Implications of Updating the Minimum Dietary Diversity for Children Indicator for Tracking Progress in the Eastern and Southern Africa Region

Heidkamp, Rebecca; Kang, Yunhee; Chimanya, Kudakwashe; Garg, Aashima; Matji, Joan; Nyawo, Mara; Craig, Hope; Arimond, Mary; Lyman, Andrew L Thorne

doi:10.1093/cdn/nzaa141

Cited by 14 publications

(14 citation statements)

References 13 publications

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“…The study, however, had several limitations. First, minimum dietary diversity was defined as the proportion of children aged 6–23 months who consumed ≥4 of 7 food groups (minimum dietary diversity—7) in the previous 24 h instead of ≥5 of 8 food groups (minimum dietary diversity—8) in the previous 24 h as reported [ 62 ], but a current study that examines minimum dietary diversity in eastern and southern African regions indicated that confidence intervals for prevalence estimates regarding minimum dietary diversity—7 and minimum dietary diversity—8 overlapped in most eastern and southern African countries [ 63 ]. Second, this study did not consider the new IYCF indicators such as mixed milk feeding, sweet beverage consumption, unhealthy food consumption, and zero vegetable or fruit consumption, which was reported in the 2020 IYCF indicators [ 62 ], Third, several discussed factors associated with IYCF practices may differ for adolescent and adult mothers.…”

Section: Discussionmentioning

confidence: 99%

Infant and Young Child Feeding Practices among Adolescent Mothers and Associated Factors in India

et al. 2021

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Adequate infant and young child feeding (IYCF) improve child survival and growth. Globally, about 18 million babies are born to mothers aged 18 years or less and have a higher likelihood of adverse birth outcomes in India due to insufficient knowledge of child growth. This paper examined factors associated with IYCF practices among adolescent Indian mothers. This cross-sectional study extracted data on 5148 children aged 0–23 months from the 2015–2016 India National Family Health Survey. Survey logistic regression was used to assess factors associated with IYCF among adolescent mothers. Prevalence of exclusive breastfeeding, early initiation of breastfeeding, timely introduction of complementary feeding, minimum dietary diversity, minimum meal frequency, and minimum acceptable diet rates were: 58.7%, 43.8%, 43.3%, 16.6%, 27.4% and 6.8%, respectively. Maternal education, mode of delivery, frequency of antenatal care (ANC) clinic visits, geographical region, child’s age, and household wealth were the main factors associated with breastfeeding practices while maternal education, maternal marital status, child’s age, frequency of ANC clinic visits, geographical region, and household wealth were factors associated with complementary feeding practices. IYCF practices among adolescent mothers are suboptimal except for breastfeeding. Health and nutritional support interventions should address the factors for these indicators among adolescent mothers in India.

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Section: Discussionmentioning

confidence: 99%

Infant and Young Child Feeding Practices among Adolescent Mothers and Associated Factors in India

et al. 2021

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“…Much of the validation work related to the child MDD indicator to date has focused on its ability to serve as a proxy for nutrient adequacy ( 27 , 28 ). Subsequently, refinement of the indicator from a 7-item to an 8-item score including breast milk took place to improve its utility as a more comprehensive indicator of children's diets during the 6- to 23-mo period ( 10 , 11 ). However, even though patterns in food insecurity and food availability are known to be seasonal in many rural contexts, we believe that this is the first study to examine the seasonality of the MDD indicator from the perspective of understanding its validity for monitoring high-level changes in diet quality over time (i.e., the type of monitoring done by UN agencies, governments, and global accountability initiatives).…”

Section: Discussionmentioning

confidence: 99%

“…MDD is a core indicator in the WHO Global Nutrition Monitoring framework, and national estimates are tracked over time for all WHO member states ( 9 ). Many low- and middle-income countries (LMICs) have set national and subnational targets for MDD related to reducing the proportion of children with a low MDD or minimum acceptable diet (MAD), an indicator derived in part from MDD ( 10 ). Country profiles for the Global Nutrition Report, a global nutrition accountability report, include both MDD and MAD ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

Season of Data Collection of Child Dietary Diversity Indicators May Affect Conclusions About Longer-Term Trends in Peru, Senegal, and Nepal

