scholarly journals The Role of Household Structure and Composition in Influencing Complementary Feeding Practices in Ethiopia

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 130
Author(s):  
Asnake Ararsa Irenso ◽  
Dan Chamberlain ◽  
Miaobing Zheng ◽  
Karen J. Campbell ◽  
Rachel Laws
Keyword(s):  
Complementary Feeding ◽  
Dietary Diversity ◽  
Random Effect ◽  
Feeding Practices ◽  
Household Composition ◽  
Household Structure ◽  
Category Effect ◽  
Age Diversity ◽  
Composition And Structure ◽  
Average Marginal Effects

While the household in which a child grows up is considered a critical environment that influences nutrition outcomes, there is little research examining the influence of household composition and structure on complementary feeding practices. This study examined the influence of household structure and composition on complementary feeding practices, using the Ethiopian Demographic and Health Survey (EDHS), 2000 to 2016. The composition variables were calculated from the attributes of household members (alters) and the structure variables from their kinship status. A multilevel mixed-effects regression model, specifying survey rounds as the random effect, was used to examine the association between household structure/composition and the Minimum Meal Frequency (MMF) and Minimum Dietary Diversity (MDD). The average Marginal Effects (MEs) were calculated to facilitate practical interpretation. Children of caregivers with a higher number of alters (degree), unique number of kinship category (effect size), closely related (constraint), and mixed-age alters (age diversity) seemed to increase the probability of meeting the MDD. Degree and effective size decreased the probability of meeting MMF, while constraint increased it. Overall, this study revealed some associations between household structure and composition and complementary feeding practices. Hence, complementary feeding interventions could be adapted to account for the household structure and composition variations.

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.

scholarly journals Determinants and Current Level of Optimal Complementary Feeding Practices among Lactating Mothers of Children in Ambo Town, Oromia, Ethiopia

2020 ◽  
Vol 1 (1) ◽  
pp. 31-50
Author(s):  
Haile Abebe ◽  
◽  
Belay Assefa ◽  
Keyword(s):  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Current Level ◽  
Meal Frequency ◽  
Maternal Knowledge ◽  
Complementary Foods ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test

An appropriate diet is critical in the growth and development of children especially in the first two years of life. Poor complementary feeding of children aged 6 months - 23 months contributes to the characteristics negative growth trends and deaths observed in developing countries. Therefore, this study aimed to assess determinants and current level of optimal complementary feeding practices among mothers of children aged 6 months to 23 months in Ambo town, Oromia Region. The study used cross sectional study design and targeted 336 mothers with children 6 months - 23 months olds. Information from the respondents were collected using standard questionnaire. Data entry and analysis was done using SPSS version 21.0 windows statistical software. All (100%) the children 6 months - 8 months old had received solid, semi-solid/soft foods. The minimum meal frequency was attained by 88.3% (95% CI 84.3-91.4) whereas the minimum dietary diversity was attained by 17.9% (95% CI 14.1-22.5). The minimum acceptable diet was attained by 15.4% (95% CI 11.9-19.8). Maternal knowledge on: importance of breastfeeding (87.3%); age of introduction of complementary foods (85.4%) and correct meal frequency for age (74.5%) was high. On the contrary, knowledge on the importance of enriching complementary foods (34.5%) was low. Mothers who knew the importance of a diverse diet were likely (chi-square test; p=0.001) to feed their children on a diverse diet. On the other hand, mothers who knew the importance of enriching complementary foods were likely to feed their children on a minimum acceptable diet (chi-square test; p = 0.007) and maternal knowledge on enriching complementary foods (OR = 3.41, p = 0.040) were significant predictors of consumption of Vitamin A rich foods, minimum meal frequency and minimum acceptable diet, respectively. Behaviour change and communication involving all the stakeholders in infant and young child feeding should be emphasized. Messages on appropriate feeding practices should include importance of dietary diversity

scholarly journals Factors Associated With Recommended Complementary Feeding Practices Among Children in Sidama and Oromia Regions in Ethiopia

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 164-164
Author(s):  
Ana Moyeda Carabaza ◽  
Mary Murimi ◽  
Alemneh Kabeta Daba ◽  
Jessie Vipham
Keyword(s):  
Food Insecurity ◽  
International Development ◽  
Nutrition Education ◽  
Maternal Employment ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Cross Sectional ◽  
Factors Associated ◽  
Feed The Future

