%CI; 1.15, 1.42 for middle and AOR = 1.50: 95%CI; 1.42, 1.71 foe rich), employed mother (AOR = 1.27: 95%CI; 1.17, 1.37), maternal age 25-34 (AOR = 1.20: 95%CI; 1.09, 1.32) and 35-49 (AOR = 1.22: 95%; 1.06, 1.40) years, delivery in health facility (AOR = 1.43: 95%CI; 1.29, 1.59) and high community education level (AOR = 1.05: 95%CI; 1.01, 1.17) were positively associated with minimum acceptable diet child feeding practice. Meanwhile, the use of wood (AOR = 0.72: 95%CI; 0.61, 0.86) and animal dug (AOR = 0.34: 95%CI; 0.12, 0.95) as a source of cooking fuel and being from female-headed households (AOR = 0.88: 95%CI; 0.81, 0.96) were negatively associated with minimum acceptable diet feeding practice. CONCLUSION Child age, mother's educational level, source of cooking fuel, exposure to media, sex of household head, household wealth status, mother working status, age of the mother, place of delivery and community-level education were the significant determinants of minimum acceptable diet feeding practices. Therefore, designing public health interventions targeting higher-risk children such as those from the poorest household and strengthening mothers' education on acceptable child feed practices are recommended.
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Affiliation(s)
- Misganaw Gebrie Worku
- Department of Human Anatomy, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia.
| | - Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,Department of Human Physiology, College of Medicine and Health Science, School of Medicine, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Irenso AA, Chamberlain D, Zheng M, Campbell KJ, Laws R. The Role of Household Structure and Composition in Influencing Complementary Feeding Practices in Ethiopia. Nutrients 2021; 14:nu14010130. [PMID: 35011004 PMCID: PMC8747051 DOI: 10.3390/nu14010130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 02/03/2023] Open
Abstract
While the household in which a child grows up is considered a critical environment that influences nutrition outcomes, there is little research examining the influence of household composition and structure on complementary feeding practices. This study examined the influence of household structure and composition on complementary feeding practices, using the Ethiopian Demographic and Health Survey (EDHS), 2000 to 2016. The composition variables were calculated from the attributes of household members (alters) and the structure variables from their kinship status. A multilevel mixed-effects regression model, specifying survey rounds as the random effect, was used to examine the association between household structure/composition and the Minimum Meal Frequency (MMF) and Minimum Dietary Diversity (MDD). The average Marginal Effects (MEs) were calculated to facilitate practical interpretation. Children of caregivers with a higher number of alters (degree), unique number of kinship category (effect size), closely related (constraint), and mixed-age alters (age diversity) seemed to increase the probability of meeting the MDD. Degree and effective size decreased the probability of meeting MMF, while constraint increased it. Overall, this study revealed some associations between household structure and composition and complementary feeding practices. Hence, complementary feeding interventions could be adapted to account for the household structure and composition variations.
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Affiliation(s)
- Asnake Ararsa Irenso
- School of Public Health, Haramaya University, Harar P.O. Box 235, Ethiopia
- Institute for Physical Activity and Nutrition (IPAN), School of Nutrition and Exercise Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; (M.Z.); (K.J.C.); (R.L.)
- Correspondence: ; Tel.: +61-416-121-881
| | - Dan Chamberlain
- Centre for Social Impact, University of New South Wales, Kennington, NSW 2052, Australia;
| | - Miaobing Zheng
- Institute for Physical Activity and Nutrition (IPAN), School of Nutrition and Exercise Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; (M.Z.); (K.J.C.); (R.L.)
| | - Karen J. Campbell
- Institute for Physical Activity and Nutrition (IPAN), School of Nutrition and Exercise Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; (M.Z.); (K.J.C.); (R.L.)
| | - Rachel Laws
- Institute for Physical Activity and Nutrition (IPAN), School of Nutrition and Exercise Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia; (M.Z.); (K.J.C.); (R.L.)
