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Published in: International Journal for Equity in Health 1/2020

Open Access 01-12-2020 | Nutrition | Research

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

Authors: Tigist Worku, Kedir Abdela Gonete, Esmael Ali Muhammad, Asmamaw Atnafu

Published in: International Journal for Equity in Health | Issue 1/2020

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Abstract

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.
Literature
1.
go back to reference Organization, W.H. and UNICEF, Strengthening action to improve feeding of infants and young children 6–23 months of age in nutrition and child health programmes: report of proceedings, Geneva, 6–9 October 2008. 2008. Organization, W.H. and UNICEF, Strengthening action to improve feeding of infants and young children 6–23 months of age in nutrition and child health programmes: report of proceedings, Geneva, 6–9 October 2008. 2008.
2.
go back to reference Organization, W.H., Indicators for assessing infant and young child feeding practices: part 2: measurement. 2010. Organization, W.H., Indicators for assessing infant and young child feeding practices: part 2: measurement. 2010.
3.
go back to reference Mollier, L., et al., End hunger, achieve food security and improved nutrition and promote sustainable agriculture: SDG 2. 2017. Mollier, L., et al., End hunger, achieve food security and improved nutrition and promote sustainable agriculture: SDG 2. 2017.
4.
go back to reference WHO U, Mathers C. Global strategy for women's, children's and adolescents' health (2016-2030). Organization; 2016. WHO U, Mathers C. Global strategy for women's, children's and adolescents' health (2016-2030). Organization; 2016.
5.
go back to reference Akombi BJ, et al. Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS One. 2017;12(5):e0177338.CrossRef Akombi BJ, et al. Child malnutrition in sub-Saharan Africa: A meta-analysis of demographic and health surveys (2006-2016). PLoS One. 2017;12(5):e0177338.CrossRef
6.
go back to reference Agency, C.S. and E. Addis Ababa, ETHIOPA DEMOGRAPHIC AND HEALTH SURVEY 2016: ADDIS ABABA ETHIOPIA. 2016. p. 551. Agency, C.S. and E. Addis Ababa, ETHIOPA DEMOGRAPHIC AND HEALTH SURVEY 2016: ADDIS ABABA ETHIOPIA. 2016. p. 551.
7.
go back to reference Ali D, et al. Household food insecurity is associated with higher child undernutrition in Bangladesh, Ethiopia, and Vietnam, but the effect is not mediated by child dietary diversity. J Nutr. 2013;143(12):2015–21.CrossRef Ali D, et al. Household food insecurity is associated with higher child undernutrition in Bangladesh, Ethiopia, and Vietnam, but the effect is not mediated by child dietary diversity. J Nutr. 2013;143(12):2015–21.CrossRef
8.
go back to reference Organization, W.H, Strengthening action to improve feeding of infants and young children 6–23 months of age in nutrition and child health programmes. Report of Proceedings, Geneva, Switzerland, 6–9 October, 2008. Strengthening action to improve feeding of infants and young children 6–23 months of age in nutrition and child health programmes. Report of Proceedings, Geneva, Switzerland, 6–9 October, 2008., 2008. Organization, W.H, Strengthening action to improve feeding of infants and young children 6–23 months of age in nutrition and child health programmes. Report of Proceedings, Geneva, Switzerland, 6–9 October, 2008. Strengthening action to improve feeding of infants and young children 6–23 months of age in nutrition and child health programmes. Report of Proceedings, Geneva, Switzerland, 6–9 October, 2008., 2008.
9.
go back to reference White JM, et al. Complementary feeding practices: Current global and regional estimates. Matern Child Nutr. 2017;13:e12505.CrossRef White JM, et al. Complementary feeding practices: Current global and regional estimates. Matern Child Nutr. 2017;13:e12505.CrossRef
10.
go back to reference Aemro M, et al. Dietary diversity and meal frequency practices among infant and young children aged 6–23 months in Ethiopia: a secondary analysis of Ethiopian demographic and health survey 2011. J Nutr Metabol. 2013;2013. Aemro M, et al. Dietary diversity and meal frequency practices among infant and young children aged 6–23 months in Ethiopia: a secondary analysis of Ethiopian demographic and health survey 2011. J Nutr Metabol. 2013;2013.