Abstract Objectives To determine complementary feeding practices (CFP) among 6-to-23-month-old children and to identify associations between maternal and household characteristics with CFP. Methods Cross-sectional study conducted among rural communities located within the Sidama and Oromia regions in Ethiopia. Pairs of mothers and their children (N = 190) were randomly selected to participate in the survey. Data was collected using the WHO Infant and Young Child Feeding indicators, Household Food Insecurity Access Scale, and Knowledge on CFP. Multivariate logistic regressions were used to analyze factors associated with CFP. Results Most (87.4%) of the children achieved minimum meal frequency, while only 27.4% achieved minimum dietary diversity (MDD) and 26.8% minimum acceptable diet (MAD). Majority (80%) of the households were food insecure, with 40% of the households reporting severe food insecurity. Half (50.0%) of participating mothers showed poor levels of knowledge on CFP. Children of employed mothers were more likely to meet MDD (P = .014) and achieve MAD (P = .034). Furthermore, children of mothers that had adequate knowledge on the recommended CFP were more likely to achieve MDD (P < .001) and MAD (P < .001). In contrast, children living in households with an estimated annual income lower than $254 dollars were less likely to achieve MDD (P < .05) and MAD (P < .05). Similarly, children living in households with moderate to severe levels of food insecurity were less likely to achieve MDD (P = .003 and P = .012, respectively) and MAD (P = .005 and P = .023, respectively). Conclusions Complementary feeding practices were suboptimal in the Sidama and Oromia region in Ethiopia. Low household income and food insecurity seem to hinder the achievement of MDD and MAD, while maternal employment and knowledge on CFP contributed to a diversified and adequate diet among children. Thus, policies and interventions that target poverty, food insecurity, maternal unemployment, and nutrition education are necessary for the improvement of CFP. Funding Sources United States Agency for International Development (USAID) Bureau for Food Security as part of Feed the Future Innovation Lab for Livestock Systems.

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

2011 ◽  
Vol 15 (5) ◽  
pp. 827-839 ◽  
Author(s):  
Charmaine S Ng ◽  
Michael J Dibley ◽  
Kingsley E Agho
Keyword(s):  
Health Survey ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Demographic And Health Survey ◽  
Community Level ◽  
Meal Frequency ◽  
Factors Associated ◽  
Individual Household ◽  
Minimum Dietary Diversity

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.

scholarly journals Maternal Knowledge, Attitudes, and Practices of Complementary Feeding and Child Undernutrition in the Vakinankaratra Region of Madagascar: A Mixed-Methods Study

2020 ◽  
Vol 4 (11) ◽  
Author(s):  
Hasina Rakotomanana ◽  
Deana Hildebrand ◽  
Gail E Gates ◽  
David G Thomas ◽  
Fanjaniaina Fawbush ◽  
...  
Keyword(s):  
Low Income ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Child Growth ◽  
Maternal Knowledge ◽  
Complementary Foods ◽  
Child Feeding ◽  
Attitudes And Practices ◽  
Child Undernutrition

ABSTRACT Background Data are limited on how feeding knowledge and practices relate to child undernutrition in the highlands of Madagascar. Objectives This study assessed maternal knowledge and practices of complementary feeding and their associations with anthropometrics of children aged 6–23 mo in the Vakinankaratra region of Madagascar. Methods Knowledge was assessed using WHO recommendations on child feeding, and WHO infant and young child feeding (IYCF) indicators were used to evaluate feeding practices. Child growth was measured as length-for-age, weight-for-age, and weight-for-length z-scores using the 2006 WHO growth standards. A z-score less than −2 was classified as child undernutrition. Logistic regression models were used to determine associations between independent variables and outcomes. Focus group discussions among mothers and in-depth interviews with key informants were conducted; barriers and facilitators of optimal feeding practices were identified using a thematic analysis approach. Results Maternal knowledge scores regarding child feeding averaged 6.4 of 11. Better knowledge scores were associated with higher odds of appropriate complementary feeding practices before and after covariate adjustments. The proportions of children achieving the minimum dietary diversity (35.8%), minimum acceptable diet (30.2%), and consuming meat, fish, and poultry (14.1%) were low. Only consumption of iron-rich foods was associated with lower odds of underweight (adjusted OR = 0.3; 95% CI: 0.1, 0.7; P < 0.05). None of the IYCF indicators were associated significantly with stunting or wasting. Maternal attitudes about complementary foods, as well as mothers’ workload and very low income, were identified as barriers to optimal feeding practices. Maternal perceived benefits of giving appropriate complementary foods as well as their positive relationship with the community health workers were the main facilitators of optimal child feeding. Conclusions Integrated nutrition-sensitive interventions addressing these barriers while enhancing the facilitators are critical in promoting better feeding practices in the Vakinankaratra region.

