Dietary Diversity and Meal Frequency Practices among Children Aged 6-23 Months in Agro Pastoral Communities in Afar Region, Ethiopia: A Cross-sectional Study

ABSTRACT

Introduction: Inappropriate infant and young child feeding practices in the first two years of life are among the major causes of childhood malnutrition in developing countries, including Ethiopia. Dietary diversity refers to increasing the consumption of a variety of foods across and within the food groups. Therefore, this study aimed to assess the minimum dietary diversity and minimum meal frequency practices among children aged 6–23 months in Agro pastoral communities, Afar Region, Ethiopia.

Methods: A community-based cross-sectional study was conducted from December 1–30, 2018. A multi-stage stratified sampling followed by a systematic random sampling technique was used to select participants. An interviewer-administered questionnaire was used to collect data. Bivariate and multivariable logistic regression analysis was employed to identify factors associated with minimum dietary diversity and meal frequency. The adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals (CI) were computed to see the association between the outcome and independent variables. The statistical significance was declared at p-value <0.05.

Results: The proportion of children who met the minimum dietary diversity and meal frequency were 21.8% (95% CI: 19.0%-24.7%) and 43.8% (95% CI: 40.4%-47.2%) respectively. Maternal education (AOR = 2.5, 95% CI = 1.1–5.3 and AOR = 3.9, 95% CI = 1.3–11.5), maternal occupation (AOR = 4.2, 95% CI = 2.3–7.8), sex of child (AOR = 2.6, 95% CI = 1.5–4.5) and history of postnatal care visit (AOR = 1.8, 95% CI = 1.1–3.2) were independently associated with minimum dietary diversity. Similarly, age of child (AOR = 2.8, 95% CI = 1.4–5.5 and AOR = 5.3, 95% CI = 2.3–12.4), sex of child (AOR = 2.6, 95% CI = 1.4–4.6) and history of postnatal care visit (AOR = 2.2, 95% CI = 1.3–3.8) were the factors significantly associated with minimum meal frequency practices.

Conclusions: The current study showed that the proportions of children who met the minimum dietary diversity and meal frequency were low. Increasing maternal education, being a housewife, being a male child and attending a postnatal care visit were independently associated with minimum dietary diversity. Likewise, increasing the age of a child, being a male child and attending a postnatal care visit were significantly associated with minimum meal frequency. Improving maternal education and health care utilization, health and nutrition counseling during postnatal care visits are highly recommended to improve infant and young child feeding practices.

Abbreviations ANC: Ante Natal Care, DHS: Demographic and Health Surveys, EDHS: Ethiopian Demographic and Health Surveys, RERC: Research and Ethical Review Committee, IYCF: Infant and Young Child Feeding, MDD: Minimum Dietary Diversity, MMF: Minimum Meal Frequency, PNC: Post Natal Care, WHO: World Health Organization.

KEYWORDS:

• Dietary diversity
• meal frequency
• agro-pastoral
• Afar region
• Ethiopia

Acknowledgments

Authors would like to thank the Samara University, Dubti district Administrative and Health Office and respective Kebele Administrations, study participants, data collectors and supervisors for their cooperation in this study.

Authors’ Contributions

AGW and WA conceived the study, developed the tool, conducted the research and carried out the statistical analysis and wrote the manuscript. AMB and PSR also participated in the design of the study, tool development, statistical analysis and drafted the manuscript. All authors read and approved the final manuscript.

Author Details

¹Department of Public Health, College of Medical and Health Sciences, Samara University, Semera, Afar region, Ethiopia.

²Department of Public health, WHO-Ethiopia: Afar Region Branch Office, Semera, Ethiopia

³School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Tigray region, Ethiopia.

Ethics approval and consent to participate

The ethical approval was obtained from Samara University, College of health sciences, Research and Ethical Review Committee (RERC). Informed consent was obtained from the participant’s parent before being enrolled in the study. In addition, participants were assured about the aim, possible risk if any and confidentiality of the study using their own local language (Afaraff language).

Availability of data and material

The datasets used during the current study are available from the corresponding author on reasonable request.

Conflict of Interests

The authors declared that they have no conflict of interest.

Additional information

Funding

Not applicable