11.
go back to reference Belew AK, et al. Dietary diversity and meal frequency among infant and young children: a community based study. Ital J Pediatr. 2017;43(1):73.CrossRef Belew AK, et al. Dietary diversity and meal frequency among infant and young children: a community based study. Ital J Pediatr. 2017;43(1):73.CrossRef
12.
go back to reference Beyene M, Worku AG, Wassie MM. Dietary diversity, meal frequency and associated factors among infant and young children in Northwest Ethiopia: a cross-sectional study. BMC Public Health. 2015;15(1):1007.CrossRef Beyene M, Worku AG, Wassie MM. Dietary diversity, meal frequency and associated factors among infant and young children in Northwest Ethiopia: a cross-sectional study. BMC Public Health. 2015;15(1):1007.CrossRef
13.
go back to reference Dangura D, Gebremedhin S. Dietary diversity and associated factors among children 6-23 months of age in Gorche district, Southern Ethiopia: Cross-sectional study. BMC Pediatrics. 2017;17(1):6.CrossRef Dangura D, Gebremedhin S. Dietary diversity and associated factors among children 6-23 months of age in Gorche district, Southern Ethiopia: Cross-sectional study. BMC Pediatrics. 2017;17(1):6.CrossRef
14.
go back to reference Ickes SB, Baguma C, Brahe CA, Myhre JA, Adair LS, Bentley ME, Ammerman AS. Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study. BMC Nutrtion. 2017;3:32.CrossRef Ickes SB, Baguma C, Brahe CA, Myhre JA, Adair LS, Bentley ME, Ammerman AS. Maternal participation in a nutrition education program in Uganda is associated with improved infant and young child feeding practices and feeding knowledge: a post-program comparison study. BMC Nutrtion. 2017;3:32.CrossRef
15.
go back to reference Khanal V, Sauer K, Zhao Y. Determinants of complementary feeding practices among Nepalese children aged 6–23 months: findings from demographic and health survey 2011. BMC Pediatr. 2013;13(1):131.CrossRef Khanal V, Sauer K, Zhao Y. Determinants of complementary feeding practices among Nepalese children aged 6–23 months: findings from demographic and health survey 2011. BMC Pediatr. 2013;13(1):131.CrossRef
16.
go back to reference Tegegne M, et al. Factors associated with minimal meal frequency and dietary diversity practices among infants and young children in the predominantly agrarian society of bale zone, Southeast Ethiopia: a community based cross sectional study. Arch Public Health. 2017;75(1):53.CrossRef Tegegne M, et al. Factors associated with minimal meal frequency and dietary diversity practices among infants and young children in the predominantly agrarian society of bale zone, Southeast Ethiopia: a community based cross sectional study. Arch Public Health. 2017;75(1):53.CrossRef
17.
go back to reference Moss C, et al. Sustainable Undernutrition Reduction in Ethiopia (SURE) evaluation study: a protocol to evaluate impact, process and context of a large-scale integrated health and agriculture programme to improve complementary feeding in Ethiopia. BMJ Open. 2018;8(7):e022028.CrossRef Moss C, et al. Sustainable Undernutrition Reduction in Ethiopia (SURE) evaluation study: a protocol to evaluate impact, process and context of a large-scale integrated health and agriculture programme to improve complementary feeding in Ethiopia. BMJ Open. 2018;8(7):e022028.CrossRef
18.
go back to reference Temesgen H, Yeneabat T, Teshome M. Dietary diversity and associated factors among children aged 6–23 months in Sinan Woreda, Northwest Ethiopia: a cross-sectional study. BMC Nutrition. 2018;4(1):5.CrossRef Temesgen H, Yeneabat T, Teshome M. Dietary diversity and associated factors among children aged 6–23 months in Sinan Woreda, Northwest Ethiopia: a cross-sectional study. BMC Nutrition. 2018;4(1):5.CrossRef
19.
go back to reference Saaka M, et al. Magnitude and factors associated with appropriate complementary feeding among children 6–23 months in northern Ghana. BMC Nutrition. 2016;2(1):2.CrossRef Saaka M, et al. Magnitude and factors associated with appropriate complementary feeding among children 6–23 months in northern Ghana. BMC Nutrition. 2016;2(1):2.CrossRef
20.
