Minimum acceptable diet and associated factors among infants and young children aged 6-23 months in Amhara region, Central Ethiopia: community-based cross-sectional study

Micronutrient intake inadequacies in Northwest Ethiopian children aged 6-23 months

The early stages of childhood are a crucial period of life for health, with inadequate nutrition impacting physical growth, cognitive development, and the immune system. A considerable proportion of children are affected by micronutrient intake inadequacy and deficiency across the globe. Evidence on micronutrient intake among children aged 6-23 months is limited in Northwest Ethiopia, where there is a divergence between production and dietary consumption practices compared to other regions of the country. This study aimed to determine micronutrient inadequacy and associated factors among children aged 6-23 months. From February 1 to February 18, 2023, 435 children aged 6-23 months participated in a community-based cross-sectional study in the North Mecha District of the Amhara Region, Northwest Ethiopia. The study participants were selected using a multistage sampling technique. A multiphasic interactive 24-h dietary recall was used to collect dietary intake data via an interviewer-administered questionnaire. The interviews were conducted with the mothers of the selected children. Nutrient values for the selected 12 micronutrients were calculated using the NutriSurvey 2007 software and food composition tables from Ethiopia, Tanzania, and Kenya. SPSS version 25 was used for the remaining parts of the analysis. The Nutrient Adequacy Ratio and Mean Adequacy Ratio were calculated to evaluate the nutrient intakes. To identify the factors associated with overall micronutrient intake inadequacy, a binary logistic regression analysis was performed, with statistical significance determined at a p-value < 0.05. The overall prevalence of micronutrient intake inadequacy was 64.7% (95% CI 59.9, 69.2). The odds of inadequacy of micronutrient intake were 2.8 times higher among children aged 6-8 months than children aged 9-23 months (AOR = 2.80, 95% CI 1.71, 4.59). Children with paternal education unable to read and write and primary school incomplete were 3.1 (AOR = 3.12, 95% CI 1.26, 7.70) and 2.4 (AOR = 2.40, 95% CI 1.01, 5.73) times more likely to have micronutrient intake inadequacy, respectively, compared to children with paternal education of primary school completed and above. The likelihood of micronutrient intake inadequacy was 1.8 times higher among children from mothers who had an unfavorable nutrition-related attitude than those from mothers who had a favorable attitude (AOR = 1.76, 95% CI 1.02, 3.05). Inadequate intake of micronutrients was shown to be highly prevalent among children aged 6-23 months. Child age, paternal education, and maternal nutrition-related attitude were significantly associated with micronutrient intake inadequacy. Integrating community-guided nutrition interventions targeting nutrition-related knowledge and attitudes of parents is critical in addressing the inadequate micronutrient intake of children in the study community, where production is not a major problem.

Urban-rural disparities in minimum acceptable diet intake among children aged 6-23 months in Ethiopia: A multivariable Decomposition analysis of Ethiopian demographic and health survey 2019

Introduction

The achievement of the minimum acceptable diet intake (MAD) stands at 14% among urban and 10% among rural under-five children in Ethiopia. Consequently, identifying the determinants of the urban-rural gap is vital for advancing Sustainable Development Goals (SDGs), fostering healthier communities, and developing evidence-driven approaches to enhance health outcomes and address disparities.

Objective

The objective of the study was to decompose the urban-rural disparities in minimum acceptable diet intake in Ethiopia using the Ethiopian Mini-Demographic and Health Survey 2019 data.

Method

The study was conducted using the Ethiopian Demographic and Health Survey 2019 report. A total of 1,496 weighted children aged 6-23 months were included using stratified sampling techniques. The main outcome variable minimum acceptable diet was calculated as a combined proportion of minimum dietary diversity and minimum meal frequency. A decomposition analysis was used to analyze the factors associated with the urban-rural discrepancy of minimum acceptable diet intake, and the results were presented using tables and figures.

