Factors Associated With Complementary Feeding Practices in Afghanistan: Analysis of the Multiple Indicator Cluster Survey 2022-2023.

Abstract

Children between the ages of 6 and 23 months require the age-appropriate introduction of complementary foods alongside breastfeeding to meet their nutritional needs, but in humanitarian settings children frequently do not receive appropriate diets. Using data from 9193 children aged 6-23 months in the Afghanistan Multiple Indicator Cluster Survey 2022-2023, this paper provides nationally representative estimates of the percentage of children meeting key IYCF indicators and assesses the child, maternal and household determinants of receiving minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) using multivariable logistic regression. Results showed that 85%, 65% and 93% of children were not fed a diet that met MDD, MMF or MAD criteria, respectively. Older children (18-23 months) had significantly higher odds of meeting all three criteria compared to younger children (6-11 months) (MDD aOR = 2.46, 95% CI: 1.93-3.12; MMF aOR = 1.29, 95% CI: 1.11-1.50; MAD aOR = 2.00, 95% CI: 1.51-2.65), as did children from the richest households (vs. poorest) (MDD aOR = 2.85, 95% CI: 1.72-4.70; MMF aOR = 1.82, 95% CI: 1.35-2.46; MAD aOR = 3.88, 95% CI: 2.14-7.04). There was substantial variation in the odds of all outcomes by region. Rural residence (vs. urban) was also associated with higher odds of receiving MMF (aOR = 1.60, 95% CI: 1.25-2.05) and MAD (aOR = 1.69, 95% CI: 1.18-2.42) but not MDD. Overall, alarmingly few children in Afghanistan are receiving appropriate complementary diets amidst a context of concurrent political, economic and environmental crises. Reversals to funding reductions are vital to ensure proven interventions responding to the determinants identified here continue to be delivered to support nutrition among Afghanistan's infants and young children.