Socio-economic inequalities in and factors associated with minimum dietary diversity among children aged 6–23 months in South Asia: a decomposition analysis

Rahman, Md Ashfikur; Kundu, Satyajit; Rashid, Harun Or; Tohan, Mortuja Mahamud; Islam, Md Akhtarul

doi:10.1136/bmjopen-2023-072775

Cited by 4 publications

(1 citation statement)

References 47 publications

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“…In comparison to figures from other Asian countries, our findings align closely with those from Indonesia (46%) (IDHS) 16 , and the Philippines (53%) (PDHS) 17 . Yet, these figures are considerably lower than the findings reported in India (72%) 18 , and Pakistan (85%) 18 , which suggests that children aged 6-23 months face inadequate access to MDD across different countries. This discrepancy may be attributed to variations in food cultures [19][20][21] .…”

Section: Discussioncontrasting

confidence: 59%

Exploring minimum dietary diversity among cambodian children using four rounds of demographic and health survey

Singh,

Rahut,

Sonobe

2024

Sci Rep

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Dietary diversity among children is a crucial factor influencing their nutritional status; therefore, this paper uses data from four rounds of the Cambodia Demographic and Health Survey (CDHS) to examine the minimum dietary diversity among children aged 6–23 months. Multilevel binary regression is used to evaluate the variation in minimum dietary diversity at the cluster and province levels. The results show that nearly half of Cambodian children consistently lacked access to vitamin A-rich fruits and vegetables. Although the prevalence of inadequate minimum dietary diversity (MDD) among children significantly dropped from 76% in 2005 to 51% in 2021–2022, it is still high and needs attention. A decomposition analysis (Blinder–Oaxaca decomposition) was further used to understand the drivers of this temporal change in dietary diversity. The empirical results show that clusters represented the most significant source of geographic variation with respect to all eight food groups and MDD. Nutritional policy should improve education and awareness, reduce socio-economic disparities, leverage media, and promote full antenatal care to improve dietary diversity in Cambodia. Initiatives targeting the enhancement of insufficient minimum dietary diversity intake should encompass individual aspects and be customized to suit geographic and community settings.

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Section: Discussioncontrasting

confidence: 59%

Exploring minimum dietary diversity among cambodian children using four rounds of demographic and health survey

Singh,

Rahut,

Sonobe

2024

Sci Rep

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Determinants of minimum dietary diversity for lactating and pregnant women

Hossain,

Uddin,

Rahman

et al. 2024

PLoS ONE

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Introduction Maternal and child health, which is integral to public health, depends on maintaining a healthy diet during pregnancy and lactation to achieve optimal outcomes. This study aimed to investigate the prevalence and determinants of minimum dietary diversity (MDD) among pregnant and lactating women (PLW) in this particular context. Methods A stratified cluster sampling approach was employed, encompassing intervention areas (Rangpur and Nilphamari in Bangladesh) as strata, with 30 clusters. The study included 631 pregnant and lactating women (PLW) aged 15 to 49 years, focusing on their consumption of a minimally diverse diet. The outcome variable was binary: MDD (1 = if they consumed ≥ 5 food items from a basket of 10 food groups, indicating they met the MDD; 0 = if they consumed < 5 items, indicating they did not meet the MDD), assessed based on ten food groups over a 24-hour period. The data were analyzed using a binary logistic regression model. Results The study found that 51.19% of PLW met MDD criteria, indicating positive dietary practices. Those aged 21–49 years had significantly lower odds of meeting MDD than those aged 15–20 years. Education played a key role, with completion of primary (p = 0.029) and secondary incomplete education (p = 0.055) associated with higher odds of meeting MDD. Other identified predictors included climate-smart techniques for agriculture, women’s empowerment, food security, producing legume, nut and seeds and negative impact on family expenditure due to increase in commodity prices, especially food prices. Employing climate-smart agriculture increased odds by 1.58 times (p = 0.028), empowered women had 2.31 times higher odds (p < 0.001), and food security played a crucial role (p = 0.006). Moreover, producing legumes, nuts, or seeds was significantly associated with higher odds of meeting MDD (OR = 1.55, p = 0.039), while experiencing negative economic impacts lowered the odds (OR = 0.63, p = 0.034). Conclusion The study provides insights into factors influencing MDD among PLW in northern Bangladesh. Empowering women and promoting climate-smart techniques for agriculture emerged as pivotal determinants, alongside enhancing education levels, increasing food security, and addressing economic barriers. Implementing multifaceted interventions that consider socio-demographic diversity, economic disparities, and dietary preferences is crucial for enhancing dietary diversity and improving health outcomes in this vulnerable population.

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Changing maternal and child nutrition practices through integrating social and behavior change interventions in community-based self-help and support groups: literature review from Bangladesh, India, and Vietnam

Verma,

Nguyen,

Purty

et al. 2024

Front. Nutr.

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IntroductionSelf-help groups (SHGs) and Support Groups (SGs) are increasingly recognized as effective mechanisms for improving maternal and young child nutrition due to their decentralized, community-based structures. While numerous studies have evaluated the outcomes and impact of SHGs and SGs on nutrition practices, there remains a gap in the literature. To address this, we conducted a literature review to examine the role of SHGs and SGs in improving health and nutrition outcomes, focusing on marginalized women, especially pregnant and lactating women (PLW), in India, Bangladesh, and Vietnam, with an emphasis on programs supported by the international non-governmental initiative, Alive & Thrive.Methods and materialsWe conducted a literature review to assess various models, summarizing findings from 34 documents, including research studies, evaluation reports, program materials, strategies, annual reports, work plans, and toolkits. Relevant information from these documents was extracted using predetermined forms.ResultsIn India, the models used SHGs with 10–20 women, federated into larger village and district organizations. Bangladesh and Vietnam SGs have similar structures but with local leaders and committees playing key roles. In all three countries, interventions aimed to improve health and nutrition practices through social behavior change (SBC) interventions, including peer-to-peer learning, interpersonal communication, home visits, and community meetings. Outcomes of the interventions showed that SHG members had increased knowledge of breastfeeding, complementary feeding, and improved dietary diversity compared to non-SHG participants. Interventions helped improve infant and young child feeding practices. Common challenges included sustaining the SHGs, ensuring adequate participation, socio-cultural barriers, and logistical difficulties in reaching PLW in remote areas. Limited time for health topics during SHG meetings and the dissolution of older SHGs were also significant issues.ConclusionSHG and SG models demonstrate success in improving health and nutrition outcomes but face challenges in scale, sustainability, and participation. Integrating nutrition-focused SBC interventions into SHGs and SGs requires significant capacity building for technical and counseling skills. Ensuring comprehensive coverage and robust quality assessment during community-based rollouts is essential. To sustain these interventions, it is crucial to prevent group dissolution, allow time for maturation, and secure strong stakeholder engagement and political support.

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Socio-economic inequalities in and factors associated with minimum dietary diversity among children aged 6–23 months in South Asia: a decomposition analysis

Cited by 4 publications

References 47 publications

Exploring minimum dietary diversity among cambodian children using four rounds of demographic and health survey

Exploring minimum dietary diversity among cambodian children using four rounds of demographic and health survey

Determinants of minimum dietary diversity for lactating and pregnant women

Changing maternal and child nutrition practices through integrating social and behavior change interventions in community-based self-help and support groups: literature review from Bangladesh, India, and Vietnam

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