scholarly journals Complementary Feeding Practices and Associated Factors Among Infants and Young Children 6–23 Months in Fort Portal Kabarole District Uganda (P11-049-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Sharon Bagaaya ◽  
Henry Wamani ◽  
Richard Kajura
Keyword(s):  
Young Children ◽  
Low Income ◽  
Associated Factors ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Child Feeding ◽  
Cross Sectional ◽  
Infants And Young Children

Abstract Objectives To determine the prevalence of appropriate complementary feeding practices and associated factors among infants and young children 6–23 months in Fort Portal municipality Kabarole Uganda Methods A community based cross sectional study was conducted among 206 mothers/caregivers of infants and young children 6–23 months using both quantitative and qualitative methods. Probability proportionate to population size technique was used to select study subjects. A pretested WHO standard questionnaire for measuring infant and young child feeding practices was adopted for assessing complementary feeding practices. Appropriate complementary feeding was defined as attaining both minimum meal frequency and minimum dietary diversity in the last 24 hours. Prevalence ratios and there 95% confidence intervals were generated. Modified poisson regression analysis method was used to generate factors associated with appropriate complementary feeding. Five focus group discussions were conducted to capture participants perceptions on appropriate complementary feeding practices. Results The prevalence of appropriate complementary feeding was 21.4%. Formal employment (PR: 7.05; CI:1.69-29.36), cohabiting (PR: 2.15; CI: 1.10-4.18) and having no child illness (PR: 1.85; CI: 0.88-4.35) were associated with appropriate complementary feeding. Qualitative results showed that inadequate information and low income as major challenges towards appropriate complementary feeding practices. Conclusions Appropriate complementary feeding practices were low. unless interventions such as; health services access and women entrepreneurship are put in place, the inappropriate complementary feeding practices are unlikely to change. Funding Sources Ministry of Health Uganda. Supporting Tables, Images and/or Graphs

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 Understanding Complementary Feeding Practices in Children 6–23 Months in the West and Central Africa Region: A Mixed Methods Regional Analysis of 24 Countries

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 871-871
Author(s):  
Muzi Na ◽  
Anne-Sophie Le Dain ◽  
Stephen Kodish ◽  
Laura Murray-Kolb ◽  
Raphia Ngoutane ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Literature Review ◽  
Vitamin A ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Phase 1 ◽  
Feeding Practices ◽  
Phase 2 ◽  
Factors Influencing ◽  
Modifiable Factors

Abstract Objectives 1) To describe the trends of complementary feeding since 2010; 2) to understand the factors influencing the sub-optimal feeding practices; and 3) to generate recommendations to inform future interventions. Methods Mixed methods study with an iterative, two phase design. Phase 1: quantitative data analysis of 13 key complementary feeding indicators reported in 68 national survey reports from 2010 to 2018. Phase 2: semi-structured qualitative interviews with 14 regional informants (UN, Government, NGO, and donor communities). We conducted a literature review of grey and peer-reviewed publications in 2010–2019 to contextualize the results. Results Phase 1. Across 24 WCAR countries, mean continued breastfeeding at 1y was 89%, but halved to 44% by 2y. Introduction of complementary foods occurred in 64% of children 6–8 mos. Minimum meal frequency in children 6–23 mos increased over time from 27% to 38% while minimum dietary diversity and minimum acceptable diet were stagnant (22% and 10%, respectively) since 2010. Intake of nutrient rich foods (vitamin A, animal source, iron-rich) were reported in about half of children, respectively. The proportion of children (only reported for < 5 y) receiving vitamin A (66%), or iron supplements (15%), or iodized salt (79%) varied. Phase 2. Regionally, we identified policy, community, institutional, household, interpersonal, and individual level barriers. Additionally, non-modifiable factors including environmental shocks/hazards and security issues (i.e., violence), were said to disrupt food systems. From a systems perspective, major facilitators to optimal complementary feeding fell within the ‘health and nutrition’ or ‘food system’ sectors; fewer were ascribed to ‘WASH’ or ‘social protection’. Preliminary recommendations from key informants and supported by the literature review were largely multi-sectorial, yet a strong emphasis was placed on the policy level. Conclusions Since 2010, complementary feeding practices in WCAR have remained nearly unchanged. Inter-related factors influencing complementary feeding distribute across levels and sectors, suggesting the need for more multi-sectorial, integrated intervention strategies to improve child nutrition in WCAR. Funding Sources Bill & Melinda Gates Foundation funding to UNICEF-WCARO.