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Zebadia E, Mahmudiono T, Atmaka DR, Dewi M, Helmyati S, Yuniar CT. Factors Associated with Minimum Acceptable Diet in 6–11-Month-Old Indonesian Children Using the 2017 IDHS. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Inadequate complementary feeding practices are known to contribute to children’s nutritional status. A minimum acceptable diet (MAD) is one of the simple, valid, and reliable indicators to assess complementary feeding practices in 6–23-month-old children on food diversity and meal frequency. Based on the UNICEF data, the MAD of 6–11 months in Indonesia was 26.3% in 2017 and the lowest compared to other groups. Hence, this study research question is posing toward several factors associated with the low MAD among 6–11 months infant.
AIM: This study aimed to determine factors associated with MAD in 6–11-month-old children in Indonesia.
METHODS: This study was a secondary analysis using the 2017 Indonesia Demographic and Health Survey. This is a cross-sectional study involving 17,848 children in Indonesia. Final sample to be analyzed were 1,441 children of 6–11-month-old. Logistic regression model was applied to identify the significant risk factors associated with MAD.
RESULTS: The result showed that the prevalence of MAD in this study is 29%. From the multivariate logistic regression, wealth index, television ownership, and mother’s occupation were significantly associated with MAD of 6–11-month-old children in Indonesia.
CONCLUSION: In conclusion, factors associated with MAD among 6–11-month-old children were wealth index, television ownership, and mother’s occupation.
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Shagaro SS, Mulugeta BT, Kale TD. Complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia: Secondary data analysis of Ethiopian mini demographic and health survey 2019. Arch Public Health 2021; 79:205. [PMID: 34809724 PMCID: PMC8607675 DOI: 10.1186/s13690-021-00725-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/30/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Optimal nutrition in early child's life plays a vital role in improving mental and motor development, reduces the possibility of contracting various infectious diseases and related deaths, decreases the risk of obesity, and fosters better overall development. However, 45% of deaths in children under five years of age that occur globally is attributed to nutrition-related factors and the majority of these deaths occur in low-and middle-income countries. Therefore, this study aims to assess complementary feeding practices and associated factors among mothers of children aged 6-23 months in Ethiopia. METHOD The study used the Ethiopian mini demographic and health survey 2019 data. A two-stage stratified cluster sampling technique was used to select 1465 mothers of children aged 6-23 months in Ethiopia. Two-level multilevel mixed-effects logistic regression model analysis was computed, and variables with p-value of less than 5% and an adjusted odds ratio with a 95% confidence interval in the final model were reported as statistically significant factors with appropriate complementary feeding practice. RESULT The overall prevalence of appropriate complementary feeding practice among mothers of children aged 6-23 months was 9.76%. In our study, mothers who attended primary[AOR = 2.72; 95%CI: 1.47-5.01], secondary[AOR = 2.64; 95%CI: 1.18-5.92] and higher school[AOR = 5.39; 95%CI: 2.29-12.64], being from medium income household[AOR = 2.89; 95%CI: 1.41-5.92], attended 1-3 times ANC visits in index pregnancy[AOR = 0.41; 95%CI: 0.18-0.89], mothers who have 12-17 months[AOR = 1.96; 95%CI: 1.16-3.33] and 18-23 months old children[AOR = 2.61; 95%CI: 1.49-4.54], currently breastfeeding mothers[AOR = 3.69; 95%CI: 1.73-7.91], mothers from pastoralist contextual regions[AOR = 0.29; 95%CI: 0.09-0.91], and mothers who have resided in rural areas[AOR = 0.49; 95%CI: 0.25-0.97] were factors significantly associated with appropriate complementary feeding practice. CONCLUSION This study showed low prevalence of appropriate complementary feeding practice. Therefore, the concerned health authorities need to strengthen the existing approaches designed for provision of nutrition education particularly targeting mothers who are unschooled, who have 6-11 months old children, live in pastoralist regions and reside in rural parts of the country, and create strategies that improve maternal job opportunities.