Thorne‐Lyman

Bevis

Kuo

et al. 2021

Current Developments in Nutrition

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Background The WHO-UNICEF minimum dietary diversity (MDD) indicator for children aged 6–23 months is a global monitoring indicator used to track multi-year population-level changes in dietary quality, but the influence of seasonality on MDD estimates remains unclear. Objective Examine how seasonality of data collection may influence population-level MDD estimates and inferences about MDD change over multiple survey years. Methods Three countries were selected with three or more consecutive years of MDD data collection including continuous national Demographic Health Surveys in Senegal (2012–2017, N = 12,183) and Peru (2005–16, N = 35,272) and the PoSHAN sentinel site seasonal surveys (covering 3 seasons/year) in Nepal (2013–2016, N = 1309). MDD prevalence (≥5 of 8 food groups) and an 8-item continuous food group score (FGS) and 95% confidence intervals were estimated by month and compared for lean and non-lean seasons using Ordinary Least Squares (OLS) regression with dummy variables for year. Results The national prevalence of MDD was higher in Peru (75.4%) than in Nepal (39.1%) or in Senegal (15.7%). Children in Peru were 1.8% [coefficient: –0.0179 (–0.033, –0.002)] less likely to achieve MDD during the lean season. Similar seasonal magnitudes were observed in Senegal [–0.0347, (–0.058, –0.011)] and for Nepal [–0.0133 (–0.107, 0.081)]. FGS was about 0.1 item lower during the lean season in all three countries. In comparison, MDD increased by an average rate of only 4.2 and 4.4 percentage points per five years in Peru and Senegal respectively. Intake of specific food groups was stable across months in all countries with the provitamin-A rich food group exhibiting the most seasonality. Conclusions The magnitude of seasonal variation in MDD prevalence was smaller than expected but large relative to longer term changes. If large-scale surveys are not conducted in the same season, biased conclusions about trends are possible.

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“…Understanding the trends and determinants of dietary diversity may help explain the progress towards global infant and young child nutrition targets, thus improving the design of programme interventions (19) . Moreover, it is critical to conduct a study using the MDD-8 indicator due to the country's transition to the new measure and the need for a valid interpretation of dietary diversity trends and determinants (12) . Thus, this study aimed to examine the trends and determinants of MDD-8 among children aged 6-23 months using nationally representative data collected from the 2007, 2012 and 2017 IDHS.…”

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confidence: 99%

Trends and determinants of minimum dietary diversity among children aged 6–23 months: a pooled analysis of Indonesia Demographic and Health Surveys from 2007 to 2017

Paramashanti

Huda

Alam

et al. 2021

Public Health Nutr.

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Objective: To examine minimum dietary diversity (MDD) trends and determinants among children aged 6–23 months. Design: Secondary analysis of the Indonesia Demographic and Health Surveys (IDHS) between 2007 and 2017. The primary outcome was MDD, the consumption of at least five out of eight food groups (MDD-8). We included a total of 5015 (IDHS 2007), 5050 (IDHS 2007) and 4925 (IDHS 2017) children aged 6 to 23 months to estimate trends of MDD-8 and to identify factors associated with MDD-8. We used multiple logistic regression analysis adjusted for the complex sampling design to investigate the association between the study factors and MDD-8. Setting: Indonesia. Participant: A total of 14 990 children aged 6–23 months. Results: Over the 10 years, the percentage of children who consumed a diversified diet was 53·1 % in 2007, 51·7 % in 2012 and 53·7 % in 2017. Multivariate analyses showed that older age children, higher maternal education, maternal weekly access to media, paternal non-agricultural occupation, history of at least four antenatal care visits and wealthier households were associated with the increased odds of MDD-8. Children living in rural areas, Sulawesi and Eastern Indonesia, were less likely to eat a diversified diet. Conclusions: The proportion of children meeting MDD-8 has stagnated in the last decade. Child, parental, health care, household and community factors are associated with MDD-8. Therefore, nutrition education programmes and behaviour change communication activities should target mothers and families from socio-economically and geographically disadvantaged populations.

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Implications of Updating the Minimum Dietary Diversity for Children Indicator for Tracking Progress in the Eastern and Southern Africa Region

Cited by 14 publications

References 13 publications

Infant and Young Child Feeding Practices among Adolescent Mothers and Associated Factors in India

Infant and Young Child Feeding Practices among Adolescent Mothers and Associated Factors in India

Season of Data Collection of Child Dietary Diversity Indicators May Affect Conclusions About Longer-Term Trends in Peru, Senegal, and Nepal

Trends and determinants of minimum dietary diversity among children aged 6–23 months: a pooled analysis of Indonesia Demographic and Health Surveys from 2007 to 2017

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