Result

The magnitude of minimum acceptable diet among children aged 6-23 months in Ethiopia was 11.0%. There has been a significant disparity in the intake of minimum acceptable diet between urban and rural under-five children with 14 and 10%, respectively. Endowment factors were responsible for 70.2% of the discrepancy, followed by 45.1% with behavioral coefficients. Educational status of college and above was responsible for narrowing the gap between urban and rural residents by 23.9% (β = 0.1313, 95% CI: 0.0332-0.245). The number of children in the household and the age of the child between 18 and 23 months were responsible for widening the gap in minimum acceptable diet intake discrepancy between urban and rural residents by 30.7% and 3.36%, respectively (β = -0.002, 95% CI: -0.003 to -0.0011 and β = -30.7, 95% CI: -0.025 - -0.0085). From the effect coefficients, the effect of institutional delivery was responsible for 1.99% of the widening of the gap between urban and rural residents in minimum acceptable diet intake (β = -0.0862, 95% CI: -0.1711 - -0.0012).

Conclusion

There is a significant variation between urban and rural residents in minimum acceptable diet. The larger portion of the discrepancy was explained by the endowment effect. Educational status of mothers with college and above, parity, age of child, and place of delivery were the significant factors contributing to the discrepancy of minimum acceptable diet intake between urban and rural residents.

Minimum acceptable diet and associated factors among 6-23 months old children enrolled in outpatient therapeutic program in the Tulla district, Sidama region, Ethiopia: a community-based cross-sectional study

BACKGROUND

Improving the minimum acceptable diet (MAD) is essential for ensuring optimal growth and development of children, as well as preventing malnutrition and its consequences. Previous studies in Ethiopia have focused on the magnitude and determinants of a minimum acceptable diet. However, much emphasis was not given to minimum acceptable diet and its associated factors among 6-23 months old children enrolled in Outpatient therapeutic programs (OTP), particularly, in the study area. This study determines the minimum acceptable diet and associated factors among 6-23-month-old children enrolled in OTP.

METHODS

A community-based cross-sectional study was conducted among 346 randomly selected mothers with children aged 6-23 months who were admitted to the OTP. The data were collected using interviewer-administered structured questionnaires. The data were entered, cleaned, coded into Epidata version 4.6, and exported to SPSS version 26 for further analysis. Multivariate logistic regression was used to assess the determinants of MAD.

RESULTS

The overall prevalence of minimum Acceptable diet among children aged 6-23 months enrolled to OTP was 14.5% (95% CI: 12.02-19%). The odds of MAD were 1.9 times higher among children aged 18-23 months compared to children aged 6-11 months (AOR = 1.9, 95% CI ((1.2 3.9). The odds of MAD were 2.9times higher in children whose mothers had a good knowledge on recommended feeding (AOR = 2.9, 95% CI (1.2, 6.35). Mothers who had no formal education were 81% less likely to provide minimum acceptable diets for their children compared to their counterpart.(AOR = 1.94, 95% CI = 1.24, 4.19).

CONCLUSION

The practice of a minimum acceptable diet is inadequate. Nutrition education should be emphasized to improve the mothers' nutrition knowledge regarding infant and young child feeding recommendations, to support mothers in overcoming barriers to feeding their children with adequate diets, and to foster complementary feeding practices for malnourished children.

Minimum acceptable diet and its predictors among children aged 6-23 months in Ethiopia. A multilevel cloglog regression analysis

Despite significant progress made previously and the recognized health benefits of optimal feeding practices, ensuring a minimum acceptable diet in developing countries like Ethiopia remains a formidable challenge. Additionally, there is a scarcity of data in this area. Therefore, our study aims to identify predictors of a minimum acceptable diet using a powerful tool called complementary log-log regression analysis. Thus, it contributes to accelerating the pathway of ending child undernutrition thereby promoting optimal child health. A multilevel analysis was conducted among a weighted sample of 1427 children aged 6-23 months using the 2019 Ethiopian Demographic Health Survey (EDHS). The EDHS sample was stratified and selected in two stages. A minimum acceptable diet is defined as a composite of children fed with both minimum dietary diversity and minimum meal frequency. Data extraction took place between August 1 and 30, 2023. We used STATA software version 17 for data analysis. A complementary log-log regression model was fitted to identify significant predictors of the minimum acceptable diet. A p-value of ≤0.05 was used to declare statistically significant predictors. Only 10.44% (95CI: 8.90-12.15) of the children meet the minimum acceptable diet. Child aged (18-23 month) (AOR = 1.78, 95CI:1.14-2.78)], mother's educational level (secondary and above education) (AOR = 279,95CI: 1.51-5.15), number of children three and above [(AOR = 0.78,95CI: 0.53-0.94], institutional delivery [AOR = 1.77,95CI: 1.11-3.11], having postnatal-check-up [AOR = 2.33,95CI: 1.59-3.41] and high community poverty level (AOR = 0.49,95CI: 0.29-0.85) were found to be predictors of minimum acceptable diet. In Ethiopia, only one in ten children achieve a minimum acceptable diet. Which is lower than the global report findings (16%). Enhancing maternal education programs and promoting family planning strategies to reduce household size are essential. Besides, encouraging institutional deliveries and postnatal check-ups are also recommended. It is necessary to implement targeted interventions for poverty reduction in communities to ensure that families can afford nutritious diets for their children.

