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

Abstract

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.

Determinants of Inadequate Minimum Dietary Diversity Intake Among Children Aged 6–23 Months in Sub-Saharan Africa: Pooled Prevalence and Multilevel Analysis of Demographic and Health Survey in 33 Sub-Saharan African Countries

“…This is in line with the research conducted in India (77%) (19) and Myanmar (75.4%) (46). But our study indicated that this percentage is higher than studies conducted in Bangladesh (58.1%) (47), Nepal (53.5%) (17), Indonesia (46.7%) (20), Sri Lanka (29%) (21), and a study in two South-East Asian countries, namely, Cambodia (52.3%) and Indonesia (41.8%) (46), which shows that children aged 6-23 months have inadequate access to MDD. The discrepancy might be due to differences in food cultures (10,27,46).…”

“…In many countries, less than one-quarter of children are reported not getting the nutrition they need to grow well, particularly in the crucial first 1,000 days (13,16). The magnitude of inadequate minimum dietary diversity (MDD) in Nepal was 53.5% (17); in India, it ranges from 36.15 to 77% (18,19), MDD in Indonesia was 46.7% (20), and MDD in Sri Lanka was 29% (21).…”

Wealth- and education-related inequalities in minimum dietary diversity among Indonesian infants and young children: a decomposition analysis

“…We selected the contributory factors to socioeconomic inequality in dietary diversity based on our study on MDD determinants in Indonesia. For the present study analysis, we only included significant variables in relation to MDD found in our previous research [ 23 ]. These variables included child’s age (6–11 months, 12–17 months, 18–23 months), mother’s education (none or incomplete primary school, completed primary school, completed secondary school, completed higher education), mother’s access to media (none, at least one media), mother’s occupation (not working, agricultural, non-agricultural), father’s occupation (not working, agricultural, non-agricultural), number of ANC visits in the last pregnancy (<4 visits, ≥4 visits), household wealth (poorest, poorer, middle, richer, richest), area of residence (rural, urban), and regions (Java and Bali, Sumatera, Kalimantan, Sulawesi, Eastern Indonesia).…”

“…Children of higher economic status are at greater odds of receiving foods from diverse foods [ 19–23 ]. Mothers with higher education are more likely to have children who consume a more varied diet than those with lower education [ 19–21 , 23–25 ]. Other factors, such as maternal employment [ 26 ], paternal education [ 20 , 27 ], antenatal care (ANC) [ 20 , 25 ] and residency [ 21 , 26 ], are often related to increasing dietary diversity but have shown mixed results across studies.…”

“…Yet, despite the overall economic improvement of the country, dietary diversity among children has stagnated. A nationally representative analysis study showed that the consumption of a minimum of five out of eight groups in Indonesia was 53.1% in 2007, 51.7% in 2012, and 53.7% in 2017 [ 23 ]. One important reason might be the persistent income inequality, which could have worsened the unequal access to nutrition, clean water, sanitation, and health services [ 29 ].…”