Concordance of mother-child (6-23month) dietary diversity, its implications and associated factors in kucha district, gamo gofa zone, south Ethiopia tesfaye guja

Abstract

Introduction: Meeting minimum standards of dietary quality in mothers & children is a challenge in many developing countries including Ethiopia. Until recently, the focus has been primarily on micronutrient supplementation, which is essential for nutritionaly high risk mothers and children and emergencies, but cannot provide the long term nutrition and economic benefits. Emerging evidence suggests that maternal and child dietary diversity is associated but little is known about associated factors & there are no/ few studies, on concordance of mother-child dietary diversity and associated factors in Ethiopia and none is documented in the study area. Objective: To examine the concordance/ discordance of mother- child (6-23month) dietary diversity, its implication & associated factors in Kucha district, Gamo Gofa zone, South Ethiopia Method: Community based cross-sectional study was conducted in Kucha district, South Ethiopia from March 6 to April 13, 2017. A total of 791 mother- child (6-23 months) pairs were assessed in 11 selected kebeles of the district. Mother-child pairs were selected by simple random sampling method using the family folder of the health post as a sampling frame. The socio-demographic & economic characteristics, the previous 24 hours dietary consumption of mothers and children, food insecurity status /HFIAS/ and wealth index of the household data were collected by trained interviewers. The 7 food groups of WHO for children (IYCF) & the 10 food groups of FANTA/FAO, 2016 (MDD-W) for mothers were used to analyze. Cohen’s Kappa statistics was calculated to see the strength of concordance. Multivariable logistic regression model was fitted to determine the predictors of mother-child dietary diversity concordance. Result: Cohen’s Kappa statistics (Kappa = 0.43), showed that the strength of concordance between mother- child dietary diversity was good. Only 56 (7.1%) of mothers were negative deviants and 133 (16.8%) of mothers were positive deviants in dietary diversity consumption. A rural dwellers (AOR =3.49; 95% CI: 1.90-6.41), mothers who had no formal education (AOR= 1.8; 95% CI: 1.08-3.05, mothers who had no milking cow (AOR= 1.7; 95% CI: 1.10- 2.56) and children who fed low diversity diets (AOR= 8.23; 95% CI: 5.17-13.08) and mothers who consumed low dietary diversity (AOR= 0.46; 95% CI: 0.29-0.74) were found to be independent predictors of concordance. An increase in the percentage of children reaching the minimum dietary diversity was greater with successive increase in maternal dietary diversity. Conclusion and recommendations: Despite, interesting similarity between mothers & children dietary consumption, more than three quarter of concordants didn’t achieve the recommended dietary diversity score (were low concordants). Take into account the multi-sectoral and multidimensional nature of nutrition- continued mobilization (monthly) of mothers by health facilities on diversified diet consumption, facilitate rural women’s access to high school education, enhance home based milking cow rearing and promote nutrition sensitive agriculture to meet the dietary requirements of mothers and children in a sustainable manner and public health efforts to improve child nutrition may be strengthened by promoting maternal dietary diversity due to its potential effect on the entire family.