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Affiliation(s)
- Sewunet Sako Shagaro
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Be'emnet Tekabe Mulugeta
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Temesgen Dileba Kale
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Paramashanti BA, Huda TM, Alam A, Dibley MJ. Trends and determinants of minimum dietary diversity among children aged 6-23 months: a pooled analysis of Indonesia Demographic and Health Surveys from 2007 to 2017. Public Health Nutr 2021; 25:1-12. [PMID: 34743776 PMCID: PMC9991623 DOI: 10.1017/s1368980021004559] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 09/22/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine minimum dietary diversity (MDD) trends and determinants among children aged 6-23 months. DESIGN Secondary analysis of the Indonesia Demographic and Health Surveys (IDHS) between 2007 and 2017. The primary outcome was MDD, the consumption of at least five out of eight food groups (MDD-8). We included a total of 5015 (IDHS 2007), 5050 (IDHS 2007) and 4925 (IDHS 2017) children aged 6 to 23 months to estimate trends of MDD-8 and to identify factors associated with MDD-8. We used multiple logistic regression analysis adjusted for the complex sampling design to investigate the association between the study factors and MDD-8. SETTING Indonesia. PARTICIPANT A total of 14 990 children aged 6-23 months. RESULTS Over the 10 years, the percentage of children who consumed a diversified diet was 53·1 % in 2007, 51·7 % in 2012 and 53·7 % in 2017. Multivariate analyses showed that older age children, higher maternal education, maternal weekly access to media, paternal non-agricultural occupation, history of at least four antenatal care visits and wealthier households were associated with the increased odds of MDD-8. Children living in rural areas, Sulawesi and Eastern Indonesia, were less likely to eat a diversified diet. CONCLUSIONS The proportion of children meeting MDD-8 has stagnated in the last decade. Child, parental, health care, household and community factors are associated with MDD-8. Therefore, nutrition education programmes and behaviour change communication activities should target mothers and families from socio-economically and geographically disadvantaged populations.
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Affiliation(s)
- Bunga A Paramashanti
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
- Department of Nutrition, Faculty of Health Sciences, Universitas Alma Ata, Yogyakarta55183, Indonesia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
| | - Ashraful Alam
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
| | - Michael J Dibley
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW2006, Australia
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Seboka BT, Hailegebreal S, Yehualashet DE, Gilano G, Kabthymer RH, Ewune HA, Demeke AD, Amede ES, Tesfa GA. Exploring Spatial Variations and Determinants of Dietary Diversity Among Children in Ethiopia: Spatial and Multilevel Analysis Using EDHS (2011-2016). J Multidiscip Healthc 2021; 14:2633-2650. [PMID: 34584420 PMCID: PMC8464345 DOI: 10.2147/jmdh.s327456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Dietary diversity has a significant impact on children’s nutritional health. For developing and implementing interventions, it is critical to understand the regional distribution of dietary diversity and underlying factors. However, the application of spatial techniques in dietary studies has not been well documented. The study’s goal was to look into the regional variances and factors that influence children’s dietary diversity. Further, we have discussed the spatial correlation of dietary diversity with nutritional status. Methods Data from the National Demographic and Health Survey were used during analyses. This work evaluated the overall dietary diversity of children aged 6–23 months based on the 2017 WHO and UNICEF classification of minimum dietary diversity (MDD). The Local Anselin Moran’s I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariate multilevel logistic regression was used for factor analyses. Results Overall, only 13.3% (95% CI: 10.2–14.7%) of children in 2011 and 24% (95% CI: 15.5–26.5%) in 2016 achieved MDD. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) in the districts of northern Ethiopia, notably in the Amhara, Tigray, and Afar regions, and clusters of low inadequate dietary diversity (cold spots) in the country’s central and western regions. In both studies, the frequency of dietary diversity was significantly higher among older children, those who had media exposure, and mothers and fathers who had received formal education. Conclusion According to our findings, the MDD of children in Ethiopia, as measured by WHO dietary assessment, slightly increased from 2011 to 2016. The dietary diversity of children was distributed non-randomly in different districts across regions of Ethiopia. Localized intervention and preventative methods to improve dietary patterns and culture can be developed using existing socio-demographic factors and districts with a larger distribution of inadequate dietary diversity.
