Abstract
While the household in which a child grows up is considered a critical environment that influences nutrition outcomes, there is little research examining the influence of household composition and structure on complementary feeding practices. This study examined the influence of household structure and composition on complementary feeding practices, using the Ethiopian Demographic and Health Survey (EDHS), 2000 to 2016. The composition variables were calculated from the attributes of household members (alters) and the structure variables from their kinship status. A multilevel mixed-effects regression model, specifying survey rounds as the random effect, was used to examine the association between household structure/composition and the Minimum Meal Frequency (MMF) and Minimum Dietary Diversity (MDD). The average Marginal Effects (MEs) were calculated to facilitate practical interpretation. Children of caregivers with a higher number of alters (degree), unique number of kinship category (effect size), closely related (constraint), and mixed-age alters (age diversity) seemed to increase the probability of meeting the MDD. Degree and effective size decreased the probability of meeting MMF, while constraint increased it. Overall, this study revealed some associations between household structure and composition and complementary feeding practices. Hence, complementary feeding interventions could be adapted to account for the household structure and composition variations.
Highlights
Optimal nutrition during the first 1000 days of life, spanning from conception to age two, lays the foundation for child health and well-being [1]
The number of analyzed cases varies for each outcome
Minimum Dietary Diversity (MDD) results were available for Ethiopian Demographic and Health Survey (EDHS) 2000, 2005, and 2016; Minimum Meal Frequency (MMF)
Summary
Optimal nutrition during the first 1000 days of life, spanning from conception to age two, lays the foundation for child health and well-being [1]. Suboptimal complementary feeding is defined by poor adherence to optimal feeding recommendations, such as the appropriate timing of introducing foods at around six months of age, providing a diverse diet with adequate meal frequency, and continued breastfeeding up to two years of age [4]. A recent systematic review on the quality of complementary feeding practices in Ethiopia highlighted that around 18% of children met Minimum Dietary Diversity (MDD) requirements (defined as eating at least four food groups per day), and 56% of children met the Minimum Meal Frequency (MMF). Complementary feeding practices are influenced by longstanding child-feeding traditions and social norms within families [6] These traditions and norms are embedded in the household interpersonal/social environment, and they determine who feeds the child, the timing of introduction of foods, and what is fed and how. Household members direct and indirect actions influence child taste preferences, eating habits and nutritional outcomes [6,9,10,11]
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