Nutrition Intervention Using Behavioral Change Communication without Additional Material Inputs Increased Expenditures on Key Food Groups in Bangladesh

ABSTRACT Background Behavioral change communication (BCC) promotes skills and knowledge to improve infant and young child feeding, but without additional material inputs, recipients must develop strategies to translate knowledge into action. Using data from the Alive & Thrive initiative in Bangladesh (2010–2014), we aimed to test whether households receiving the intensive intervention (opposed to the nonintensive intervention) increased expenditures on key foods for mothers and children (e.g., foods that were promoted by the intervention and also changed in maternal and child diets). Methods The intensive intervention provided interpersonal counseling, community mobilization, and mass media campaigns to promote breastfeeding and complementary feeding. A cluster-randomized design compared 20 subdistricts randomly assigned to the intensive (4281 households) or nonintensive (4284 households) intervention. Measures included food and nonfood expenditures, dietary diversity, and women's economic resources. Linear and logistic regression tested difference-in-differences (DD) in expenditures and dietary diversity, accounting for subdistricts as clusters, and the association between maternal and child consumption of specific food groups and corresponding food expenditures. Results Expenditures on eggs and flesh foods increased more in intensive areas than in nonintensive areas by 53 (P < 0.01) and 471 (P < 0.01) taka/mo, respectively. Household food expenditures increased more in intensive areas by 832 taka (P = 0.02), whereas changes in nonfood expenditures did not differ. Women's employment and control of income increased more in intensive areas by 12 (P = 0.03) and 13 (P < 0.01) percentage points, respectively, while jewelry ownership decreased more by 23 percentage points (P < 0.01). Higher expenditures on food groups were reflected in higher consumption by women and children. Conclusions Recipients in the intensive intervention mobilized additional resources to improve diets, reflected in increased expenditures and consumption of promoted foods. BCC interventions should document how recipients produce desired results without additional material inputs, particularly for behaviors that likely require additional resources. This trial was registered at clinicaltrials.gov as NCT01678716.

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Knowledge, Food Vouchers, and Child Nutrition: Evidence from a Field Experiment in Ethiopia (P11-116-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-116-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Seollee Park ◽

Yae Eun Han ◽

Hyuncheol Kim

Keyword(s):

Child Nutrition ◽

Dietary Diversity ◽

Study Groups ◽

Child Growth ◽

Control Group ◽

Maternal Knowledge ◽

Child Feeding ◽

Young Child Feeding ◽

Change Communication ◽

Randomized Design

Abstract Objectives Young children in developing countries often maintain poor diets, evidenced by strikingly low dietary diversity. Through formative research, we identified the lack of knowledge and affordability as key barriers to improved infant and young child feeding (IYCF) practices in Ethiopia. The aim of this study is to investigate ways to promote healthy IYCF by analyzing the impacts of an IYCF behavior change communication (BCC) program and food vouchers on mother's IYCF knowledge and practices, and child growth. Methods Using a clustered randomized design, we compare the effects of two independent interventions—IYCF BCC program and food vouchers—on four study groups: BCC only (BCC), voucher only (Voucher), BCC and voucher (BCC + Voucher), and the control group. The BCC program offered weekly group IYCF sessions to mothers who has children between 4 to 20 months of age for 16 weeks, employing participatory learning methods. The voucher program provided food vouchers worth approximately 10 USD per month for four months, which could be used at nearby markets for purchasing a wide variety of food items. We identified 641 eligible households residing in 79 villages in Ejere through census. As shown in Figure 1, 79 villages were randomly assigned to one of the four study groups: BCC, Voucher, BCC + Voucher, and control. All eligible mothers living in treatment villages were invited to participate in the program to which the village she lives in was assigned. Results We show that BCC improves maternal knowledge of nutrition and IYCF behaviors, while food vouchers alone do not (Figure 2). Impacts are largest when both knowledge and income constraints are addressed simultaneously through BCC + Voucher (Table 1). Only in this group do we see these treatments reducing stunting by 9 percentage points (Figure 3). Moreover, we show that BCC + Voucher prevented stunting from occurring during this critical age range rather than reversing it (Figure 4). Conclusions Our results suggest that, when both knowledge and income are intertwined challenges for improved child-feeding practices, addressing both constraints simultaneously may augment the positive impacts due to their complementary relationship. Funding Sources Africa Future Foundation. Supporting Tables, Images and/or Graphs