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

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.

Geospatial pattern of level of minimum acceptable diet and its determinants among children aged 6-23 months in Ethiopia. Spatial and multiscale geographically weighted regression analysis

Background

Despite prior progress and the proven benefits of optimal feeding practices, improving child dietary intake in developing countries like Ethiopia remains challenging. In Ethiopia, over 89% of children fail to meet the minimum acceptable diet. Understanding the geographical disparity and determinants of minimum acceptable diet can enhance child feeding practices, promoting optimal child growth.

Methods

Spatial and multiscale geographically weighted regression analysis was conducted among 1,427 weighted sample children aged 6-23 months. ArcGIS Pro and SatScan version 9.6 were used to map the visual presentation of geographical distribution failed to achieve the minimum acceptable diet. A multiscale geographically weighted regression analysis was done to identify significant determinants of level of minimum acceptable diet. The statistical significance was declared at P-value <0.05.

Results

Overall, 89.56% (95CI: 87.85-91.10%) of children aged 6-23 months failed to achieve the recommended minimum acceptable diet. Significant spatial clustering was detected in the Somali, Afar regions, and northwestern Ethiopia. Children living in primary clusters were 3.6 times more likely to be unable to achieve the minimum acceptable diet (RR = 3.61, LLR =13.49, p < 0.001). Mother's with no formal education (Mean = 0.043, p-value = 0.000), family size above five (Mean = 0.076, p-value = 0.005), No media access (Mean = 0.059, p-value = 0.030), home delivery (Mean = 0.078, p-value = 0.002), and no postnatal checkup (Mean = 0.131, p-value = 0.000) were found to be spatially significant determinants of Inadequate minimum acceptable diet.

Conclusion

Level of minimum acceptable diet among children in Ethiopia varies geographically. Therefore, to improve child feeding practices in Ethiopia, it is highly recommended to deploy additional resources to high-need areas and implement programs that enhance women's education, maternal healthcare access, family planning, and media engagement.

Minimum acceptable diet and associated factors among 6-23 months children in rural households with irrigated users and non-irrigated users in Ethiopia: a comparative cross-sectional study

INTRODUCTION

Poor quality of complementary foods is a key contributor to undernutrition even with optimal breastfeeding. Minimum Acceptable Diet (MAD) has tremendous health and nutrition benefits but only 12% of Ethiopian children's feeding practices meet its standards. The Ethiopian government has recently increased efforts to expand nutrition-sensitive irrigation to improve child nutrition. However, the impact that irrigation has brought on the minimum acceptable diet practice of children below two years has not yet been studied. The aim of this study was to compare the magnitude of MAD practice and associated factors among children aged 6-23 months in households with irrigated users and non-users of North Mecha district, Ethiopia.

METHODS

A community-based comparative cross-sectional study was employed among 824 mother-child pairs. For infant and young child feeding practices, the data collection tools were adapted from the World Health Organization's standardized questionnaire developed in 2010. X2 test was used to compare the MAD practices of irrigated users' and non-irrigated users. Bivariate and multivariable logistic regression analyses were performed to see the predictor variables. p-value < 0.05 was taken to declare statistical significance.

RESULTS

The present study showed that the MAD practice of under two children in irrigated users is significantly higher than non-users (X2 = 13.91, P <.001). Maternal involvement in decision-making [AOR = 4.37, 95% CI: (2.05,9.33)], initiation of breastfeeding [AOR = 5.29, 95% CI: (2.393,11.672)], and history of illness [AOR = 4.10, 95%CI: (1.48,11.38)] were independent predictors for MAD practice among irrigated users. Whereas, maternal involvement in decision making [AOR = 4.71, 95% CI: ( 2.28, 9.75)], place of delivery [AOR = 2.51, 95% CI: ( 1.14, 5.55)], postnatal care (PNC) follow-up [AOR = 3.01, 95%CI: (1.57, 5.77)] and growth monitoring and promotion (GMP) service utilization [AOR = 4.64, 95% CI: (2.40, 8.95)] were the independent predictors among the non-users.

