Fathers’ Complementary Feeding Support Moderates the Association Between Mothers’ Autonomous Household Decision-Making and Optimal Complementary Feeding

Abstract

ObjectivesThe evidence base on the role of maternal decision-making autonomy in optimal complementary feeding practices is not consistent, leaving questions about moderation by social support. The objective of this research is to examine the moderation effect of fathers’ complementary feeding support on the association of maternal decision-making autonomy with complementary feeding indicators. MethodsWe used logistic regression interaction models to examine whether complementary feeding support was a moderator of the association between decision-making autonomy and complementary feeding using data from endline (cross-sectional) surveys administered to 495 cohabiting mothers and fathers of children aged 6–23 months in Igabi local government area (LGA), Kaduna State, Nigeria. The 12-month Alive & Thrive intervention engaged fathers through complementary feeding messages from religious and community leaders, text, and voice messages. Mothers received home visits and feeding bowls from community health extension workers (CHEWs). The intervention also included mass media messaging on radio and TV. ResultsMaternal decision-making autonomy was associated with minimum dietary diversity (AOR, 1.15; 95% CI, 1.00, 1.32), minimum meal frequency (AOR, 1.31; 95% CI, 1.11, 1.53), minimum acceptable diet (AOR, 1.24; 95% CI, 1.09, 1.41) and feeding children fish (AOR, 1.23; 95% CI, 1.08, 1.40). Complementary feeding support was associated with minimum dietary diversity (AOR, 1.38; 95% CI, 1.08, 1.75), minimum meal frequency (AOR, 1.34; 95% CI, 1.05, 1.70), minimum acceptable diet (AOR, 1.40; 95% CI, 1.14, 1.73), feeding eggs (AOR, 1.49; 95% CI, 1.16, 1.90) and feeding fish (AOR, 1.30; 95% CI, 1.06, 1.60). In the interaction models, the simple slopes for decision-making were significant for most of the complementary feeding indicators when fathers offered > 2 types of support. ConclusionsWithin the context of Kaduna, high levels of fathers’ complementary feeding support strengthen the association of maternal decision-making autonomy with complementary feeding practices. Funding SourcesThis research was funded by The Alive & Thrive initiative, managed by FHI Solutions, and funded by the Bill & Melinda Gates Foundation, Irish Aid, and other donors.