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

10.21203/rs.2.16657/v1 ◽

2019 ◽

Author(s):

Ahmed Gharib Khamis ◽

Akwilina Wendelin Mwanri ◽

Julius Edward Ntwenya ◽

Katharina Kreppel

Keyword(s):

Fruits And Vegetables ◽

Dietary Diversity ◽

Secondary Data ◽

Food Group ◽

Limited Information ◽

Food Groups ◽

Child Feeding ◽

Young Child Feeding ◽

Nutritional Status Of Children ◽

Minimum Dietary Diversity

Abstract Background Undernutrition poses a serious health challenge in developing countries. Tanzania has the highest undernutrition burdens in East and Southern Africa. Poor infant and young child feeding practices including consumption of undiversified diet are the main cause for undernutrition. There is limited information regarding the association between dietary diversity and undernutrition in Tanzania. The objective of this paper was to examine to what extent the dietary diversity is associated with undernutrition of children of 6 to 23 months in Tanzania.Methods This is a secondary data analysis from data collected by the Tanzania Demographic and Health Survey of 2015-2016. Stunting, wasting and underweight were calculated from Z-scores based on 2006 WHO standards. A dietary diversity score was created by summing the number of food groups reported for each child by the mother ranging from 0 to 7. Then, a Minimum Dietary Diversity (MDD) indicator was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the odds ratios of becoming undernourished.Results A total of 2,960 children were enrolled in this study. The majority (73.9%) of children did not reach the recommended Minimum Dietary Diversity (MDD). The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food group consumed increased. Children who did not received an MDD diet had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal source foods has been found to be associated with reduced stunting among children.Conclusion Consumption of a diverse diet was associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

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Feeding practices of young children aged 12–23 months in different socio-economic settings: a study from an urban area of Indonesia

British Journal Of Nutrition ◽

10.1017/s0007114515003438 ◽

2015 ◽

Vol 116 (S1) ◽

pp. S1-S7 ◽

Cited By ~ 2

Author(s):

Otte Santika ◽

Judhiastuty Februhartanty ◽

Iwan Ariawan

Keyword(s):

Young Children ◽

Dietary Diversity ◽

Feeding Practices ◽

Feeding Practice ◽

Low Ses ◽

Food Groups ◽

Cross Sectional Survey ◽

Fortified Foods ◽

Child Feeding ◽

Child Feeding Practices

AbstractPoor feeding practices among young children lead to malnutrition, and the poor are at a greater risk than the better off groups. Child-feeding practices in various socio-economic strata, especially in urban settings, have not yet been well studied in Indonesia. This study aims to explore the feeding practices of 12–23 months old children from different socio-economic status (SES) groups. A cross-sectional survey was conducted, which included low (n 207), medium-high (n 205), medium-low (n 208) and high SES households (n 194) in forty-three villages within thirty-three sub-districts of Bandung city. Two non-consecutive 24 h recall and eight core indicators of child-feeding practices were assessed through interviews. The results showed that children from the high SES group were more likely to be exclusively breast-fed and to continue breast-feeding up to 1 year of age, met minimum dietary diversity and minimum acceptable diet, and also consumed Fe-rich or Fe-fortified foods. In contrast, children from low SES consumed more energy-rich food (grain) but fewer foods from the other food groups. Consumption of major nutrients differed across the SES groups. Inadequate nutrition was higher among children from the lower SES groups. Fortified foods were consumed by a larger proportion of children from the high SES group and contributed considerably to their overall nutrient intake. This study shows that young children’s feeding practices were not adequate, most notably among the low SES households. However, after adjusting with potential confounders, there was not enough evidence to conclude SES as a risk factor for feeding practice.