CONCLUSION

MAD practice was much higher in irrigated users than in non-irrigated users. Involvement in a decision, place of delivery, PNC, and GMP are independent predictors of MAD in children from non-irrigated households. The study suggested that expanding access to irrigation to households may be the best approach to improve child nutrition.

Analysis of Malnutrition among Children under Five Years across Contrasting Agroecosystems of Northwest Ethiopia: Application of Structural Equation Modeling

Child malnutrition remains a public health challenge in developing countries, but a comprehensive understanding of its burden and its determinants in specific local contexts is generally lacking. This study examined the prevalence of malnutrition and its determinants among children aged <5 years across contrasting agroecosystems in northwest Ethiopia. A community-based cross-sectional study involving 400 respondents was employed. Data were collected through semi-structured questionnaires and anthropometric measurements, complemented with focus group discussions and key informant interviews. The direct and indirect effects of the determinants of malnutrition were examined using structural equation modeling (SEM). The overall prevalence of child malnutrition, measured using the Composite Index of Anthropometric Failure, was 49%, with notable variation across agroecosystems (from 36.1% [midland with red soil] to 59% [lowland and valley fragmented]). Disease experience had significant positive direct effects on malnutrition. Dietary intake had negative and significant total (direct and indirect) effects on malnutrition, partially mediated through disease experience. Serial mediation in SEM analysis revealed significant indirect relationships between malnutrition and food security, feeding and care practices, household environment, health services, maternal diet, maternal empowerment, household wealth, and nutrition-sensitive agricultural practices. In conclusion, child malnutrition was highly prevalent and higher among children in the lowland and valley fragmented agroecosystem, characterized by unfavorable agro-climatic conditions, lower wealth status, poor health services access, and higher disease (particularly malaria) exposure. This study demonstrates the dynamics and multifaceted nature of malnutrition, highlighting the importance of considering geographical differences when planning interventions for childhood malnutrition and its determinants.

Minimum acceptable diet and associated factors among children aged 6-23 months in Ethiopia: a systematic review and meta-analysis

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.

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

BACKGROUND

The minimum acceptable diet is the proportion of children aged 6-23 months who consumed the minimum meal frequency and minimum dietary diversity during the previous day or night. The minimum acceptable diet assesses both micronutrient adequacy and the quantity of food consumed during the previous day or night. Inappropriate infant and young child feeding practices during this period result in significant threats to child health through impaired cognitive development. Therefore, this study aims to assess the minimum acceptable diet and associated factors among children aged 6-23 months in Jig-Jiga, Somali region, Eastern Ethiopia.

METHODS

A community-based, cross-sectional study was conducted in Jig-Jiga town. A systematic random sampling technique was used to select 536 children aged 6-23 months with their mothers. Data were collected using a pre-tested, structured questionnaire. The data were entered into Epi-data 3.1. The data were cleaned and analyzed using SPSS v20. Bi-variable and multivariable logistic regression analyses were done, and model fitness was checked and tested by the Hosmer-Lemeshow goodness of fit test. The results of the adjusted odds ratio with 95% confidence intervals and P < 0.05 were considered statistically significant.

RESULT

The overall prevalence of a minimum acceptable diet was 47.2% (95% CI: 43.1-51.6). Occupation of fathers (AOR = 0.5, 95%CI: 0.3-0.8), child age of 6-11 months (AOR = 3.6, 95%CI: 1.7-7.7), age of the mother 15-24 years (AOR = 7.6, 95%CI: 1.5-38.146), 25-34 years (AOR = 5.56, 95%CI: 1.17-26.325), mothers who had only one under-five child (AOR = 2.1, 95%CI: 1.298-3.471), and media as a source of information (AOR = 0.16, 95%CI: 0.061-0.433) were associated with the minimum acceptable diet.

CONCLUSION

This study showed that the prevalence of a minimum acceptable diet was low. Factors associated with a minimum acceptable diet included the father's occupation, the child's age, the mother's age, having one under-five child, and the media as a source of information. Therefore, interventional strategies that focus on family planning and advocacy for infant and young child feeding are required to improve the provision of a minimum acceptable diet.