go back to reference Solomon D, Aderaw Z, Tegegne TK. Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. Int J Equity Health. 2017;16(1):181.CrossRef Solomon D, Aderaw Z, Tegegne TK. Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. Int J Equity Health. 2017;16(1):181.CrossRef
21.
go back to reference Coates J, Swindale A, Bilinsky P. Food and Nutrition Technical Assistance Project (FANTA): Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide (v. 3). Washington, DC: Food and Nutrition Technical Assistance Project; 2007. Coates J, Swindale A, Bilinsky P. Food and Nutrition Technical Assistance Project (FANTA): Household Food Insecurity Access Scale (HFIAS) for Measurement of Food Access: Indicator Guide (v. 3). Washington, DC: Food and Nutrition Technical Assistance Project; 2007.
22.
go back to reference Mekonnen TC, et al. Meal frequency and dietary diversity feeding practices among children 6–23 months of age in Wolaita Sodo town, Southern Ethiopia. J Health Popul Nutr. 2017;36(1):18.CrossRef Mekonnen TC, et al. Meal frequency and dietary diversity feeding practices among children 6–23 months of age in Wolaita Sodo town, Southern Ethiopia. J Health Popul Nutr. 2017;36(1):18.CrossRef
23.
go back to reference Edris M, Atnafu N, Abota T. Determinants of Dietary Diversity Score among Children Age between 6-23 Months in Bench Maji Zone, Southwest Ethiopia. Ped Health Res. 2018;3(3):10. Edris M, Atnafu N, Abota T. Determinants of Dietary Diversity Score among Children Age between 6-23 Months in Bench Maji Zone, Southwest Ethiopia. Ped Health Res. 2018;3(3):10.
24.
go back to reference Sagaro GG, Alemayehu M. Dietary diversity and associated factors among infants and young children in Wolaita Zone, Southern Ethiopia. Sci J Clin Med. 2017;6(4):53.CrossRef Sagaro GG, Alemayehu M. Dietary diversity and associated factors among infants and young children in Wolaita Zone, Southern Ethiopia. Sci J Clin Med. 2017;6(4):53.CrossRef
25.
go back to reference Demilew YM, Tafere TE, Abitew DB. Infant and young child feeding practice among mothers with 0–24 months old children in Slum areas of Bahir Dar City, Ethiopia. Int Breastfeed J. 2017;12(1):26.CrossRef Demilew YM, Tafere TE, Abitew DB. Infant and young child feeding practice among mothers with 0–24 months old children in Slum areas of Bahir Dar City, Ethiopia. Int Breastfeed J. 2017;12(1):26.CrossRef
26.
go back to reference Gebremedhin S, et al. Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia. Nutrition. 2017;33:163–8.CrossRef Gebremedhin S, et al. Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia. Nutrition. 2017;33:163–8.CrossRef
27.
go back to reference Harvey CM, Newell M-L, Padmadas SS. Socio-economic differentials in minimum dietary diversity among young children in South-East Asia: evidence from Demographic and Health Surveys. Public Health Nutr. 2018;21(16):3048–57.CrossRef Harvey CM, Newell M-L, Padmadas SS. Socio-economic differentials in minimum dietary diversity among young children in South-East Asia: evidence from Demographic and Health Surveys. Public Health Nutr. 2018;21(16):3048–57.CrossRef
28.
go back to reference Dewey, K., M. Arimond, and M. Ruel, Working group on infant and young child feeding indicators. Developing and validating simple indicators of dietary quality of infants and young children in developing countries: additional analysis of. 10. Food and Nutrition Technical Assistance Project (FANTA),Washington DC, USA, 2006. Dewey, K., M. Arimond, and M. Ruel, Working group on infant and young child feeding indicators. Developing and validating simple indicators of dietary quality of infants and young children in developing countries: additional analysis of. 10. Food and Nutrition Technical Assistance Project (FANTA),Washington DC, USA, 2006.
29.
go back to reference Issaka AI, et al. Determinants of inadequate complementary feeding practices among children aged 6–23 months in Ghana. Public Health Nutr. 2015;18(4):669–78.CrossRef Issaka AI, et al. Determinants of inadequate complementary feeding practices among children aged 6–23 months in Ghana. Public Health Nutr. 2015;18(4):669–78.CrossRef
30.
