Determinants of Minimum Dietary Diversity Among Children Aged 6–23 Months in 7 Countries in East and Southern Africa (P10-035-19)

Abstract

Study objectives were to identify the prevalence and risk factors associated with the newly revised WHO indicator of minimum dietary diversity (MDD) among children aged 6–23 months in 7 countries in East and Southern Africa and to identify shared risk factors of programmatic importance across countries.MDD was defined as having >5 of 8 food groups including breastmilk in the past 24 hours. We used Demographic and Health Survey data from four East African countries, (Ethiopia 2015, n = 2965; Tanzania 2015, n = 3170; Rwanda 2014, n = 1162; Uganda 2016, n = 4418) and three Southern African countries, (Malawi 2015–16, n = 4879; Mozambique 2011, n = 3339, and Zambia 2013–14, n = 3776). A total of 8 child, 16 maternal, 8 household and 3 community level characteristics were selected for investigation and tested for associations with MDD using univariable logistical regression models. Significant (P <0.05) variables were included in multivariable adjusted models. The sampling design of the original surveys was accounted for in all analyses.The proportion of children reaching MDD was highest in Mozambique (27.4%) and lowest in Ethiopia (12.0%). Among four East African countries, common risk factors for not meeting MDD apparent across multiple countries included lowest wealth quintile (Adjusted OR [AOR] range: 2.04∼3.45, ref: highest), no formal maternal education, (AOR: 1.68∼3.30, ref: higher education than secondary), maternal age of 15–24y (AOR: 1.28∼1.59, ref: 25–34y), mothers not engaging in agriculture work (ref: agriculture) (AOR: 1.64∼3.30) and protective risk factors included older child age (AOR: 0.46∼0.71, ref:6–11 months) and weekly exposure to media (radio, tv or newspaper; AOR: 0.56∼0.68). Among Southern African countries, female household head (AOR: 1.25∼1.72) was positively and older child age (AOR: 0.53∼0.67; ref:6–11 months) negatively associated with not meeting MDD.Common risk factors were identified across countries and may help to inform policy and targeting of programs related to improving the quality of complementary feeding in the region.None.