Level of minimum acceptable diet and its associated factors among children aged 12-23 months in Ugandan districts

Uganda has made notable progress in improving child nutrition indicators, albeit not fast enough to meet global targets. Navigating the landscape of child nutrition in Uganda demands attention, particularly in light of the necessity for a minimum acceptable diet (MAD) for children aged 12-23 months. While the focus on local nutritional planning is crucial, the absence of routine-specific nutritional status data creates a significant information gap. To bridge this void, this study used datasets from the 2021 Lot Quality Assurance Sampling (LQAS) survey. Data were analysed using multilevel mixed-effects logistic regression (clustering districts based on regional boundaries) at a 5% statistical significance level using STATA version 17. Of the 7,111 children surveyed, 3,256 (49.20%) received the minimum meal frequency, 695 (9.80%) received the minimum dietary diversity, and only 380 (5.34%) received the MAD. There was a notable variation in the proportion of children that received the MAD across regions and districts. Children living in urban areas, children whose mothers had a higher education, and children whose mothers had a diverse diet were more likely to receive the MAD. Children were less likely to receive the MAD if they lived in a household that did not receive a health worker visit within the year. These findings suggest a need to prioritize initiatives aimed at increasing dietary diversity among children in Uganda. This could be done through a variety of approaches, such as leveraging the use of home gardens to boost nutrition through diverse crop cultivation, demonstration gardens, and offering nutrition counselling through village health teams.

Peer counselling as an approach to improve complementary feeding practices: a narrative review

BACKGROUND

Appropriate complementary feeding can help reduce the risk of malnutrition and is especially important in Asian and African countries. Peer counselling has been used as an approach to improve complementary feeding practices and is often combined with other interventions, like food fortification or supplements, or as a part of broader nutrition education program. The aim of this narrative review is to assess the effectiveness of peer counselling on improving complementary feeding practices in Asian and African countries.

METHODS

We searched through seven electronic databases: CINAHL, MEDLINE (OVID), PubMed, Embase, Web of Science, the Cochrane Library and WHO Global Health library from 2000 to April 2021, and had the following inclusion criteria. Studies were included if they were community- or hospital-based, had infants aged 5-24 months old, had individual or group peer counselling, and the effects of peer counselling on complementary feeding practices were measured. Methodological quality was assessed using the Joanna Briggs Institute's critical appraisal checklist for evidence studies.

RESULTS

Out of 6 studies that met the above criteria, 3 studies were randomised controlled trials and 3 were quasi-experimental studies. In Bangladesh, India, Nepal and Somalia, peer counselling was found to be effective in improving timely initiation of complementary feeding, minimum meal frequency and minimum dietary diversity in all of our selected studies. In addition, improvement in breastfeeding practices, complementary foods preparation, hygiene, psychological stimulation for cognitive development of children and mothers' understanding of hunger cues were observed in some of our selected studies.

CONCLUSIONS

This review evaluates the effectiveness of peer counselling to improve complementary feeding practices in Asian and African countries. Peer counselling improves timely complementary feeding and ensures the correct proportions and consistency of foods including adequate amounts of food is given. Other important complementary feeding indicators like minimum dietary diversity, minimum meal frequency and minimum acceptable diet can also be increased through peer-counselling interventions. Peer counselling is well known to enhance the rate of breastfeeding practices, but this review suggests it is also effective for complementary feeding and may inform future nutrition programs to extend the length of peer counselling for mothers.

Minimum acceptable dietary intake among children aged 6-23 months in Ethiopia: A systematic review and meta-analysis

BACKGROUND

In the absence of minimum acceptable diet, children aged 6-23 months are vulnerable to malnutrition. Not feeding at least the minimum acceptable diet is a major global problem, particularly in developing countries. Even though many studies have been conducted in Ethiopia there are inconsistencies. Therefore, this review aimed to estimate the pooled prevalence of a minimum acceptable diet in Ethiopia.

METHODS

Published articles from various electronic databases, such as PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct were systematically searched. All cross-sectional studies conducted on the minimum acceptable diet of children aged 6-24 months and published up to October 30/2021 were included in this review. Data were extracted using an Excel spreadsheet and analyzed using STATA version 14.1. The random-effects model was used to estimate the pooled prevalence, and a subgroup analysis was performed to identify the possible source of heterogeneity. Begg's and Egger's tests were used to identify possible publication bias.

