Complementary feeding indicators and determinants of poor feeding practices in Indonesia: a secondary analysis of 2007 Demographic and Health Survey data

AbstractObjectiveThe present study aimed to assess complementary feeding practices and identify the potential risk factors associated with inappropriate complementary feeding in Indonesia for a nationally representative sample of births from 2004 to 2007.DesignThe data source for the analysis was the 2007 Indonesia Demographic and Health Survey. Multiple logistic regression was performed to analyse the factors associated with complementary feeding, using individual-, household- and community-level determinants.SettingIndonesia.SubjectsChildren (n 4604) aged 6–23 months.ResultsMultivariate analysis revealed that infants from poor households were significantly less likely to be introduced to complementary feeding (adjusted odds ratio, AOR = 4·32; 95 % CI 1·46, 12·80) and meet the minimum dietary diversity (AOR = 1·76; 95 % CI 1·16, 2·68). Mother's education (AOR for no education in dietary diversity = 1·92; 95 % CI 1·09, 3·38; AOR for no education in meal frequency = 2·03; 95 % CI 1·13, 3·64; AOR for no education in acceptable diet = 3·84; 95 % CI 2·07, 7·12), residence and decreased age of the infant were negatively associated with minimum dietary diversity, minimum meal frequency and an acceptable diet. Infants aged 6–11 months were also significantly less likely to meet minimum dietary diversity (AOR = 6·36; 95 % CI 4·73, 8·56), minimum meal frequency (AOR = 2·30; 95 % CI 1·79, 2·96) and minimum acceptable diet (AOR = 2·27; 95 % CI 1·67, 3·09). All geographical regions compared with Sumatra were more likely to give the recommended meal frequency and an acceptable diet to breast-fed children.ConclusionsPublic health interventions to improve complementary feeding should address individual-, household- and community-level factors which significantly influence the introduction of complementary feeding. Complementary feeding intervention programmes in Indonesia should ensure that restraints on families with low socio-economic status are addressed. Infants aged 6–11 months and mothers with low education levels may also need special focus. Promotion strategies should also target the health-care delivery system and the media.

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Determinants of inadequate complementary feeding practices among children aged 6–23 months in Ghana

Public Health Nutrition ◽

10.1017/s1368980014000834 ◽

2014 ◽

Vol 18 (4) ◽

pp. 669-678 ◽

Cited By ~ 30

Author(s):

Abukari I Issaka ◽

Kingsley E Agho ◽

Penelope Burns ◽

Andrew Page ◽

Michael J Dibley

Keyword(s):

Risk Factors ◽

Health Survey ◽

Complementary Feeding ◽

Dietary Diversity ◽

Feeding Practices ◽

Demographic And Health Survey ◽

Meal Frequency ◽

Factors Associated ◽

Minimum Dietary Diversity ◽

Breast Fed

AbstractObjectiveTo explore complementary feeding practices and identify potential risk factors associated with inadequate complementary feeding practices in Ghana by using the newly developed WHO infant feeding indicators and data from the nationally representative 2008 Ghana Demographic and Health Survey.DesignThe source of data for the analysis was the 2008 Ghana Demographic and Health Survey. Analysis of the factors associated with inadequate complementary feeding, using individual-, household- and community-level determinants, was done by performing multiple logistic regression modelling.SettingGhana.SubjectsChildren (n 822) aged 6–23 months.ResultsThe prevalence of the introduction of solid, semi-solid or soft foods among infants aged 6–8 months was 72·6 % (95 % CI 64·6 %, 79·3 %). The proportion of children aged 6–23 months who met the minimum meal frequency and dietary diversity for breast-fed and non-breast-fed children was 46·0 % (95 % CI 42·3 %, 49·9 %) and 51·4 % (95 % CI 47·4 %, 55·3 %) respectively and the prevalence of minimum acceptable diet for breast-fed children was 29·9 % (95 % CI 26·1 %, 34·1 %). Multivariate analysis revealed that children from the other administrative regions were less likely to meet minimum dietary diversity, meal frequency and acceptable diet than those from the Volta region. Household poverty, children whose mothers perceived their size to be smaller than average and children who were delivered at home were significantly less likely to meet the minimum dietary diversity requirement; and children whose mothers did not have any postnatal check-ups were significantly less likely to meet the requirement for minimum acceptable diet. Complementary feeding was significantly lower in infants from illiterate mothers (adjusted OR=3·55; 95 % CI 1·05, 12·02).ConclusionsThe prevalence of complementary feeding among children in Ghana is still below the WHO-recommended standard of 90 % coverage. Non-attendance of postnatal check-up by mothers, cultural beliefs and habits, household poverty, home delivery of babies and non-Christian mothers were the most important risk factors for inadequate complementary feeding practices. Therefore, nutrition educational interventions to improve complementary feeding practices should target these factors in order to achieve the fourth Millennium Development Goal.

