Predictors of Minimum Acceptable Diet among Children Aged 6–23 Months in Nepal: A Multilevel Analysis of Nepal Multiple Indicator Cluster Survey 2019

Abstract

Background: Minimum Acceptable Diet (MAD), developed by the WHO and UNICEF, is a binary indicator of infant and young child feeding practice that assesses the quality and sufficiency of a child’s diet between the ages of 6 and 23 months. Identifying factors associated with MAD among children can inform policymakers to improve children’s nutritional status. Methods: We extracted data of 1930 children aged 6–23 months from the Nepal Multiple Indicator Cluster Survey 2019. Multilevel analysis was performed to identify factors associated with MAD. Results: Only 30.1% of the children received MAD. Children aged 13–18 months [aOR (Adjusted odds ratio): 2.37, 95% CI (95% Confidence Interval): 1.77, 3.17] and 19–23 months (aOR: 2.6, 95% CI: 1.95, 3.47) were more likely to receive MAD than children aged 6–12 months. Early breastfed children (aOR: 1.34, 95% CI: 1.05, 1.72), those currently breastfeeding (aOR: 4.13, 95% CI: 2.21, 7.69) and children without siblings aged under five (aOR: 1.33, 95% CI: 1.03, 1.73) were more likely to receive MAD. Younger maternal age (aOR: 0.97, 95% CI: 0.95–1.0), higher level of mother’s education (aOR: 1.04, 95% CI: 1.0–1.08) and more media exposure among mothers (aOR: 1.66, 95% CI: 1.24, 2.21) were positive predictors of MAD. Relatively disadvantaged ethnicity/caste (aOR: 0.71, 95% CI: 0.53, 0.94), rural residence (aOR: 1.45, 95% CI: 1.06, 2.00) and residing in Madhesh province (aOR: 0.61, 95% CI: 0.37, 1.0) were also significant predictors of MAD. Conclusions: Children aged 6–12 months, without appropriate breastfeeding, having under-five years siblings, with older mother or mother without media exposure or low education, from relatively disadvantaged ethnicity/caste, from urban areas and residing in Madhesh Province were less likely to receive MAD. Our findings can inform infant and young child feeding policies and practices in Nepal.

Minimum acceptable diet and associated factors among children aged 6–23 months in Ethiopia: A systematic review and meta-analysis

“…The odds of having good minimum acceptable diet were 1.714 and 2.150 times higher among mothers with having elementary and secondary and above education level compared to those illiterate mothers, respectively. This are supported with the study done on the Demographic and health survey data of Nepal(DHS 2011 and 2019) [53,59],…”

“…Our pooled prevalence of MAD was also lower than the study done on DHS 2019 [59] Nepalese study with estimated prevalence of 30.1%. The difference might be due to more than three-fourth of the participants were being urban and have accessibility to variety of foods.…”

“…Such, opportunity will increase infant and young children feeding habit [70,71]. Likewise, the odds of having MAD were DHS(2019)Nepal [59]. Mass media exposure will increase chance of being good knowledge related to dietary diversity (IYCF).…”

Minimum acceptable diet and associated factors among children aged 6–23 months in Ethiopia: a systematic review and meta-analysis

“…Our pooled prevalence of MAD was also lower than the study done on DHS 2019 [ 57 ] Nepalese study with estimated prevalence of 30.1%. The difference might be due to more than three- fourth of the participants were being urban and have accessibility to variety of foods.…”

Spatial distribution of stunting and wasting in 6–59 months children in Nepal: analysis using a Bayesian distributional bivariate probit model

“…But there is a paucity of programs that focus on child nutrition from 24 to 59 months children. Moreover, several socio-demographic factors and cultural practices correlate with child feeding practices among children in Nepal ( 46 ) . Furthermore, children of an underweight mother were significantly more likely to be stunted or wasted; however, children of overweight mothers had significantly fewer chances of being stunted.…”