go back to reference Gatahun A, Abyu M. Dietary diversity feeding practice and determinants among children aged 6–23 months in Kemba Woreda, southern Ethiopia implication for public health intervention. Nutrition & Food Sciences; 2015.CrossRef Gatahun A, Abyu M. Dietary diversity feeding practice and determinants among children aged 6–23 months in Kemba Woreda, southern Ethiopia implication for public health intervention. Nutrition & Food Sciences; 2015.CrossRef
31.
go back to reference Organization, W.H. Global nutrition targets 2025: Stunting policy brief. Geneva: World Health Organization; 2014. Organization, W.H. Global nutrition targets 2025: Stunting policy brief. Geneva: World Health Organization; 2014.
32.
go back to reference Santos SFG, et al. Thao-Child Health Programme: community based intervention for healthy lifestyles promotion to children and families: results of a cohort study. Nutricion Hospitalaria. 2015;32(6):2584–7. Santos SFG, et al. Thao-Child Health Programme: community based intervention for healthy lifestyles promotion to children and families: results of a cohort study. Nutricion Hospitalaria. 2015;32(6):2584–7.
33.
go back to reference Abebe Z, Haki GD, Baye K. Health extension workers’ knowledge and knowledge-sharing effectiveness of optimal infant and young child feeding are associated with mothers’ knowledge and child stunting in Rural Ethiopia. Food Nutr Bull. 2016;37(3):353–63.CrossRef Abebe Z, Haki GD, Baye K. Health extension workers’ knowledge and knowledge-sharing effectiveness of optimal infant and young child feeding are associated with mothers’ knowledge and child stunting in Rural Ethiopia. Food Nutr Bull. 2016;37(3):353–63.CrossRef
34.
go back to reference Senarath U, Dibley MJ. Complementary feeding practices in South Asia: analyses of recent national survey data by the South Asia Infant Feeding Research Network. Matern Child Nutr. 2012;8:5–10.CrossRef Senarath U, Dibley MJ. Complementary feeding practices in South Asia: analyses of recent national survey data by the South Asia Infant Feeding Research Network. Matern Child Nutr. 2012;8:5–10.CrossRef
35.
go back to reference Ruel MT, et al. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The lancet. 2013;382(9891):536–51 Organization, W.H., Global nutrition targets 2025: Stunting policy brief. 2014, World Health Organization.CrossRef Ruel MT, et al. Nutrition-sensitive interventions and programmes: how can they help to accelerate progress in improving maternal and child nutrition? The lancet. 2013;382(9891):536–51 Organization, W.H., Global nutrition targets 2025: Stunting policy brief. 2014, World Health Organization.CrossRef
36.
go back to reference Kumera G, Tsedal E, Ayana M. Dietary diversity and associated factors among children of Orthodox Christian mothers/caregivers during the fasting season in Dejen District, North West Ethiopia. Nutr Metabol. 2018;15(1):16.CrossRef Kumera G, Tsedal E, Ayana M. Dietary diversity and associated factors among children of Orthodox Christian mothers/caregivers during the fasting season in Dejen District, North West Ethiopia. Nutr Metabol. 2018;15(1):16.CrossRef
38.
go back to reference Owino V, Amadi B, Sinkala M, Filteau S, Tomkins A. Complementary feeding practices and nutrient intake from habitual complementary foods of infants and children aged 6-18 months old in Lusaka, Zambia. Afr J Food Agric Nutr Dev. 2008;8(1):28–47. Owino V, Amadi B, Sinkala M, Filteau S, Tomkins A. Complementary feeding practices and nutrient intake from habitual complementary foods of infants and children aged 6-18 months old in Lusaka, Zambia. Afr J Food Agric Nutr Dev. 2008;8(1):28–47.
39.
go back to reference GCP/ZAM/059/BEL – Luapula Food Security, Nutrition Action and Communication Project (LFSNAC) (Zambia). GCP/ZAM/059/BEL – Luapula Food Security, Nutrition Action and Communication Project (LFSNAC) (Zambia).
Metadata
Title
Sustainable under nutrition reduction program and dietary diversity among children’s aged 6–23 months, Northwest Ethiopia: Comparative cross-sectional study
Authors
Tigist Worku
Kedir Abdela Gonete
Esmael Ali Muhammad
Asmamaw Atnafu
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Nutrition
Published in
International Journal for Equity in Health / Issue 1/2020
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-019-1120-1

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