Minimum dietary diversity behaviour among children aged 6 to 24 months and their determinants: insights from 31 Sub-Saharan African (SSA) countries.

Abstract

Background: Feeding practices during infancy have a significant impact on a child's cognitive development and long-term health outcomes. Dietary diversity guidelines from the WHO and UNICEF recommend a diverse range of foods for children aged below 24 months for their optimal growth and development. However, in sub-Saharan Africa (SSA), little is known about the extent to which dietary diversity behaviour in children aged 6 to 24 months aligns with the recommendations and the factors associated with the differentials in dietary behaviour. This study aimed to fill this gap.

Methods: This study employed an analytical cross-sectional approach, drawing on recent Demographic and Health Survey (DHS) data from 31 SSA countries. The study included a weighted sample of 44,071 children aged between 6 and 24 months, and their respective mothers aged 15-49 years. The primary outcome was Minimum Dietary Diversity (MDD) categorised per WHO recommendation. Multivariable logistic regression was used to examine the association of MDD with demographic and socio-economic characteristics.

Results: The pooled MDD intake among children aged 6-24 months in SSA was 11% ranging from as low as 1.3% in Burkina Faso to 32.9% in South Africa. Children of mothers aged 45-49 years had 52% significant higher likelihood of MDD compared to those aged 15-19 years (AOR = 1.52, 95% CI:1.03, 2.24). Higher maternal education levels also increased MDD odds in the children: 22% higher for mothers who had attained secondary education (AOR = 1.22, 95% CI:1.07, 1.39), and 36% higher for those with education beyond secondary level (AOR = 1.36, 95% CI:1.09, 1.71) compared to no education. Children of rich mothers had 44% higher odds of MDD than those with poor mothers (AOR = 1.44, 95% CI:1.27, 1.62). Increased antenatal visits, and urban residence also contributed to higher MDD odds.

Conclusion: Based on the current global estimate of approximately 28% MDD rate, the reported 11% MDD intake among children in this study is relatively low. There is a positive association between MDD intake in children and several factors, including maternal education, antenatal visits, wealth index, and residency. These findings highlight the need for policymakers and other stakeholders to give urgent attention to empowering parents to ensure adequate nutrient intake among children for better child growth and development.