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Affiliation(s)
| | - Samuel Hailegebreal
- Department of Health Informatics, Arba Minch University, Arba Minch, Ethiopia
| | | | - Girma Gilano
- Department of Health Informatics, Arba Minch University, Arba Minch, Ethiopia
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Ahmed KY, Agho KE, Page A, Arora A, Ogbo FA. Interventions to improve infant and young child feeding practices in Ethiopia: a systematic review. BMJ Open 2021; 11:e048700. [PMID: 34400457 PMCID: PMC8370540 DOI: 10.1136/bmjopen-2021-048700] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE In Ethiopia, despite the implementation of several interventions to improve infant and young child feeding (IYCF) practices, no published studies have highlighted the most effective IYCF interventions in the country. This systematic review investigated the impacts of various interventions on IYCF in Ethiopia. SOURCE OF INFORMATION A systematic search was conducted on seven computerised bibliographic databases (Embase, ProQuest Central, Scopus, PsycINFO, Web of Science, MEDLINE/PubMed and CINAHL) to locate experimental or quasi-experimental studies published between the year 2000 and May 2021. STUDY ELIGIBILITY CRITERIA Interventional studies that measured IYCF indicators (early initiation of breast feeding (EIBF), exclusive breast feeding (EBF), the introduction of complementary foods, minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet) as outcome variables were included. STUDY APPRAISAL AND SYNTHESIS All included studies were examined for biases related to interventional studies (ie, selection bias, performance bias, attrition bias, detection bias and reporting bias). Author reports of effect size measures were used to narratively report the findings of each study. RESULTS Of the 23 eligible studies, 14 studies were quasi-experimental and 9 studies were cluster randomised trials (CRTs). Eight quasi-experimental studies had a serious risk of bias, while two CRTs had a high risk of bias. Four studies for EBF and six studies for EIBF showed significant impacts of policy advocacy, health service strengthening, interpersonal communication, community mobilisation and mass media campaigns. Six studies for MDD and three studies for MMF indicated significant effects of community-level and health facility complementary feeding promotions on infants and young children. Interventions that delivered in combination increased the impacts in improving EIBF, MDD and MMF compared with a single intervention. CONCLUSION Our review showed that 12 out of 21 eligible studies that implemented in the form of community-level and health facility interventions improved EIBF, EBF, and/or MDD in Ethiopia. PROTOCOL REGISTRATION NUMBER PROSPERO, CRD42020155519.
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Affiliation(s)
- Kedir Y Ahmed
- Department of Public Health, Samara University, Samara, Afar, Ethiopia
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Kingsley Emwinyore Agho
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- School of Health Sciences, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- African Vision Research Institute (AVRI), University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- School of Health Sciences, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- Oral Health Services, Sydney Dental Hospital, Surry Hills, New South Wales, Australia
- Health Equity Laboratory, Campbelltown, New South Wales, Australia
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Westmead, New South Wales, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University-Campbelltown Campus, Campbelltown, New South Wales, Australia
- Barmera Medical Clinic (Lake Bonney Private Medical Clinic), Barmera, South Australia, Australia
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21
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Abegunde D, Hutchinson P, Anaba U, Oyedokun-Adebagbo F, Johansson EW, Feyisetan B, Mtiro E. Socioeconomic inequality in exclusive breastfeeding behavior and ideation factors for social behavioral change in three north-western Nigerian states: a cross-sectional study. Int J Equity Health 2021; 20:172. [PMID: 34315476 PMCID: PMC8314581 DOI: 10.1186/s12939-021-01504-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022] Open
Abstract
Background Socioeconomic inequalities could mitigate the impact of social and behavior change (SBC) interventions aimed at improving positive ideation towards the practice of exclusive breastfeeding. This study explores the empirical evidence of inequalities in the practice of exclusive breastfeeding (EBF) and associated ideational dimensions and domains of the theory of Strategic Communication and Behavior Change in three north-western Nigeria states. Methods We used cross-sectional data from 3007 randomly selected women with under-two-year-old children; the convenient regression method was applied to estimate the concentration indexes (CIxs) of exclusive breastfeeding behavior, ranked by household wealth index. Inequality was decomposed to associated ideational factors and sociodemographic determinants. Avoidable inequalities and the proportion of linear redistribution to achieve zero inequality were estimated. Results Women from wealthier households were more likely to practice exclusive breastfeeding CIx = 0.1236, p-value = 0.00). Attendance of at least four antenatal clinic visits (ANC 4+) was the most significant contributor to the inequality, contributing CIx = 0.0307 (p-value = 0.00) to the estimated inequality in exclusive breastfeeding practice. The elasticity of exclusive breastfeeding behavior with respect to partners influencing decision to breastfeed and ANC4+, were 0.1484 (p-value = 0.00) and 0.0825 (p-value = 0.00) respectively. Inequality in the regular attendance at community meetings (CIx = 0.1887, p-value =0.00); ANC 4+) (CIx = 0.3722, p-value = 0.00); and maternal age (CIx = 0.0161, p-value = 0.00) were pro-rich. A 10.7% redistribution of exclusive breastfeeding behavior from the wealthier half to the poorer half of the population could eliminate the inequality (line of zero inequality). Inequalities were mainly in the cognitive and social norms dimension and were all pro-poor. Conclusion Socioeconomic inequalities exist in exclusive breastfeeding behaviors and in associated ideation factors in the three states but are mostly avoidable. A 10.7% redistribution from wealthier to the poorer half of the population will achieve elimination. Messaging for SBC communication interventions to improve breastfeeding practices could be more effective by targeting the mitigation of these inequalities.