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Individual-, household-, and community-level factors associated with eight or more antenatal care contacts in Nigeria: Evidence from Demographic and Health Survey

PLoS ONE ◽

10.1371/journal.pone.0239855 ◽

2020 ◽

Vol 15 (9) ◽

pp. e0239855

Author(s):

Michael Ekholuenetale ◽

Faith Owunari Benebo ◽

Ashibudike Francis Idebolo

Keyword(s):

Antenatal Care ◽

Health Survey ◽

Demographic And Health Survey ◽

Community Level ◽

Factors Associated ◽

Individual Household

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Individual/Household and Community-Level Factors Associated with Child Marriage in Mali: Evidence from Demographic and Health Survey

BioMed Research International ◽

10.1155/2021/5529375 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Betregiorgis Zegeye ◽

Comfort Z. Olorunsaiye ◽

Bright Opoku Ahinkorah ◽

Edward Kwabena Ameyaw ◽

Eugene Budu ◽

...

Keyword(s):

Higher Education ◽

Health Survey ◽

Fixed Effects ◽

Educational Status ◽

Demographic And Health Survey ◽

Community Level ◽

Child Marriage ◽

Major Public Health Problem ◽

Factors Associated ◽

Individual Household

Background. Child marriage is a major public health problem globally, and the prevalence remains high in sub-Saharan African countries, including Mali. There is a dearth of evidence about factors associated with child marriage in Mali. Hence, this studyaimed at investigating the individual/household and community-level factors associated with child marriage among women in Mali. Methods. Using data from the 2018 Mali Demographic and Health Survey, analysis was done on 8,350 women aged 18-49 years. A Chi-square test was used to select candidate variables for the multilevel multivariable logistic regression models. Fixed effects results weree xpressed as adjusted odds ratios (aOR) at 95% confidence intervals (CI). Stata version 14 software was used for the analysis. Results. The results showed that 58.2% (95% CI; 56.3%-60.0%) and 20.3% (95%; 19.0%-21.6%) of women aged 18-49 years were married before their 18th and 15th birthday, respectively. Educational status of women (higher education: aOR = 0.25 , 95% CI; 0.14-0.44), their partner’s/husband’s educational status (higher education: aOR = 0.64 , 95% CI; 0.47-0.87), women’s occupation (professional, technical, or managerial: aOR = 0.50 , 95% CI; 0.33-0.77), family size (five and above: aOR = 1.16 , 95% CI; 1.03-1.30), and ethnicity (Senoufo/Minianka: aOR = 0.73 , 95% CI; 0.58-0.92) were the identified individual/household level factors associated with child marriage, whereas region (Mopti: aOR = 0.27 , 95% CI; 0.19-0.39) was the community level factor associated with child marriage. Conclusions. This study has revealed a high prevalence of child marriage in Mali. To reduce the magnitude of child marriage in Mali, enhancing policies and programs that promote education for both girls and boys, creating employment opportunities, improving the utilization of family planning services, and sensitizing girls and parents who live in regions such as Kayes on the negative effects of child marriage is essential. Moreover, working with community leaders so as to reduce child marriage in the Bambara ethnic communities would also be beneficial.

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Dietary Diversity and Meal Frequency Practices among Infant and Young Children Aged 6–23 Months in Ethiopia: A Secondary Analysis of Ethiopian Demographic and Health Survey 2011

Journal of Nutrition and Metabolism ◽

10.1155/2013/782931 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 38

Author(s):

Melkam Aemro ◽

Molla Mesele ◽

Zelalem Birhanu ◽

Azeb Atenafu

Keyword(s):

