Predictors of dietary diversity in children ages 6 to 23 mo in largely food-insecure area of South Wollo, Ethiopia.

ABSTRACT

OBJECTIVE: The aim of this study was to assess the level and predictors of dietary diversity (DD) in predominantly food-insecure area of South Wollo, Ethiopia among children ages 6 to 23 mo. METHODS: The study was conducted in October 2014. We selected 2080 children using a multistage sampling technique. DD in the preceding day of the survey was assessed with the standard seven-food group score. Predictors of DD were identified via Poisson regression model and the outputs are presented using adjusted incidence rate ratio (IRR) with 95% confidence interval (CI). RESULTS: Only 7% (95% CI, 5.9%-8.1%) of the children met the recommended minimum DD. Child age and maternal knowledge of infant and young child feeding (IYCF) were significant predictors of DD with IRR of 1.027 (95% CI, 1.022-1.032) and 1.026 (95% CI, 1.010-1.043). Households with moderate and severe food insecurity had 9% (95% CI, 3.8-13.9%) and 24.9% (95% CI, 14.6-44%) reduced chance of providing diversified food. Husbands' direct involvement in IYCF increased DD by 13.7% (95% CI, 7.4-20.4). Caregivers who discussed IYCF with health extension workers, participated in cooking demonstrations, and heard radio spots about IYCF in the preceding 3 mo had 11.7% (95% CI, 3.4-20.7%), 18.9% (95% CI, 0.3-40.9%), and 11.4% (95% CI, 4.8-18.4) higher chance of providing diversified food, respectively. Backyard gardening (IRR, 1.088; 95% CI, 1.031-1.148) and number of chickens owned (IRR, 1.011; 95% CI, 1.001-1.021) also were significant predictors. CONCLUSIONS: In predominately food-insecure areas, nutrition education, implementation of nutrition-sensitive agriculture, and husband involvement in IYCF can improve children's DD.