Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia

Gebremedhin, Samson; Baye, Kaleab; Bekele, Tamrat; Tharaney, Manisha; Asrat, Yonas; Abebe, Yewelsew; Reta, Nigusse

doi:10.1016/j.nut.2016.06.002

Cited by 61 publications

(72 citation statements)

References 15 publications

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“…The possible reason might be that Ethiopia as a multiethnic country has diverse geographic and weather conditions which may affect the accessibility of adequate dietary diversity. However, our result was higher than those of studies conducted in the Slum areas of Bahir Dar city (20%) [25], Dangilla, northwest Ethiopia (12.6%) [12], Gorche district, Southern Ethiopia(10,6%) [13] and North Wollo zone, north east Ethiopia (7%) [26]. The possible reason might be differences in study times or times of data collection.…”

Section: Discussioncontrasting

confidence: 83%

Sustainable under nutrition reduction program and dietary diversity among children’s aged 6–23 months, Northwest Ethiopia: Comparative cross-sectional study

Worku

Gonete

Muhammad

et al. 2020

Int J Equity Health

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Introduction: Adequate dietary diversity is vital for the survival, growth and development of infants and children. Inadequate dietary diversity is the major cause of micronutrient deficiency in Sub-saharan Africa, including Ethiopia, where only less than one-fourth of the children aged 6-23 months obtain adequate diversified diet. Thus country implemented a strategy known as the Sustainable Undernutrtion Reduction (SUR) programs to alleviate the problem. However, empirical evidences are scarce on the impact of the program on children aged 6-23 months. Therefore, this study aimed to compare the level of dietary diversity among children aged 6-23 months in districts covered and not covered by SURE program in West Gojjam zone. Methods: A community based comparative cross-sectional study was conducted in three districts of West Gojjam zone, Ethiopia, from February 29 to April 20, 2019. A total of 832 mother and child pairs were selected by the simple random sampling technique. A pretested and structured interviewer-administered questionnaire was used to collect data. A binary logistic regression model was fitted to identify factors associated with dietary diversity. Crude odds and adjusted odds ratios with 95% confidence intervals (CI) were calculated to assess the strength of associations and significance of the identified factors for dietary diversity score. Result: The overall proportion of adequate dietary diversity among children aged 6-23 months was 29.9% (95% CI: 27.0-33.0), whereas in SURE covered and uncovered districts it was 33.4% (95%CI: 29.0-38.and 26.4%(95% CI: 22.0, 31.0), respectively. ANC (Antenatal care) (AOR = 1.7; 95% CI: 1.16, 2.55) and postnatal care services (AOR = 2.1; 95% CI: 1.38, 3.28), participating in food preparation programs (AOR = 1.9; 95% CI: 1.19, 2.96), GMP (AOR = 2.74,95%CI: 1.80, 4.18), vitamin A supplementation (AOR = 2.10,95%CI:1.22, 3.61) and household visits by health extension workers (AOR = 2.0; 95% CI: 1.25, 3.21) were significantly associated with dietary diversity. Conclusion: The proportion of adequate dietary diversity was higher among children in the program than those out of the program. ANC visits, PNC follow-ups, women's participating in food preparation programs and household visits by health extension workers were significantly associated with dietary diversity. Therefore, and strengthening and scaling up the program to non covered districts and providing health and nutrition counseling on Infant and Young Child Feeding (IYCF) during ANC and PNC services are recommended for achieving the recommended dietary diversity.

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Section: Discussioncontrasting

confidence: 83%

Sustainable under nutrition reduction program and dietary diversity among children’s aged 6–23 months, Northwest Ethiopia: Comparative cross-sectional study

Worku

Gonete

Muhammad

et al. 2020

Int J Equity Health

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“…Indeed, in this and other similar LMIC settings, socioeconomic status and maternal education were found associated with complementary feeding practices (Fein, Labiner‐Wolfe, Scanlon, & Grummer‐Strawn, ). Nutrition education through the health extension programme in Ethiopia has been shown to improve knowledge and practice of complementary feeding to varying extents (Gebremedhin et al, ). This high variability in impact can be related to inconsistent levels of counseling skills of HEWs but could also be determined by the aptitude of caregivers to integrate and practice recommended actions.…”

Section: Discussionmentioning

confidence: 99%

Maternal depression is associated with child undernutrition: A cross‐sectional study in Ethiopia