RESULTS

Nine cross-sectional studies involving 4,223 participants were included. Significant heterogeneity was observed across the studies (I2 = 99.4%). The pooled prevalence of minimum acceptable diet in Ethiopia was found to be 25.69% (95% CI: 11.96, 39.41).

CONCLUSION

This review revealed that the minimum acceptable dietary intake among children aged 6-23 months in Ethiopia was relatively low; only 1 in 4 of children met the minimum acceptable diet. This indicates that the government should promote child feeding practices according to guidelines to increase the proportion of children with a minimum acceptable diet.

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

BACKGROUND

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

OBJECTIVE

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

METHOD

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

FINDINGS

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

CONCLUSION

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

Determinants of meeting the minimum acceptable diet among children aged 6 to 23 months in Bangladesh: Evidence from a national representative cross-sectional study

Background

Minimum acceptable diet (MAD) is a core indicator of infant and child feeding practices (IYCF). Meeting the MAD is essential to enhance the nutritional status of children aged 6-23 months.

Objective

To identify the determinants of meeting the MAD among children aged 6-23 months in Bangladesh.

Methods

The study was based on a secondary dataset of the 2017-2018 Bangladesh Demographic and Health Survey (BDHS 2017-18). Complete (weighted) data from 2,426 children aged 6-23 months were analyzed.

Results

The overall percentage of meeting the MAD was 34.70%, whereas, in terms of urban and rural, it was 39.56% and 32.96%, respectively. Age of the children 9-11 months [Adjusted odds ratio (AOR) = 3.54; 95% CI: 2.33-5.4], 12-17 months [AOR = 6.72; 95% CI: 4.63-9.77], and 18-23 months [AOR = 7.12; 95% CI: 1.72-5.98], the maternal primary [AOR = 1.75; 95% CI: 1.07-2.86], secondary [AOR = 2.3; 95% CI: 1.36-3.89], and higher education [AOR = 3.21; 95% CI: 1.72-5.98], currently working mothers [AOR = 1.45; 95% CI: 1.13-1.79], mothers' access to mass media [AOR = 1.29; 95% CI: 1-1.66], and at least four antenatal care (ANC) from medically skilled providers [AOR = 1.74; 95% CI: 1.39,2.18] were independent determinants of meeting the MAD.

Conclusions

Many children are still far behind in meeting the MAD. Nutritional interventions like improved nutrition recipes, nutrition education and homemade food supplementation, nutritional counseling by home visits, community mobilization, health forums, antenatal and postnatal sessions, and media campaigns on IYCF are needed to meet MAD practice.

Optimal complementary feeding practices and associated factors among mothers having children 6 to 23 months, south WOLLO zone, Dessie ZURIA, Ethiopia

INTRODUCTION

Optimal complementary feeding practice is a child feeding practice that fulfills the minimum dietary diversity, the minimum meal frequency, continuing breastfeeding with complementary feeding, and initiation of complementary feeding from 6 to 8 months.

METHOD

A community-based comparative cross-sectional study was conducted on a total of 732 randomly selected mothers having children 6 to 23 months of age from March 10 to April 21 /2021.Data were collected using a pre-tested interviewer-administered questionnaire. Data entry was performed by using Epi data version 3.1 and was exported to Stata version 14.1. Descriptive statistics were done. Multivariable Logistic regression was used to predict the role of independent variables on optimal complementary feeding. Findings with a p-value <0.05 at a 95% confidence interval (CI) were considered statistically significant in the final model.

RESULT

The overall proportion of mothers with optimal complementary feeding practice was 18.1% (95% C I 15.3% - 21.0). Only 90 (25.1%, 95% CI = 20.6-29.7) of mothers were found to have optimal complementary feeding practice in NGO supported kebeles but only 37 (10.8%, 95% CI = 7.5-14.1) practiced optimal complementary feeding is not NGO-supported kebeles. Mothers from Kebeles with no NGO support were 46% (AOR = 0.54, 95% CI 0.31, 0.96) less likely to practice optimal complementary feeding. On the other hand, mothers of children aged20-23 months were four times (AOR = 4.47, 95% CI 2.02-9.91) more likely to practice optimal complementary feeding than mothers having children 6-8 months of age.

