Association of food security and other socio-economic factors with dietary diversity and nutritional statuses of children aged 6-59 months in rural Bangladesh

Abstract

Introduction Dietary diversity score (DDS) is a proxy indicator for measuring nutrient adequacy. In this study, we aimed to identify the nutritional statuses and current patterns of DDS among children between 6–59 months old and their associations with different individual and household level factors in rural Bangladesh. Methods The Nobokoli programme of World Vision Bangladesh was implemented in Mymensingh, Sherpur, Rangpur, Dinajpur, Thakurgaon, Panchagar, and Nilphamari districts of Bangladesh between 2014 and 2017. A cross-sectional community household survey was administered between July and October 2014 to collect baseline data to evaluate the Nobokoli programme. A total of 6,468 children between 6–59 months old were included in the final analysis. Anthropometric data was collected following WHO guidelines on using wooden height and digital weight scales. We collected food intake information for the past 24 hours of the survey. The WHO’s child growth standard medians were used to identify the nutritional indices of stunting, wasting, and underweight. Food items consumed were categorized into nine food groups and the DDS was constructed by counting the consumption of food items across these groups during the preceding 24 hour period. The association of DDS and nutritional status (stunting, wasting and underweight) with sociodemographic factors and household food security status were examined using multivariable models; linear regression and logistics regression respectively. Results The prevalence of stunting, wasting and underweight among children aged 6-59months were 36.8%, 18.2% and 37.7% respectively. Our findings revealed that almost all children ate any form of starch followed by consumption of milk or milk products (76%) and fleshy meat /fish (61%) respectively. The mean DDS among children was 3.93(sd 1.47). Forty percent of the children obtained a DDS score less than 4. Multivariable analysis suggested that children whose mothers had higher educational attainment and are skilled workers had higher DDS (15% and 48% respectively) compared to their counterparts. The DDS showed strong positive association with household wealth status. Children from food secure households had 26% higher DDS compared to children from food insecure households. Similarly, increasing maternal education and household wealth were found to be protective against childhood stunting and undernutrition. Discussion Our findings reiterate the need for improving household socioeconomic factors and household food security status for improving dietary diversity practices and nutritional status of children. Evidence-based solutions are needed to be implemented and expanded at scale to ensure appropriate dietary practices and improve nutritional status of the children in local context.

The Effect of Maternal Depressive Symptoms on Infant Feeding Practices in Rural Ethiopia: Community Based Birth Cohort Study

“…Mothers with primary and above school qualification seemed to perform better with respect to IFPs than illiterate mothers. This finding is in agreement with previous studies in Ethiopia and elsewhere [13,42,44,45,75]. This may be explained by educated mothers having better understanding of IYCF itself and/or had exposure to IYCF awareness raising campaigns (through their ability to read leaflets, posters and banners) that have been conducted for several years by the Ministry of Health and development partners in Ethiopia.…”

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Effect of diversified meals only, or either enriched with Amaranthus tricolor and Moringa oleifera leaf powder or commercial micronutrient powder on prevention/treatment of anemia in Adivasi children, West Bengal, India

“…Moreover a cash income >5000 INR was associated with higher Hb increases over time, suggesting that a higher cash flow improves the nutritional outcomes for children early in life. This is in line with published evidence that household wealth status is associated with dietary diversity and nutritional status of Bangladeshi children [126], as well as with hemoglobin concentration of Bangladeshi women due to increased iron intake from animal sources [127]. Therewith, the observed weight gain in our study is rather low, however is in line with other trials not achieving the proposed daily weight gain of 5g/kg/bw.…”

The Effect of Maternal Depressive Symptoms on Infant Feeding Practices in Rural Ethiopia: Community Based Birth Cohort Study

“…Systematic reviews in 2019 and 2015concluded that depressed women breastfed their children for shorter duration than non-depressed women [30,31]. Other previous studies also reported a negative association of maternal depression with early initiation of breastfeeding [28], timey complementary feeding initiation [27] and infants' dietary diversity [34,35].…”

“…Among the psychosocial factors, prenatal and postnatal depression consistently predicted components of IFPs such as breastfeeding initiation [28,29], exclusive breastfeeding [30][31][32], breastfeeding duration [33] complementary feeding timely initiation [27] and dietary diversity [34,35]. Moreover, researchers reported that other psychosocial factors such as intimate partner violence and maternal social support are important predictors of IFPs.…”