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A Complementary Feeding Intervention for Fathers and Mothers in Northern Nigeria Improves Children's Minimum Meal Frequency and Consumption of Eggs and Fish

Current Developments in Nutrition ◽

10.1093/cdn/nzab045_023 ◽

2021 ◽

Vol 5 (Supplement_2) ◽

pp. 641-641

Author(s):

Valerie Flax ◽

Abiodun Ipadeola ◽

Courtney Schnefke ◽

Sarah Kwasu ◽

Abdulrahaman Mikail ◽

...

Keyword(s):

Cross Sections ◽

Complementary Feeding ◽

Dietary Diversity ◽

Survey Design ◽

Meal Frequency ◽

Health Extension Workers ◽

Child Feeding ◽

Cross Sectional ◽

Change Communication ◽

Gates Foundation

Abstract Objectives The objective of this study was to measure the effects of a social behavior change communication (SBCC) intervention on fathers’ and mothers’ complementary feeding knowledge and attitudes, fathers’ support for complementary feeding, and children's dietary diversity and meal frequency. Methods This study used cross-sectional surveys of cohabiting fathers and mothers with a child 6–23 months before (N = 497) and after (N = 495) the intervention in Igabi local government area, Kaduna State, Nigeria. Participants were randomly sampled within 99 clusters selected proportional to population size. Regression models weighted for the survey design, including inverse propensity weights to adjust for differences in sociodemographic characteristics of the cross-sections, were used to assess before/after differences. Alive & Thrive's 12-month intervention engaged fathers through community meetings, religious services, and mobile phone text and voice messages. Mothers received home visits from community health extension workers (CHEWs), which fathers also could attend. SBCC materials included TV and radio messages, sermon guides, counseling cards, pamphlets, posters, and feeding bowls. Results Exposure of fathers to CHEW visits, fathers and mothers to mass media messages, and fathers to text/voice messages increased from baseline to endline. Fathers’ and mothers’ knowledge of the timing of introduction of different foods and meal frequency shifted toward the global recommendations. Fathers’ support for child feeding by providing money for food increased (79% to 90%, P < 0.001). The percentage of children with minimum dietary diversity did not change (62% to 65%, P = 0.358). The percentage of children who consumed fish (36% to 44%, P = 0.012) and eggs (8% to 20%, P = 0.004), had minimum meal frequency (58% to 73%, P < 0.001), and had minimum acceptable diet (40% to 52%, P < 0.001) increased from baseline to endline. Conclusions A multipronged SBCC intervention improved fathers’ and mothers’ knowledge of complementary feeding, increased fathers’ support for complementary feeding, and modified some complementary feeding practices. Funding Sources This research was funded by the Alive & Thrive initiative, managed by FHI Solutions, and currently funded by the Bill & Melinda Gates Foundation, Irish Aid, the Tanoto Foundation, UNICEF, and the World Bank.

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Higher Maternal and Child Undernutrition in Pulse than Cereal Growing Rural Communities of Ethiopia: A comparative Cross-sectional Study

Journal of Food Research ◽

10.5539/jfr.v8n2p100 ◽

2019 ◽

Vol 8 (2) ◽

pp. 100

Author(s):

Getahun Ersino ◽

Carol J. Henry ◽

Gordon A. Zello

Keyword(s):