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Affiliation(s)
- Dele Abegunde
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent Jabi, Abuja, Nigeria. .,Population Council, Washington, DC, USA.
| | - Paul Hutchinson
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Udochisom Anaba
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent Jabi, Abuja, Nigeria.,Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | | | - Emily White Johansson
- Breakthrough RESEARCH/Nigeria, Plot 839 Idris Ibrahim Crescent Jabi, Abuja, Nigeria.,Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Bamikale Feyisetan
- United States Agency for International Development (USAID), Abuja, Nigeria
| | - Emma Mtiro
- United States Agency for International Development (USAID), Abuja, Nigeria
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Mapping Geographical Differences and Examining the Determinants of Childhood Stunting in Ethiopia: A Bayesian Geostatistical Analysis. Nutrients 2021; 13:nu13062104. [PMID: 34205375 PMCID: PMC8234472 DOI: 10.3390/nu13062104] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/06/2021] [Accepted: 06/16/2021] [Indexed: 01/08/2023] Open
Abstract
Understanding the specific geographical distribution of stunting is essential for planning and implementing targeted public health interventions in high-burdened countries. This study investigated geographical variations in the prevalence of stunting sub-nationally, and the determinants of stunting among children under 5 years of age in Ethiopia. We used the 2016 Ethiopia Demographic and Health Survey (EDHS) dataset for children aged 0–59 months with valid anthropometric measurements and geographic coordinates (n = 9089). We modelled the prevalence of stunting and its determinants using Bayesian geospatially explicit regression models. The prevalence of stunting among children under five years was 36.3% (95% credible interval (CrI); 22.6%, 51.4%) in Ethiopia, with wide variations sub-nationally and by age group. The prevalence of childhood stunting ranged from 56.6% (37.4–74.6%) in the Mekelle Special zone of the Tigray region to 25.5% (10.5–48.9%) in the Sheka zone of the Southern Nations, Nationalities and Peoples region. Factors associated with a reduced likelihood of stunting in Ethiopia included non-receipt of breastmilk, mother’s BMI (overweight/obese), employment status (employed), and higher household wealth, while the enablers were residence in the “arid” geographic areas, small birth size of the child, and mother’s BMI (underweight). The prevalence and determinants of stunting varied across Ethiopia. Efforts to reduce the burden of childhood stunting should consider geographical heterogeneity and modifiable risk factors.
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Minimum acceptable diet among children aged 6-23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study. BMC Pediatr 2021; 21:239. [PMID: 34011304 PMCID: PMC8132412 DOI: 10.1186/s12887-021-02713-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02713-0.