scholarly journals Maternal Attributes and Child Minimum Acceptable Diet during COVID-19 Pandemic in Indonesia

2021 ◽  
Vol 8 (2) ◽  
pp. 108
Author(s):  
Athiya Fadlina ◽  
Judhiastuty Februhartanty ◽  
Saptawati Bardosono
Keyword(s):  
Online Survey ◽  
Complementary Feeding ◽  
Dietary Diversity ◽  
Feeding Practices ◽  
Optimal Growth ◽  
P Value ◽  
Chi Square ◽  
Exact Test ◽  
Infant And Young Children ◽  
The Relationship

<p>Appropriate complementary feeding practices must be sustained during the COVID-19 pandemic for optimal growth and development of a child. However, the studies assessing factors associated with complementary feeding practices during COVID-19 are still limited. The objective of this study was to evaluate maternal attributes and minimum acceptable diet (MAD) of 6-11-month-old children during the COVID-19 pandemic in Indonesia. This study was part of the “COVID-19 Mom-Infant Study” and was conducted in all regions of Indonesia using an online survey. Chi-square or Fisher's exact test was performed to examine the relationship between MAD and maternal attributes, with a significant level at p-value &lt;0.05. From a total of 262 data collected, 74%, 77.1%, 94.3% of the children aged 6-11 months have met MAD, MDD (minimum dietary diversity), and MMF (minimum meal frequency), respectively. Mother’s education level (OR= 3.625; 95%CI [1.805 – 7.280]) and working status (OR= 2.197; 95%CI [1.291 – 3.895] were found associated with child’s MAD. One-third of children did not receive the recommended infant and young children feeding practices. Conducting nutrition interventions to mothers with lower education and not working should be a priority under these circumstances.</p>

scholarly journals Complementary feeding practices and associated factors among children aged 6–23 months in Pakistan

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247602
Author(s):  
Muhammad Ali ◽  
Muhammad Arif ◽  
Ashfaq Ahmad Shah
Keyword(s):  
Complementary Feeding ◽  
Dietary Diversity ◽  
Premature Mortality ◽  
Feeding Practices ◽  
Multivariate Regression Analysis ◽  
Child Feeding ◽  
Household Level ◽  
Individual Level ◽  
Young Child Feeding ◽  
The Individual

Premature mortality and undernutrition rates in Pakistan are among the highest in the world. Inadequate infant and young child feeding are the major causes of premature mortality and undernutrition. Yet, very little is known about the determinants of complementary feeding practices in Pakistan. Therefore, this study aims to identify the determinants of inadequate complementary feeding practices among children aged 6 to 23 months in Pakistan by using the latest nationally representative data from the Pakistan Demographic and Health Survey (2017–18). The results show that only 12% of children consume a minimum acceptable diet, 21% achieve minimum dietary diversity, and 38% reach minimum meal frequency. Multivariate regression analysis shows that child age, child weight at birth, mother’s access to newspapers/magazines at the individual level, wealth at the household level, and prenatal visits at the community level are significant predictors of complementary feeding practices among children aged 6–23 months in Pakistan. These findings show that, in addition to poverty alleviation, raising awareness through health practitioners, increasing access to media, and expanding access to child and maternal healthcare can improve complementary feeding practices in Pakistan. This consequently reduces premature mortality and undernutrition.

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