Dietary Diversity ◽

Health Benefits ◽

Household Size ◽

Nutrition Intervention ◽

Unexpected Finding ◽

Food Groups ◽

Child Undernutrition ◽

Dairy Consumption ◽

Nutritional Health ◽

Land Size

Background: Whether growing pulses (low fat legumes rich in protein and micronutrients) translates to nutritional health benefits has not been well documented in Ethiopia. In pulse- and cereal-based agricultural communities, we compared the nutrition of mothers and children (<5y) through anthropometric and dietary assessment to document evidence of pulse agriculture translating to nutritional health benefits. We also explored contextual factors influencing nutritional status. Methods: Comparative study was conducted in purposively selected pulse- and cereal-growing Ethiopian communities, from rural Halaba and Zeway, with randomly selected individual participants of 413 and 217 mother-child dyads, respectively. Dietary diversity scores (DDS) and consumption indexes for selected food groups were assessed; median intakes of energy, protein, Fe, Zn, Ca were determined from a single-day weighed food records (in a subsample). Mother-child undernutrition was estimated using anthropometric assessments of weight, length/height and mid-upper-arm-circumference, MUAC. Results: Median energy and nutrient intakes for pulse-mothers, but not children, were significantly higher than cereal-mothers (p<0.01); Median DDS for mothers-children were three, out of nine food groups, in both communities; consumption index of pulses, although higher in the pulse-community (p<0.001), was generally low amounting to consumption of only 1-2/week; consumption from animal sources was minimal. Undernutrition in mothers was 22% in pulse and 14% in cereal. Child stunting, wasting and underweight were 53.5%, 10.4% and 36.5% in pulse and 41.8%, 4.1% and 21.6% in the cereal group, respectively. Gender-sensitive factors, such as access to own-land and work-burden predicted maternal-MUAC. Stunting, household size, land size, antenatal-clinic visits and frequency of dairy consumption also predicted maternal-MUAC. Child age, community (i.e., pulse- or cereal-growing), household size and land size predicted chid height-for-age z-score (HAZ). Pulses were mostly sold and women had limited control; mothers’ knowledge of the nutrition benefits of pulses was lower in pulse community (p<0.01). Conclusions: Poor DDS, pulse or animal-source food consumption and high levels of maternal and child undernutrition were found in both communities. The unexpected finding of greater undernutrition in the pulse-growing Halaba communities was of concern needing further investigation. The pulse-community could benefit from educational nutrition-intervention focusing on nutrition and other benefits of pulses.

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Self-monitoring improved child feeding among low educated slum mothers in Bangladesh, a pilot study

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.882 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

K Jannat ◽

M Rahman ◽

K Agho ◽

S Parvez ◽

D Merom

Keyword(s):

Complementary Feeding ◽

Dietary Diversity ◽

Qualitative Interviews ◽

Feeding Practices ◽

Future Research ◽

Food Groups ◽

Child Feeding ◽

Self Monitoring ◽

Visual Aid ◽

Low Educated

Abstract Issue Child undernutrition in urban slums is the most serious but least addressed health problem in many LMICs including Bangladesh. Slum children are deprived of adequate feeding as advocated by WHO. Face-to-face contact to monitor adherence to child feeding recommendations is costly. We aimed to identify if a visual aid for self-monitoring, in the form of a pictorial calendar, could assist illiterate slum mothers to self-regulate their child feeding behaviours and increase adherence to recommended child feeding practices. Description of the practice: A mixed method study was conducted (Randomised Controlled Trial + semi-structured qualitative interviews) over four weeks in a slum area of Dhaka city. Thirty-four mothers to child aged 6-23 months having <5 years of education were recruited. Mothers randomized to intervention arm (n = 17) received an hour of complementary feeding education along with a pictorial calendar and color-coded stickers representing food groups. The control arm received the education session only. The primary outcome was Minimum Dietary Diversity (MDD: ≥4 food groups in past 24 hours); the Generalised Estimation Equations (GEE) with a log link and binomial family was used to test treatment by time interactions. Results The proportion of achieving MDD was more common (RR 1.2, 95%CI 0.8, 1.8) among mothers from intervention arm compared to control mothers. Intervention mothers were more likely to identify the appropriate food groups compared to control mothers. More than 80% of the mothers completed the calendar for all 28 days of study duration. During qualitative interviews, most mothers (4/5) stated that the pictorial calendar acted as a reminder for them. Lessons An encouraging tendency towards better complementary feeding and better knowledge was seen among the intervention mothers compared to controls. Future research with a larger sample is needed to establish the significance of effect size. Key messages Pictorial calendar appeared to help sustain knowledge and improve feeding practices. Self-monitoring using a pictorial calendar could be a good visual aid for low-educated mothers from low socio-economic status.

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In Ethiopia, India, and Peru, Household Expenditures on Fats Are More Strongly Associated with Children's Future Heights Than Expenditures on Other Food Groups (P10-006-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-006-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Debbie Humphries ◽

Sarah Weingarten ◽

Kirk Dearden ◽

Benjamin Crookston ◽

Mary Penny ◽

...