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Liaquathali F, Maruthupandian J, Govindasamy R. An assessment of age-appropriate infant and young child feeding practices among children in Kancheepuram district, Tamil Nadu, India. J Family Med Prim Care 2020; 9:4692-4698. [PMID: 33209785 PMCID: PMC7652157 DOI: 10.4103/jfmpc.jfmpc_668_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/10/2020] [Accepted: 07/01/2020] [Indexed: 11/06/2022] Open
Abstract
Background: Appropriate Infant and Young Child Feeding (IYCF) practices are a cornerstone to reduce child morbidity and mortality. Assessment of IYCF practices among the mother of young children is the need of the hour to find the breaches in their performance and to find out the influencing factors for these gaps. The study was undertaken with the objectives to assess the IYCF practices and the factors influencing among the children of age 7–24 months. Methodology: A cross-sectional study was undertaken in the rural area of Kancheepuram district, Tamilnadu from June 2019 to December 2019. One hundred forty-three children of age less than 2 years were selected by two-stage random sampling method. Data was collected house-to-house using the pretested questionnaire and WHO Infant and Young Child feeding questionnaire. Proportions were calculated and Chi-square test was applied. Results: The mean age of the children was 14 ± 5 months. Among the study participants, only 10.2% were exclusively breastfed for 6 months. 58.6% of children were introduced on soft/solid/semisolid food at the end of 6–8 months. The minimum acceptable diet of breastfeeding children was 31.5% and nonbreastfeeding children was 14%. Age of mother, educational qualification of mother, working status of mother, and mode of delivery were statistically associated with appropriate Infant and Young Children feeding practices. Conclusion: The results revealed that there is only improvement in early infant practices and there are indigent practices of complementary feeding among the mothers.
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Affiliation(s)
- Fasna Liaquathali
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV)- Deemed to be University, Nellikuppam, Chengalpattu, India
| | - Jasmine Maruthupandian
- Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Sri Balaji Vidyapeeth (SBV)- Deemed to be University, Nellikuppam, Chengalpattu, India
| | - Ravivarman Govindasamy
- Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education (CARE), Kelembakkam, Kancheepuram, Tamil Nadu, India
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Trends and factors associated with the utilisation of antenatal care services during the Millennium Development Goals era in Tanzania. Trop Med Health 2020; 48:38. [PMID: 32518496 PMCID: PMC7268642 DOI: 10.1186/s41182-020-00226-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/20/2020] [Indexed: 01/10/2023] Open
Abstract
Background A detailed understanding of trends, as well as what act as enablers and/or barriers to the utilisation of antenatal care (ANC) among Tanzanian women, is essential to policymakers and health practitioners to guide maternal health efforts. We investigated the trends and factors associated with ANC service use during the Millennium Development Goals (MDG) era in Tanzania between 1999 and 2016. Methods The study used the Tanzania Demographic and Health Survey (TDHS) data for the years 1999 (n = 2095), 2004–2005 (n = 5576), 2010 (n = 6903) and 2015–2016 (n = 5392). Multivariate multinomial logistic regression models were used to investigate the association between predisposing, enabling, need and community-level factors and frequency of ANC (1–3 and ≥ 4) visits in Tanzania. Results The proportion of women who made one to three ANC visits improved significantly from 26.4% in 1999 to 47.0% in 2016. The percentage of women who make four or more ANC visits declined from 71.1% in 1999 to 51.0% in 2016. Higher maternal education, belonging to wealthier households, being informally employed and listening to the radio were associated with four or more ANC visits. Women who did not desire pregnancy had a lower likelihood to attend four or more ANC visits. Women who had primary or higher education, those who resided in wealthier households and those who were informally employed were more likely to make between one and three ANC visits. Conclusion The study showed that there was an improvement in the proportion of Tanzanian women who made one to three ANC visits, but it also indicated a concurrent decrease in the prevalence of four or more ANC visits. Improving uptake of ANC among Tanzanian women is achievable if national health policies and programmes also focus on key amenable maternal factors of education, household wealth and employment.