Anato

Baye

Tafese

et al. 2019

Maternal & Child Nutrition

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Child undernutrition is widespread in low‐ and middle‐income countries (LMIC) and is associated with health and economic losses. Undernutrition is estimated to contribute to 3.1 million deaths per year in children less than 5 years of age. A complex causal and contextual factors contributing to child undernutrition have been assessed, but maternal depression, which could contribute to child undernutrition by interfering with the mother's child caring practice and ability, has been received little attention. The objective of this study was to assess the association between maternal postpartum depression symptoms and infant (5–10 months of age) stunting in northern Ethiopia. A community‐based cross‐sectional study was conducted among mother–infant pairs (n = 232) between March and April 2018. Through interviewer‐administrated questionnaire, information on sociodemographic variables were collected, and maternal depression symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS≥13). Infants' length and weight were measured and converted to length and weight for age Z scores using the WHO growth standards. Breastfeeding was a norm, but the adequacy of complementary feeding practice was sub‐optimal. Only 25% of the infants met the minimum meal frequency (MMF), less than 10% met the minimum dietary diversity (MMD; 9%) or minimum acceptable diet (7%). Maternal depression was prevalent (22.8%) and was significantly associated with inappropriate complementary feeding and stunting (P < .05). Improving complementary feeding practices is central to preventing stunting in this and other settings. However, such efforts should integrate interventions that address maternal depression to improve child feeding and caring practices to effectively prevent stunting.

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“…This further highlights the importance of interventions that improve feeding practices during this critical period of complementary feeding. We have previously reported that knowledge of caregivers about IYCF remain suboptimal and that delivery of nutrition education through the use of the health extension system can be instrumental, provided that the knowledge‐sharing effectiveness and counseling skills of health workers are adequate (Abebe, Haki, & Baye, ; Gebremedhin et al, ).…”

Section: Discussionmentioning

confidence: 99%

“…Instead, the corresponding RNI values are given. the knowledge-sharing effectiveness and counseling skills of health workers are adequate (Abebe, Haki, & Baye, 2016;Gebremedhin et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia

Abebe

Haki²,

Baye

2017

Maternal & Child Nutrition

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Home fortification of complementary foods (CFs) with multiple micronutrient powders (MNPs) is being scaled up in various countries, but little is known about the prevailing complementary feeding practices and the type and nutrient gaps to be filled with MNPs. The present study evaluated the complementary feeding practices of young children and simulated the risk of inadequate and excessive intakes associated with home fortification with MNPs. We have assessed the sociodemographic status, anthropometry, and complementary feeding practices of young children (N = 122) in Mecha district, rural Ethiopia. Using a 2-day, quantitative 24-hr recall, usual intakes of energy, protein, iron, zinc, and calcium were estimated. The risks of inadequate and excessive iron and zinc intakes with or without home fortification scenarios were assessed. The simulations considered intakes from CFs assuming average breast milk contributions and additional nutrients provided by the MNPs. Stunting was highly prevalent (50%) and was associated with a lower dietary diversity (P = .009) and nutrient intakes from the CFs. Median energy, zinc, and calcium intakes were below the estimated needs from CFs; protein needs were met. Median dietary iron intake appeared adequate, but 76%, 95% CI [68%, 84%], of children had inadequate intake (assuming low bioavailability), whereas another 8%, 95% CI: [3%, 13%], had excessive intakes.Simulation of daily and alternative day's fortification with MNP decreased the prevalence of inadequate iron and zinc intake but significantly increased the risk of excessive intakes that remained unacceptably high for iron (>2.5%). Untargeted MNP interventions may lead to excessive intakes, even in settings where poor complementary feeding practices are prevalent. | Sample size determinationAs part of a larger study that investigated child feeding, sample size calculations were made to enable comparison of two groups such as stunted or nonstunted and trained vs. untrained. The sample size was determined from power analyses calculated to detect a medium effect size (0.5 SD difference between with an α of 0.05 and power of 0.08).The estimated sample size was adjusted and rounded to 122 to allowfor an approximately 15% nonresponse rate. Our data and sample size allowed us to characterize the mean energy intake with a 95%confidence interval of approximately AE30 kcal. The variance (between-subject; within-subject) were estimated for Fe (0.69; 0.32), Zn (0.34; 0.68), and Ca (0.34; 0.68). | SamplingTen kebeles (smallest administrative unit) that are accessible enough for the collection of perishable samples were randomly selected. All households with children 12-23 months were identified by a census carried out before the survey. From each kebele, 12 children were randomly selected to participate in the study. The inclusion criteria were for the mother and child to reside permanently in the study area and for the child to be breastfed and apparently healthy. In the rare cases, when several children in the same househo...

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Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia

Cited by 61 publications

References 15 publications

Sustainable under nutrition reduction program and dietary diversity among children’s aged 6–23 months, Northwest Ethiopia: Comparative cross-sectional study

Sustainable under nutrition reduction program and dietary diversity among children’s aged 6–23 months, Northwest Ethiopia: Comparative cross-sectional study

Maternal depression is associated with child undernutrition: A cross‐sectional study in Ethiopia

Simulated effects of home fortification of complementary foods with micronutrient powders on risk of inadequate and excessive intakes in West Gojjam, Ethiopia

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