Keyword(s):

Dietary Diversity ◽

Food Group ◽

Child Growth ◽

Food Groups ◽

Country Level ◽

Household Food ◽

Food Expenditures ◽

Total Food ◽

Future Child ◽

Food Expenditure

Abstract Objectives We hypothesized that household food expenditures on 7 key dietary food groups—starches, fruits & vegetables, legumes, eggs, dairy, meat and fat—woul differentially affect future child height-for-age z scores (HAZ), after adjusting for household, parental and community characteristics. We investigated the associations of household food group expenditures at 5 years (y) and 8y with child HAZ at 8y and 12y, respectively. Methods We used data from 6993 children, born around 2001, from Ethiopia, India, Peru and Vietnam, collected at ages 5, 8, and 12y from the Young Lives younger cohort. We compared associations between two weeks of household food expenditures (in Purchasing Power Parity adjusted dollars (PPP$) to allow meaningful cross-country comparisons) on food groups and child HAZ at subsequent rounds of collection to assess longitudinal relations. Total food expenditures, rural/urban residence, maternal and paternal education, and child sex were controlled for in our models. Results In Ethiopia, results pointed to total food expenditure as one of the critical and significant components associated with subsequent child HAZ; and among the food groups, expenditures on fats had the largest associations with future child HAZ. In India and Peru, expenditure on one specific food group—fats—seemed to be the most important significant predictor of future HAZ in children from among food expenditures. In Vietnam, starches were a significant negative predictor of future HAZ, which may relate to the significance of dietary diversity and prediction of future HAZ for this country's cohort. Conclusions Our results pinpoint specific facets of the diet that may have had the greatest impact on child growth for each country. They also point to the importance of examining country-level context, and caution about generalizing from one context to others. These results, moreover, highlight the usefulness of household food expenditure survey data in analyzing children's nutrition at the country level, and may help to influence child food and nutrition policies in these four unique countries. Funding Sources This study is based on research funded by the Bill & Melinda Gates Foundation, Eunice Shriver Kennedy National Institute of Child Health and Development and Grand Challenges Canada.

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Father Engagement in Improving Infant and Young Child Feeding (IYCF) Practices: Evidence from a Clustered Randomized Controlled Trial in Ethiopia (P11-112-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-112-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Yae Eun Han ◽

Seollee Park ◽

Ji Eun Kim ◽

Hyuncheol Kim ◽

John Hoddinott

Keyword(s):

Randomized Controlled Trial ◽

Dietary Diversity ◽

Controlled Trial ◽

Knowledge Gain ◽

Food Groups ◽

Child Feeding ◽

Diet Diversity ◽

Young Child Feeding ◽

Randomized Controlled ◽

The Impact

Abstract Objectives We identified lack of knowledge and lack of paternal support as barriers to improved IYCF practices in Ethiopia, the focus of this study. Behavior change communication (BCC) strategies are often used to improve knowledge, but BCC programs commonly target only mothers. The objective of this study is to assess the impact of both paternal and maternal BCC program on complementary feeding practices compared to maternal BCC program alone. Methods This study is a community-based, clustered randomized controlled trial conducted in Ejere district, Ethiopia. We randomly selected three rural kebeles (ward) and three urban kebeles within the Ejere district. 63 garees (villages) were identified and randomly assigned within selected kebeles into treatment and control groups: T1, maternal BCC only; T2, both maternal BCC and paternal BCC; and C, control. The maternal BCC program and paternal BCC program consisted of weekly one-hour long group sessions for the duration of 16 and 12 weeks, respectively. Both BCC program included messages on improved IYCF practices. In addition, paternal BCC program included messages on gender roles. Results Father's IYCF knowledge increased by 0.31SD when BCC was provided to mothers and by 0.62SD when provided to both mothers and fathers. Although we see spillover of knowledge from BCC from BCC-attending mothers to their partners in maternal BCC group, we see paternal BCC additionally increase father's knowledge by 0.36SD. The provision of both maternal and paternal BCC group improves child dietary diversity score (CDDS) by 0.64 food groups and increases the likelihood they meet minimum diet diversity by 18 percentage points. However, the additional impact of paternal BCC on child diets is not statistically significant at the 5% level. We see no differential impact on child anthropometry. Conclusions Nutrition BCC program that targets both fathers and mothers have greater impact on father's knowledge, compared to nutrition BCC program that targets mothers only. However, additional knowledge gain has limited impact on IYCF practices. Funding Sources Africa Future Foundation. Supporting Tables, Images and/or Graphs