PRACTICE IMPLICATIONS

Different interventions have been implemented by governmental and non-governmental organizations to improve this condition in Dessie Zuria District. But, there is limited data on the extent to which intervention by governmental and non-governmental organizations reduces this improving condition. The aim of this study was to assess the Optimal Complementary Feeding Practice and Associated Factors among Mothers Having Children Aged 6-23 Months, Ethiopia 2021.

CONCLUSION

Optimal complementary feeding practices among mothers in NGO-supported kebeles were higher than not supported kebeles. Therefore, strengthening and scaling up the program to not-supported kebeles is recommended to improve the optimal complementary feeding practiced.

Association of maternal characteristics with child feeding indicators and nutritional status of children under-two years in Rural Ghana

Background

Optimal nutrition during the first two years of a child’s life is critical for the reduction of morbidity and mortality. In Ghana, majority of children miss out on optimal nutrition and only few (13%) of children receive a Minimum Acceptable Diet (MAD). Several studies have investigated the influence of community-level factors on infants and young children feeding (IYCF) practices. However, little is known about the influence of maternal factors on IYCF practices in rural settings. Therefore, this study assessed the influence of maternal factors on the feeding indicators and nutritional status of children aged 6–23 months in two administrative districts in Ghana.

Methods

Data were collected among 935 mothers who had children aged 6–23 months and accessed 21 Child Welfare Clinics within the study area. The study involved a face- to-face interview using structured questionnaires to capture maternal characteristics, dietary intake and anthropometric measurements of children. Multivariate logistic regression was used to study the association between maternal factors and child nutrition outcomes (MAD, dietary diversity score (DDS) and anthropometric indicators) using Stata 16.0 software.

Results

Being employed (AOR = 3.07, 95% CI: 1.71—5.49, p < 0.001) and attaining secondary or higher education (AOR = 2.86, 95% CI: 1.42—5.78, p = 0.003) were significant predictors of children receiving MAD. Similarly, having an average decision-making autonomy increased the child’s odds of receiving MAD (AOR = 1.68, 95% CI: 1.02—2.76, p = 0.040). Children of mothers who attained secondary or a higher level of education (AOR = 0.59, 95% CI: 0.36 -0.97, p = 0.040) and those whose mothers were employed (AOR = 0.71, 95% CI: 0.47—1.07, p = 0.043) were associated with a reduced risk of underweight and stunting respectively. Children of mothers with average financial independence status were more likely to receive diversified meals (AOR = 1.55, 95% CI: 1.01–2.38, p = 0.045).

Conclusions

High educational level and being employed have positive influence on MAD, stunting and underweight of children. High decision-making power and average financial independence of mothers are good predictors of children receiving MAD. Family planning, women empowerment in decision-making, providing employment opportunities for mothers and promoting girl-child education are recommended.

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

Background

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

Method

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

Results

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

Conclusion

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

Supplementary Information

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

Association between Mother's Education and Infant and Young Child Feeding Practices in South Asia

The association between mother's education and the World Health Organization's (WHO's) eight Infant and Young Child Feeding (IYCF) core indicators has yet to be explored in South Asia (SA). This study aimed to explore the association between mother's education and the WHO's eight IYCF core indicators in SA. We analyzed data from the most recent nationally representative Demographic and Health Surveys of six South Asian Countries (SACs)-Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan. We found significantly higher odds (adjusted odds ratio, AOR, 1.13 to 1.47) among mothers who completed secondary or higher education than among mothers with education levels below secondary for the following seven IYCF indicators: early initiation of breastfeeding (EIBF), exclusive breastfeeding under 6 months (EBF), the introduction of solid, semisolid or soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich or iron-fortified foods (CIRF); the exception was for the indicator of continued breastfeeding at one year. Country-specific analyses revealed significantly higher odds in EIBF (AOR 1.14; 95% CI: 1.11, 1.18) and EBF (AOR 1.27; 95% CI: 1.19, 1.34) among mothers with secondary or higher education levels in India. In contrast, the odds were lower for EIBF in Bangladesh and for EBF in Pakistan among mothers with secondary or higher education levels. For country-specific analyses for complementary feeding indicators such as ISSSF, MDD, MMF, MAD, and CIRF, significantly higher odds (AOR, 1.15 to 2.34) were also observed among mothers with secondary or higher education levels. These findings demonstrate a strong positive association between mother's education and IYCF indicators. Strengthening national policies to educate women at least to the secondary level in SACs might be a cost-effective intervention for improving IYCF practices.

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

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.