Young Children ◽

Health Survey ◽

Dietary Diversity ◽

Final Analysis ◽

Feeding Practices ◽

Demographic And Health Survey ◽

Feeding Practice ◽

Meal Frequency ◽

Dietary Diversity Score ◽

Number Of Children

Background. Appropriate complementary feeding practice is essential for growth and development of children. This study aimed to assess dietary diversity and meal frequency practice of infants and young children in Ethiopia.Methods. Data collected in the Ethiopian Demographic and Health Survey (EDHS) from December 2010 to June 2011 were used for this study. Data collected were extracted, arranged, recoded, and analyzed by using SPSS version 17. A total of 2836 children aged 6–23 months were used for final analysis. Both bivariate and multivariate analysis were done to identify predictors of feeding practices.Result. Children with adequate dietary diversity score and meal frequency were 10.8% and 44.7%, respectively. Children born from the richest households showed better dietary diversity score (OR = 0.256). Number of children whose age less than five years was important predictor of dietary diversity (OR = 0.690). Mothers who had exposure to media were more likely to give adequate meal frequency to their children (OR = 0.707).Conclusion. Dietary diversity and meal frequency practices were inadequate in Ethiopia. Wealth quintile, exposure to media, and number of children were affecting feeding practices. Improving economic status, a habit of eating together, and exposure to media are important to improve infant feeding practices in Ethiopia.

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Minimum Diet Diversity and Minimum Meal Frequency – Do They Matter Equally? Understanding IYCF Practices in India

Current Developments in Nutrition ◽

10.1093/cdn/nzaa054_084 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1012-1012

Author(s):

Ayushi Jain ◽

Muneer Kalliyil ◽

Satish Agnihotri

Keyword(s):

Child Nutrition ◽

Complementary Feeding ◽

Dietary Diversity ◽

Family Health ◽

Feeding Practices ◽

Meal Frequency ◽

Child Feeding ◽

Diet Diversity ◽

Minimum Dietary Diversity ◽

Nutritional Outcomes

Abstract Objectives Infant and Young Child Feeding practices, mainly, complementary feeding in children between 6 months and two years of age, is found to be sub-optimal and emerge as the weakest link in improving child nutrition outcomes in India. Minimum Acceptable Diet (MAD), comprising of two sub-indicator – Minimum Dietary Diversity (MDD) and Minimum Meal Frequency (MMF), serves as an essential indicator to understand the diet adequacy pattern in children. The objective of this study was thus to investigate the role of MDD-MMF dyad in influencing the nutritional outcomes in children and its pattern across regions in India. Methods Data was obtained from the National Family Health Survey – 4 (NFHS-4) from the DHS Program website. The prevalence of MMF and MDD was calculated for 640 districts in India. The MMF and MDD were classified into three categories - high, medium and low based on equal percentile distribution of their prevalence range. Districts with high MMF and high MDD formed one cohort. Similarly, eight other cohorts were created based on their performance on MMF and MDD indicator. The prevalence of Stunting (St), Wasting (Wa) and Underweight (Uw) in children between 6 months and two years of age was then calculated for each of the nine cohorts. The districts were also mapped based on their cohort category to study the variation across regions in India. Results All three anthropometric indicators – stunting, wasting and underweight showed significant decline moving across low MMF- low MDD cohort (40% St; 26.2% Wa; 37.1% Uw) to medium MMF – medium MDD cohort (38.6% St; 23.8% Wa; 35.4% Uw) to high MMF – high MDD cohort (29% St; 15.5% Wa; 19.2% Uw). Second, the importance of minimum dietary diversity in improving nutritional outcomes was revealed, as opposed to minimum meal frequency, which shows improvement only when it reaches a certain threshold. Third, mapping revealed sharp differences across various regions in MMF-MDD pattern, especially in the states like Odisha, Assam and Andhra Pradesh. States in the central region performed poorly on complementary feeding indicators, specifically diet diversity. Conclusions The study highlights the importance of optimal complementary feeding practices in improving nutrition outcomes and the need to consider the regional heterogeneities while promoting IYCF practices in India. Funding Sources None.

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Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: Cohort study

PLoS ONE ◽

10.1371/journal.pone.0250562 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0250562

Author(s):

Rachel Masuke ◽

Sia E. Msuya ◽

Johnson M. Mahande ◽

Ester J. Diarz ◽

Babill Stray-Pedersen ◽

...