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Association of Maternal Dietary Diversity and Nutritional Status with Child’s Dietary Diversity and Nutritional Status (2-5 years) in India

World Nutrition ◽

10.26596/wn.2020111110-128 ◽

2020 ◽

Vol 11 (1) ◽

pp. 110-128

Author(s):

Gulafshan Ansari ◽

Swati Jain ◽

Neena Bhatia

Keyword(s):

Nutritional Status ◽

Dietary Diversity ◽

Urban Slum ◽

Normal Weight ◽

Background Information ◽

Food Groups ◽

Child Feeding ◽

Severe Stunting ◽

Significant Difference ◽

Mother And Child

Dietary diversity is a measure of the number of individual foods or food groups consumed in a given period of time. Consumption of more diverse diets is one of the many approaches to improve the nutrition situation. Malnutrition is linked with quality and quantity of dietary intake. A higher dietary diversity has been associated with better nutritional status in an individual. The present study was designed to assess the dietary diversity of the mother and her child, their nutritional status, and any association between these. The sample comprised of mothers (n=100) and their children aged, 2-5 years (n=100), residing in Shakurpur, an urban slum of Delhi, India. Data on background information, obstetric history, household characteristics, and hygienic practices followed by the mother for herself and for her child, morbidity profile of mother and child, immunization, child feeding practices and birth information, were collected. Anthropometric measurements were taken for both mother and child and were analysed using Anthro plus software MDD-W (2016). Moderate wasting, underweight, and stunting were observed in 5%, 18%, and 20% of children respectively, as compared to severe wasting (4%), severe underweight (4%), and severe stunting (10%). No significant difference was observed in the height and weight of boys and girls. A greater proportion of mothers of pre-schoolers were either pre-obese (20%) or obese (9%) than underweight (3%) as per WHO classification, while a little over half (68%) the mothers were of normal weight. The mother’s nutritional status was significantly associated with all the indicators of her child’s nutritional status (p=0.00). More than 50% of the study population (both mothers and children) were consuming ≥5 food groups. Inadequacy in dietary diversity was more in mothers (49%) than children (42%). An association between maternal dietary diversity and child dietary diversity (χ2= 14.577, p=0.000) was observed. However, no association was found between dietary diversity of either the child or the mother and the nutritional status of the children (p>0.05). Thus, the present study showed that the diet of the mother and her child as well as the nutritional status of a mother and her child are associated. This re- emphasizes the fact that a mother and child are very closely related.

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

10.21203/rs.2.16657/v3 ◽

2019 ◽

Author(s):

Ahmed Gharib Khamis ◽

Akwilina Wendelin Mwanri ◽

Julius Edward Ntwenya ◽

Katharina Kreppel

Keyword(s):

Fruits And Vegetables ◽

Dietary Diversity ◽

Secondary Data ◽

Food Groups ◽

Child Feeding ◽

Young Child Feeding ◽

Child Feeding Practices ◽

Infant And Young Child ◽

Eastern And Southern Africa ◽

Nutritional Status Of Children

Abstract Background:Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have been identified as the main causes for undernutrition. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania. Methods: Using existing data from the Tanzania Demographic and Health Survey of 2015-2016, we carried out secondary data analysis. Stunting, wasting and underweight were calculated based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups eaten the previous day as reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight. Results: A total of 2,960 children were enrolled in this study. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a significantly higher likelihood of being stunted (AOR=1.37, 95% CI; 1.13-1.65) and underweight (AOR=1.49, 95% CI; 1.15-1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children. Conclusion: Consumption of a diverse diet is associated with a reduction in undernutrition among children of 6 to 23 months in Tanzania. Measures to improve the type of complementary foods in order to meet the energy and nutritional demands of children should be considered in Tanzania.

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