Factors Associated With Complementary Feeding Practices in Afghanistan: Analysis of the Multiple Indicator Cluster
Hannah Gardner1, Atma Prakash2, Shweta Rawal1
1UNICEF Regional Office for South Asia, Kathmandu, Nepal.
Insights
In Afghanistan, most young children (6-23 months) do not meet minimum dietary diversity, meal frequency, or acceptable diet standards. Older children and those from wealthier households have better nutrition outcomes, highlighting critical needs for intervention.
Area of Science:
- Nutrition Science
- Public Health
- Pediatrics
Background:
- Optimal infant and young child feeding practices, including timely introduction of complementary foods alongside breastfeeding, are crucial for nutritional status.
- Children aged 6-23 months in humanitarian settings often face inadequate diets, increasing risks of malnutrition and poor health outcomes.
- Key indicators for infant and young child feeding (IYCF) include minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD).
Purpose of the Study:
- To estimate the prevalence of children aged 6-23 months meeting MDD, MMF, and MAD indicators in Afghanistan.
- To identify child, maternal, and household determinants associated with meeting these IYCF indicators.
- To provide nationally representative data to inform nutrition interventions in Afghanistan.
Main Methods:
- Analysis of data from 9193 children aged 6-23 months from the Afghanistan Multiple Indicator Cluster Survey 2022-2023.
- Calculation of percentages of children meeting MDD, MMF, and MAD criteria.
- Multivariable logistic regression used to assess determinants of MDD, MMF, and MAD.
Main Results:
- High rates of inadequacy: 85% did not meet MDD, 65% did not meet MMF, and 93% did not meet MAD.
- Older children (18-23 months) and children from the richest households had significantly higher odds of meeting all three criteria.
- Rural residence was associated with higher odds of meeting MMF and MAD, but not MDD. Significant regional variations were observed.
Conclusions:
- Alarmingly low adherence to recommended complementary feeding practices among young children in Afghanistan.
- Socioeconomic status, age, and geographic location are significant factors influencing children's dietary intake.
- Urgent need for funding to support evidence-based interventions addressing identified determinants of poor nutrition.
Abstract:
Children between the ages of 6 and 23 months require the age-appropriate introduction of complementary foods alongside breastfeeding to meet their nutritional needs, but in humanitarian settings children frequently do not receive appropriate diets. Using data from 9193 children aged 6-23 months in the Afghanistan Multiple Indicator Cluster Survey 2022-2023, this paper provides nationally representative estimates of the percentage of children meeting key IYCF indicators and assesses the child, maternal and household determinants of receiving minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD) using multivariable logistic regression. Results showed that 85%, 65% and 93% of children were not fed a diet that met MDD, MMF or MAD criteria, respectively. Older children (18-23 months) had significantly higher odds of meeting all three criteria compared to younger children (6-11 months) (MDD aOR = 2.46, 95% CI: 1.93-3.12; MMF aOR = 1.29, 95% CI: 1.11-1.50; MAD aOR = 2.00, 95% CI: 1.51-2.65), as did children from the richest households (vs. poorest) (MDD aOR = 2.85, 95% CI: 1.72-4.70; MMF aOR = 1.82, 95% CI: 1.35-2.46; MAD aOR = 3.88, 95% CI: 2.14-7.04). There was substantial variation in the odds of all outcomes by region. Rural residence (vs. urban) was also associated with higher odds of receiving MMF (aOR = 1.60, 95% CI: 1.25-2.05) and MAD (aOR = 1.69, 95% CI: 1.18-2.42) but not MDD. Overall, alarmingly few children in Afghanistan are receiving appropriate complementary diets amidst a context of concurrent political, economic and environmental crises. Reversals to funding reductions are vital to ensure proven interventions responding to the determinants identified here continue to be delivered to support nutrition among Afghanistan's infants and young children.
Related Concept Videos
01:27Parenting Styles
Authoritarian Parenting
This style is strict and controlling, with little room for open dialogue. Authoritarian parents demand obedience and often enforce rules with minimal warmth. Children raised this way may lack social skills and initiative, usually comparing themselves to others unfavorably.
Authoritative...
02:01Factorial Design
01:20Attachment
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
00:55Parental Care
01:30Socioemotional Experience and Gender Development