Disparities in micronutrient intake among children 6-23 months in Ethiopia: a multi-level analysis based on national survey data

Abstract

Both micronutrient deficiency and undernutrition among children are priority areas of public health concern in Ethiopia. The main objective of this study was to examine the factors associated with disparities in micronutrients intake among children 6-23 months. Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total of 3076 children aged 6-23 months were used for the present analysis. The outcome variable was multiple micronutrient intake, which was constructed based on the linear combination of six sets of variables (4 supplements and 2 food-based intakes). Mixed-effect Poisson regression model was used to assess the determinants of multiple micronutrient intakes. The regression results show that micronutrient intakes were lower among children of non-first birth order by 58% (IRR=0.492, 95% CI:0.441-0.550); higher for children who got antenatal care (ANC) service during pregnancy (RR=1.121 95%CI:1.027-1.224) and postnatal care service in the first two months after birth (RR=1.255, 95% CI:1.138-1.383). Other predictors included mother’s age (RR=1.246, 95%CI: 1.118-1.389), parity (RR=1.538, 95% CI:1.316-1.798), maternal education (RR=1.204, 95%CI:1.089-1.331, maternal work status, household wealth, and access to the radio. The results also showed a regional disparity in micronutrient intake. Given the huge adverse impacts of poor micronutrient intake, fortification (supply side) is suggested as one of the ways to enable households to get easy access to these essential micronutrients. In conjunction with this, improving knowledge and attitude mothers through continuous behavioral change communication approaches could make a significant impact on the uptake of micronutrient supplements.