A Multilevel Analysis of Factors Associated with Minimum Dietary Diversity Among Children Aged 6–23 Months in Lesotho: A Lesotho Multiple Cluster Study Of 2018

Abstract

Background Adequately diversified nutrition during infancy and childhood is fundamental in the development and optimal growth of the child. Globally, complex, and intertwined determinants of minimum dietary diversity (MDD) have been explored at individual, household, and community level but, not in Lesotho. The objective of the study was to investigate the determinants of minimum dietary diversity at the individual, household, and community level. Methods We conducted a multilevel logistic regression using data from the Lesotho Multiple Cluster Indicator Study of 2018. The variables used in the analysis were informed by the UNICEF conceptual framework on maternal and malnutrition. MDD was defined as receiving 4 or more different food groups in the previous 24 hours. Results Only 40.5% (CI: 36.7, 44.5) of the children aged 6–23 months received MDD in 2018. At an immediate individual level: child age and weight at birth were determinants of MDD. At the underlying or household level: household wealth, maternal education, and maternal residential status were determinants of MDD. Community food security, the proportion of women and men in the community who have completed their education, community poverty, and the proportion of women in the community with media exposure were determinants of MDD at a basic or community level. Conclusion There is evidence of variability in the data in relation to MDD at community level. It also shows that community knowledge and information sharing is important in improving MDD in Lesotho. Therefore, strategies and programs to improve MDD nationwide should be done at community level.