Dietary diversity of 6- to 59-month-old children in rural areas of Moramanga and Morondava districts, Madagascar

Abstract

BackgroundA dietary imbalance or a disregard for the nutritional needs of children during early childhood can affect their growth. From the age of six months, breast milk is no longer able to meet the energy and micronutrient needs of children; the consumption of adequate complementary foods is therefore essential. Various indicators have been used to assess the quality of children's diets, and the dietary diversity score is a good indicator of children's diets. The objective of this study was to describe the dietary practices of children in rural areas of Moramanga and Morondava, Madagascar, and to identify the determinants of low dietary diversity to prioritize nutritional interventions.MethodsWe collected dietary data in 2014 on children aged 6–59 months in a study on the determinants of chronic malnutrition using the 24-hour recall method. Data on the characteristics of households and mothers were also collected. We carried out bivariate and multivariate analyses to identify the determinants of low dietary diversity scores for children.ResultsWe included 1824 children: 893 from Moramanga and 931 from Morondava. Approximately 42.1% [95% CI: 39.0–45.4] of the children from Moramanga and 47.6% [95% CI: 44.4–50.8] of those from Morondava had a poorly diversified diet, consisting mainly of foods rich in carbohydrates and poor in meat products. Poor maternal education was associated with a high likelihood of having a non-varied diet in both study areas; the adjusted odds ratios were 2.2 [95% CI: 1.3–3.8] and 4.0 [95% CI: 2.5–6.4] for children from mothers with lower education levels for Moramanga and Morondava, respectively. For children recruited in Morondava, having low household socioeconomic status (adjusted OR: 1.8, 95% CI: 1.2–2.8) and belonging to a household without livestock was associated with a low dietary diversity score (adjusted OR: 1.8, 95% CI 1.2–2.7).ConclusionOur results show the need to improve girls' education, adapt nutrition education programs for mothers based on their level of education, and strengthen poverty reduction programs.

Factors associated with dietary diversity and length‐for‐age z‐score in rural Ethiopian children aged 6–23 months: A novel approach to the analysis of baseline data from the Sustainable Undernutrition Reduction in Ethiopia evaluation

“…A study conducted in Ghana showed that as the number of food groups consumed by mother increased, so too did the number consumed by their children (Amugsi, Mittelmark, & Oduro, ). Low socio‐economic status has been identified as a risk factor for low child dietary diversity in a wide range of contexts (Karwa, Godhia, & Jadhav, ; Rakotonirainy et al, ) and associations with stunted growth are well‐established (Adekanmbi, Kayode, & Uthman, ; Devakumar et al, ; Leroy, Habicht, Gonzalez de Cossio, & Ruel, ; Poda, Hsu, & Chao, ). Similarly, land ownership was also an important protective factor for child feeding practices in this study and others (Devakumar et al, ; Hailemariam, Girmay, & Girmay, ), perhaps due to the central role of agriculture in ensuring food security via food provision and/or income.…”

Water insecurity potentially undermines dietary diversity of children aged 6–23 months: Evidence from India

“…This aligns with our objective to identify the role of household water access-not access to safe drinking water or associated hygiene practices (which we would expect to affect nutrition outcomes through the WASH pathways)-on child dietary diversity. Research on dietary diversity typically does not include sanitation or hygiene variables (see Rakotonirainy et al, 2018).…”

“…Dietary diversity among infants and young children has been associated with maternal and child characteristics, household resources, and other sociocultural factors (Rakotonirainy et al, 2018;Kumera, Tsedal & Ayana, 2018;Santoso et al 2019). Maternal education, awareness, and knowledge about child feeding practices are recognized factors affecting child's dietary diversity (Ickes et al, 2015).…”

“…Not having enough water to prepare complementary foods in this appropriate manner was the main reason cited for feeding infants lesspreferred foods in substitution in a recent cross-cultural study of 19 sites in 16 low-and middle-income countries (Schuster, Butler, Wutich, Miller, Young, & HWISE Consortium, n.d.). All these waterfood and child feeding linkages are likely mediated by gender role arrangements given that women are usually managing both household water (Das & Safini, 2018) and child care (Rakotonirainy et al, 2018) duties in many parts of the world, including India.…”

Pengembangan Indeks Ketahanan Pangan Rumah Tangga dan Kaitannya dengan Tingkat Kecukupan Zat Gizi dan Status Gizi Anak Balita

“…46,47 Semua jenis zat gizi khususnya energi, protein, seng, kalsium, dan besi diperlukan pada anak berusia di bawah lima tahun untuk mendukung proses pertumbuhan, aktivitas, serta kebutuhan metabolisme basal. 48,49 (50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60) 62,3 ± 23,0 Rawan pangan berat (≤50) 70,9 ± 25,3 p-value(r) 0,000 (-0,251)** 0,000 (0,333)** **p-value dan r-square dari hasil uji korelasi Spearman dan signifikan pada p<0,01 57 Rumah tangga dengan pendapatan rendah cenderung memberi makan yang kurang beragam pada anak-anak mereka dibandingkan dengan rumah tangga berpenghasilan tinggi. 58 Selain itu, pentingnya tingkat pendidikan orang tua terutama ibu karena kualitas makanan pada anak balita tergantung pada perilaku dan keputusan para ibu yang biasanya merawat anak.…”