Abstract
Poor complementary feeding practices among infants and young children in Côte d’Ivoire are major contributing factors to the country’s high burden of malnutrition. As part of a broad effort to address this issue, an affordable, nutritious, and locally produced fortified complementary food product was launched in the Côte d’Ivoire in 2011. The objective of the current research was to assess various levels of coverage of the program and to identify coverage barriers. A cross-sectional household survey was conducted among caregivers of children less than 2-years of age living in Abidjan, Côte d’Ivoire. Four measures of coverage were assessed: “message coverage” (i.e., has the caregiver ever heard of the product?), “contact coverage” (i.e., has the caregiver ever fed the child the product?), “partial coverage” (i.e., has the caregiver fed the child the product in the previous month?), and “effective coverage” (i.e., has the caregiver fed the child the product in the previous 7 days?). A total of 1,113 caregivers with children between 0 and 23 months of age were interviewed. Results showed high message coverage (85.0%), moderate contact coverage (37.8%), and poor partial and effective coverages (8.8% and 4.6%, respectively). Product awareness was lower among caregivers from poorer households, but partial and effective coverages were comparable in both poor and non-poor groups. Infant and young child feeding (IYCF) practices were generally poor and did not appear to have improved since previous assessments. In conclusion, the results from the present study indicate that availability on the market and high awareness among the target population is not sufficient to achieve high and effective coverage. With market-based delivery models, significant efforts are needed to improve demand. Moreover, given the high prevalence of malnutrition and poor IYCF practices, additional modes of delivering IYCF interventions and improving IYCF practices should be considered.
Highlights
The prevalence of malnutrition in infants and young children in Côte d’Ivoire is high
The primary objectives of the current research were to determine the coverage of the PACE program among children 6–23 months of age living in Abidjan, identify the major barriers to coverage of the program, and formulate recommendations for future program activities
In the first stage of sampling, nine primary sampling units (PSUs), which consisted of the smallest census unit and contained about 200 households, were randomly selected in each of the 10 communes in Abidjan with the probability of selection for each PSU being proportional to the number of households in that PSU
Summary
The prevalence of malnutrition in infants and young children in Côte d’Ivoire is high. A more recent national survey conducted in 2011–2012, which assessed the prevalence of anemia, stunting, wasting, and underweight, indicated some progress, but persistently high prevalence rates of malnutrition: 75% of children between 6 and 59 months were anemic, while 30% were stunted, 8% were wasted, and 15% were underweight [2]. After 6 months of age, the nutritional requirements of infants increase for all macro- and micronutrients such that breast milk alone can no longer cover the infants’ needs [4, 5]. To ensure adequate nutrition and healthy growth outcomes, it is essential that a variety of nutrient-dense foods be introduced into children’s diets to complement breast milk. The main strategies to increase nutrient density in children’s diet are dietary diversification, supplementation, and fortification [6]. The appropriateness and suitability of a particular approach depends on the context and nutritional needs of the target population as discussed elsewhere [6]
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