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Ahmed KY, Page A, Arora A, Ogbo FA. Associations between infant and young child feeding practices and acute respiratory infection and diarrhoea in Ethiopia: A propensity score matching approach. PLoS One 2020; 15:e0230978. [PMID: 32236145 PMCID: PMC7112197 DOI: 10.1371/journal.pone.0230978] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/12/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) and diarrhoea are the leading causes of childhood morbidity and mortality in Ethiopia. Understanding the associations between infant and young child feeding (IYCF) and ARI and diarrhoea can inform IYCF policy interventions and advocacy in Ethiopia. This study aimed to investigate the relationship between IYCF practices and ARI and diarrhoea in Ethiopian children. METHODS This study used the Ethiopia Demographic and Health Survey (EDHS) data for the years 2000 (n = 3680), 2005 (n = 3528), 2011 (n = 4037), and 2016 (n = 3861). The association between IYCF practices and (i) ARI and (ii) diarrhoea were investigated using propensity score matching and multivariable logistic regression models. The IYCF practices include early initiation of breastfeeding, exclusive breastfeeding (EBF), predominant breastfeeding, introduction of complementary foods, continued breastfeeding at two years and bottle feeding. RESULTS Infants and young children who were breastfed within 1-hour of birth and those who were exclusively breastfed had a lower prevalence of ARI. Infants who were exclusively and predominantly breastfed had a lower prevalence of diarrhoea. Early initiation of breastfeeding (Odds ratio [OR]: 0.81; 95% confidence interval [CI]: 0.72, 0.92) and EBF (OR: 0.65; 95% CI: 0.51, 0.83) were associated with lower risk of ARI. Bottle-fed children had higher odds of ARI (OR: 1.36; 95% CI: 1.10, 1.68). Early initiation of breastfeeding and EBF were associated with lower odds of diarrhoea (OR: 0.88; 95% CI: 0.79, 0.94 for Early initiation of breastfeeding and OR: 0.51; 95% CI: 0.39, 0.65 for EBF). Infants who were predominantly breastfed were less likely to experience diarrhoea (OR: 0.69; 95% CI: 0.53, 0.89). CONCLUSION The recommended best practices for preventing ARI and diarrhoeal diseases in infants and young children namely: the early initiation of breastfeeding, EBF and avoidance of bottle feeding should be institutionalized and scale-up in Ethiopia as part of implementation science approach to cover the know-do-gaps.
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Affiliation(s)
- Kedir Y. Ahmed
- College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- School of Science and Health, Western Sydney University, Campbelltown, NSW, Australia
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Sydney, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown, NSW, Australia
- General Practice Unit, Prescot Specialist Medical Centre Makurdi, Makurdi, Benue State, Nigeria
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Ahmed KY, Page A, Arora A, Ogbo FA. Trends and factors associated with complementary feeding practices in Ethiopia from 2005 to 2016. MATERNAL AND CHILD NUTRITION 2019; 16:e12926. [PMID: 31833239 PMCID: PMC7083482 DOI: 10.1111/mcn.12926] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 12/18/2022]
Abstract
Introducing appropriate complementary feeding at 6 months of age is crucial for the optimal growth and development of an infant. In Ethiopia, however, no previous national‐level studies have examined the trends and associated factors of complementary feeding practices. The aim of this study is to investigate the trends and determinants of complementary feeding practices in Ethiopia from 2005 to 2016. The study was conducted using the Ethiopia Demographic and Health Survey (EDHS) data for 2005 (N = 2,520), 2011 (N = 2,850), and 2016 (N = 2,864). Percentage point changes in complementary feeding indicators were estimated to examine the trends over the EDHS years. Multivariate logistic regression was used to examine the association between socioeconomic, demographic, health service, and community‐level factors and (a) the introduction of complementary foods, (b) minimum dietary diversity (MDD), (c) minimum meal frequency (MMF), and (d) minimum acceptable diet (MAD). The proportion of mothers who met MDD increased from 6.3% to 13.5% (p < .001), and MAD increased from 4.1% to 7.1% (p = .003) from 2005 to 2016. Improvements in the introduction of complementary foods (from 50.3% to 59.5%, p = .051) and MMF (from 41.3% to 43.6%, p = .288) were not statistically significant. Maternal education and occupation were associated with the introduction of complementary foods, MDD, MMF, and MAD. Higher partner education and frequent antenatal visits were associated with MDD and MAD. Children whose mothers listened to the radio had higher odds of MDD, MMF, and MAD. Our analysis of the EDHS suggests that the proportion of MDD and MAD were unacceptably low. Interventions aiming to improve complementary feeding practices in Ethiopia should also target mothers with low education, antenatal service usage, and media exposure.
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Affiliation(s)
- Kedir Y Ahmed
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Andrew Page
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia
| | - Amit Arora
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,School of Science and Health, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, New South Wales, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Felix Akpojene Ogbo
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Penrith, New South Wales, Australia.,General Practice Unit, Prescot Specialist Medical Centre, Makurdi, Nigeria
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