Children’s dietary diversity and related factors in Rwanda and Burundi: A multilevel analysis using 2010 Demographic and Health Surveys

Abstract

BackgroundOne of the reported causes of high malnutrition rates in Burundi and Rwanda is children's inadequate dietary habits. The diet of children may be affected by individual characteristics and by the characteristics of the households and the communities in which they live. We used the minimum dietary diversity of children (MDD-C) indicator as a proxy of diet quality aiming at: 1) assess how much of the observed variation in MDD-C was attributed to community clustering, and 2) to identify the MDD-C associated factors.MethodsData was obtained from the 2010 Demographic and Health Surveys of Burundi and Rwanda, from which only children 6 to 23 months from rural areas were analysed. The MDD-C was calculated according to the 2007 WHO/UNICEF guidelines. We computed the intra-class coefficient to assess the percentage of variation attributed to the clustering effect of living in the same community. And then we applied two-level logit regressions to investigate the association between MDD-C and potential risk factors following the hierarchical survey structure of DHS.ResultsThe MDD-C was 23% in rural Rwanda and 16% in rural Burundi, and a 29% of its variation in Rwanda and 17% in Burundi was attributable to community clustering. Increasing age and living standards were associated with higher MDD-C in both countries, and only in Burundi also increasing level of education of the mother's partner. In Rwanda alone, the increasing ages of the head of the household and of the mother at first birth were also positively associated with it. Despite the identification of an important proportion of the MDD-C variation due to clustering, we couldn't identify any community variable significantly associated with it.ConclusionsWe recommend further research using hierarchical models, and to integrate dietary diversity in holistic interventions which take into account both the household's and the community's characteristics the children live in.

Dietary Diversity and Associated Factors among Children Aged 6-59 Months in Ethiopia: Analysis of Ethiopian Demographic and Health Survey 2016 (EDHS 2016)

“…Furthermore, it is higher than the study in Kenya (6.8%) [31]. However, it is lower compared to the study conducted in Rwanda and Burundi Demographic and Health Surveys (Rwanda 23%, Burundi 16%) [32]; Tanzania [33]; Addis Ababa, Ethiopia 59.9% [34]; and Morondava (47.6%) and Moramanga (42.1%) districts of Madagascar, respectively [35].…”

Association of Infant and Child Feeding Index with Undernutrition in Children Aged 6–59 Months: A Cross-Sectional Study in the Maldives

“…21,22 Earlier, it has also shown that inadequate dietary habits and feeding practices are the proximate causes of undernutrition in children. 6 According to the UNICEF, undernutrition, including underweight, stunting, and wasting, is the outcome of insufficient dietary intake and infectious diseases. 23 There were certain limitations to this study.…”

“…Poor feeding practices and inadequate dietary practices in infants and children, along with infectious diseases, are the causes of child undernutrition. 6,7 Moreover, feeding practices are associated with physical development, and improper feeding practices lead to poor physical development in infants and young children. 8 Consuming fewer food groups high in protein and calcium like milk products and poultry/meat may be a causing factor for child malnutrition, especially stunting.…”

Overweight and obesity among under-five children in South Asia

“…Consumption of each group was scored "1" or "0" if otherwise. The total score ranged from 0 to 7 and was classified as adequate (≥4), and inadequate (≤3) (Custodio et al 2019). Maternal level explanatory variables included education, parity and body mass index.…”