scholarly journals Complementary feeding practices in 80 low- and middle-income countries: prevalence and socioeconomic inequalities in dietary diversity, meal frequency and dietary adequacy

2020 ◽  
Author(s):  
Giovanna Gatica-Domínguez ◽  
Paulo A. R. Neves ◽  
Aluísio J. D. Barros ◽  
Cesar G. Victora
Keyword(s):  
Child Nutrition ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Socioeconomic Inequalities ◽  
Meal Frequency ◽  
Socioeconomic Indicators ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

ABSTRACTObjectiveTo describe patterns and socioeconomic inequalities in complementary feeding practices among children aged 6-23 months in 80 low and middle-income countries (LMICs).MethodsWe analyzed national surveys carried out since 2010. Complementary feeding indicators for children aged 6-23 months included minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD). Between- and within-country inequalities were documented using relative (wealth deciles) and absolute (estimated household income) socioeconomic indicators.ResultsOnly 21.3%, 56.2% and 10.1% of the 80 countries showed prevalence levels above 50% for MDD, MMF and MAD, respectively. Western & Central Africa showed the lowest prevalence for all indicators, whereas the highest for MDD and MAD was Latin America & Caribbean, and for MMF in East Asia & the Pacific. Log per capita gross domestic product was positively associated with MDD (R2 = 48.5%), MMF (28.2%) and MAD (41.4%). Pro-rich within-country inequalities were observed in most countries for the three indicators; pro-poor inequalities were observed in two countries for MMF, and in none for the other two indicators. Breastmilk was the only type of food with a pro-poor distribution, whereas animal-source foods (dairy products, flesh foods and eggs) showed the most pronounced pro-rich inequality. Dietary diversity improved sharply when absolute annual household incomes exceeded about US$20,000. There were no consistent differences among boys and girls for any of the indicators studied.ConclusionMonitoring complementary feeding indicators in the world and implementing policies and programs to reduce wealth-related inequalities are essential to achieve optimal child nutrition.

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

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.

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

2014 ◽  
Vol 18 (4) ◽  
pp. 669-678 ◽  
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.

Socioeconomic inequalities in unhealthy lifestyles in low- and middle-income countries

2020 ◽  
Author(s):  
Charlotte Dieteren ◽  
Igna Bonfrer
Keyword(s):  
Alcohol Use ◽  
Tobacco Use ◽  
Socioeconomic Inequalities ◽  
Individual Characteristics ◽  
Middle Income ◽  
The Sustainable Development ◽  
Middle Income Countries ◽  
The Poor ◽  
Harmful Alcohol ◽  
Low And Middle Income

Abstract Background: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce unhealthy lifestyles. To effectively target these interventions, it is important to know how unhealthy lifestyles vary with socioeconomic characteristics. This study quantifies prevalence and socioeconomic inequalities in unhealthy lifestyles in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030.Methods: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with different unhealthy lifestyles.Results: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is “often or sometimes drunk” compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively -0.147, -0.210, -0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI -0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off.Conclusions: This study emphasizes the importance of unhealthy lifestyles in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in unhealthy lifestyles - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted.

scholarly journals The Effects of Community Home Visit and Peer Group Nutrition Intervention Delivery Platforms on Nutrition Outcomes in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 440 ◽  
Author(s):  
Amynah Janmohamed ◽  
Nazia Sohani ◽  
Zohra Lassi ◽  
Zulfiqar Bhutta
Keyword(s):  
Home Visit ◽  
Dietary Diversity ◽  
Peer Group ◽  
Meta Analysis ◽  
Home Visits ◽  
Nutrition Intervention ◽  
Middle Income ◽  
Intervention Delivery ◽  
Middle Income Countries ◽  
Low And Middle Income

Weak delivery systems reduce the potential of evidence-supported interventions to improve nutrition. We synthesized the evidence for the effectiveness of nutrition-specific intervention delivery platforms for improving nutrition outcomes in low and middle-income countries (LMIC). A systematic literature search for studies published from 1997 to June 2018 resulted in the inclusion of 83 randomized controlled trials (RCTs), quasi-randomized, and controlled before–after studies across a variety of delivery platforms. In this paper, we report on meta-analysed outcomes for community health worker (CHW) home visits and mother/peer group delivery platforms. Compared to care as usual, CHW home visits increased early initiation of breastfeeding (EIBF) (OR: 1.50; 95% CI: 1.12, 1.99; n = 10 RCTs) and exclusive breastfeeding (EBF) (OR: 4.42; 95% CI: 2.28, 8.56; n = 9 RCTs) and mother/peer groups were effective for improving children’s minimum dietary diversity (OR: 2.34; 95% CI: 1.17, 4.70; n = 4) and minimum meal frequency (OR: 2.31; 95% CI: 1.61, 3.31; n = 3). Pooled estimates from studies using both home visit and group platforms showed positive results for EIBF (OR: 2.13; 95% CI: 1.12, 4.05; n = 9), EBF (OR: 2.43; 95% CI: 1.70, 3.46; n = 12), and < 5 wasting (OR: 0.77; 95% CI: 0.67, 0.89; n = 4). Our findings underscore the importance of interpersonal community platforms for improving infant and young child feeding practices and children’s nutritional status in LMICs.

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