Keyword(s):

Cohort Study ◽

Nutritional Status ◽

Complementary Feeding ◽

Dietary Diversity ◽

Feeding Practices ◽

Meal Frequency ◽

Early Introduction ◽

Semi Solid ◽

Nutritional Status Of Children ◽

Minimum Dietary Diversity

Introduction Childhood undernutrition is a major public health problem especially in low and middle-income countries (LMIC). The prevalence of early introduction of complementary feeding, low meal frequency, and low dietary diversity are frequent in LMICs. The effect of inappropriate complementary feeding practices on the nutritional status of children is not well documented in East African countries including Tanzania. Therefore, this study aimed at determining the effect of inappropriate complementary feeding practices on the nutritional status of children aged 6–24 months in urban Moshi, Tanzania. Methodology A retrospective cohort study was done using the Pasua and Majengo cohorts of mother-child pairs in urban Moshi who were enrolled from 2002 to 2017. About 3355 mother-child pairs were included in the analysis. Appropriate complementary feeding practices were assessed using WHO IYFP indicators such as age at introduction of solid, semi-solid, or soft foods, minimum dietary diversity, and minimum meal frequency. Nutritional status (stunting, wasting, and underweight) was determined. Multilevel modeling was applied to obtain the effect of inappropriate complementary feeding practices on the nutritional status of children and to account for the clustering effect of mothers and children and the correlation of repeated measures within each child. Results Majority of the children (91.2%) were given soft/semi-solid/solid foods before six months of age, 40.3percent had low meal frequency, and 74percent had low dietary diversity. Early introduction of complementary food at age 0–1 month was statistically significantly associated with higher risks of wasting and underweight (ARR 2.9, 95%CI 1.3–6.3; and ARR 2.6, 95% CI 1.3–5.1 respectively). Children with low minimum meal frequency had higher risks of stunting, wasting, and underweight (ARR 2.9, 95%CI 2.3–3.6; ARR 1.9, 95%CI 1.5–2.5 and ARR 1.9, 95%CI 1.5–2.4 respectively). Children with low minimum dietary diversity were more likely to be stunted than is the case with their peers who received the minimum dietary diversity (ARR 1.3, 95% CI 1.01–1.6). Conclusion There were a high proportion of children, which were fed inappropriately; Inappropriate complementary feeding practices predisposed children to undernutrition. Our study supports the introduction of complementary feeding, providing minimum dietary diversity, and minimum feeding frequency at six months of age as important in improving the nutritional status of the children.

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Maternal determinants of optimal breastfeeding and complementary feeding and their association with child undernutrition in Malawi (2015–2016)

BMC Public Health ◽

10.1186/s12889-019-7877-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Christine N. Walters ◽

Hasina Rakotomanana ◽

Joel J. Komakech ◽

Barbara J. Stoecker

Keyword(s):

Urban Areas ◽

Complementary Feeding ◽

Dietary Diversity ◽

Feeding Practices ◽

Child Growth ◽

Meal Frequency ◽

Maternal Characteristics ◽

Child Undernutrition ◽

Maternal Determinants ◽

Minimum Dietary Diversity

Abstract Background Optimal breastfeeding and complementary feeding practices are critical to prevent child undernutrition. Despite the occurrence of child undernutrition and widespread suboptimal feeding practices in Malawi, the association of breastfeeding and complementary feeding practices and undernutrition among Malawian children remains unclear. The purpose of the study was to determine the current breastfeeding and complementary feeding practices, to identify maternal determinants of each practice, and to analyze the associations between breastfeeding and complementary feeding practices with stunting, underweight, and wasting. Methods The most recent Malawi Demographic Health Survey (2015–2016) was used and data for 2294 children aged 0–23 months were included. A conceptual framework of five maternal domains: sociodemographic, health status, health behaviors, women’s empowerment, and media exposure was used. Each domain contained exposure variables and the WHO Infant and Young Child Feeding indicators were used as outcome variables. All analyses were adjusted for clustering, and variables that reached a p-value of < 0.05 were considered significant in the final model. Results Among children, 30.8% were stunted, 9.9% were underweight, and 3.7% were wasted. Many (78%) were breastfed within the first hour of birth, 89% were breastfed until their first birthday, yet 40% were not exclusively breastfed to 6 months. Only 32% met minimum dietary diversity, 23% met minimum meal frequency, 12% met minimum acceptable diet and 12% consumed iron-rich foods. Children whose mothers lived in urban areas were less likely to be breastfed within 1 hour of birth but more likely to meet minimum dietary diversity. Children whose mothers listened to radio were more likely to meet minimum meal frequency. Children (13–23 months) who met minimum meal frequency and minimum acceptable diet were less likely to be underweight. Conclusions Optimal breastfeeding and complementary feeding practices in Malawi remain suboptimal and child undernutrition remains problematic. Maternal characteristics from the five domains were significantly associated with optimal breastfeeding and complementary feeding indicators. Knowledge of these maternal determinants can assist in improving nutrition policies and interventions that aim to impact breastfeeding and complementary feeding practices and child growth in Malawi.

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