Geospatial distribution and multilevel determinants of inadequate minimum dietary diversity and its consequences for
Bayuh Asmamaw Hailu1,2, Chala Daba3,4, Yawkal Tsega5
1Monitoring and Evaluation, Wollo University, Dessie, Ethiopia.
Insights
Inadequate minimum dietary diversity (MDD) affects 80.3% of young children in Sub-Saharan Africa, leading to malnutrition. Targeted interventions addressing maternal and child factors are crucial for improving child nutrition and achieving Sustainable Development Goal 2.2.
Area of Science:
- Public Health
- Nutrition Science
- Geospatial Analysis
Background:
- Inadequate minimum dietary diversity (MDD) is a primary driver of malnutrition in young children across Sub-Saharan Africa (SSA).
- Understanding the spatial patterns and multilevel factors influencing MDD is critical for achieving Sustainable Development Goal (SDG) 2.2 by 2030.
- This study investigates the geospatial distribution and determinants of inadequate MDD and its consequences in SSA.
Purpose of the Study:
- To determine the geospatial distribution of inadequate MDD in Sub-Saharan Africa.
- To identify multilevel determinants associated with inadequate MDD among children.
- To assess the consequences of inadequate MDD on child undernutrition and health outcomes.
Main Methods:
- Utilized Demographic and Health Surveys data from 57,912 children in SSA.
- Employed spatial and multilevel regression analyses to assess associations.
- Reported Adjusted Odds Ratios (AOR) with 95% Confidence Intervals (CI) for significant factors (p<0.05).
Main Results:
- Prevalence of inadequate MDD was 80.3% with significant spatial variation across SSA countries.
- High burden areas identified in Gabon, Cameroon, Ethiopia, DRC, Chad, Mali, Burkina Faso, Ivory Coast, Liberia, and Senegal.
- Child age, maternal age, education, ANC/PNC visits, media exposure, wealth, maternal stunting/wasting, and facility distance were associated with inadequate MDD. Inadequate MDD significantly increased the risk of anemia, stunting, and wasting.
Conclusions:
- High prevalence of inadequate MDD necessitates urgent attention in SSA, particularly in identified high-burden regions.
- Key determinants include maternal and child demographics, socioeconomic status, healthcare access (ANC/PNC), and maternal nutritional status.
- Geographically targeted interventions focusing on improving maternal nutrition, healthcare utilization, poverty reduction, and maternal employment are recommended.
- Improving MDD is vital for reducing child anemia, stunting, and wasting, contributing to SDG target 2.2.
Background:
Inadequate minimum dietary diversity (MMD) is the leading cause of malnutrition among young children in Sub-Saharan Africa (SSA). The evidence of geospatial distribution and multilevel determinants of inadequate MDD and its consequence among children is important for the Sustainable Development Goal (SDG0) 2030 agenda. Therefore, this study aimed to determine the geospatial distribution and multilevel determinants of inadequate MDD and its consequences among children in SSA.
Method:
The study utilized recent Demographic and Health Surveys data including 57,912 children. Spatial and multilevel analyses were employed, and variables significantly associated with inadequate MDD and undernutrition with MDD consumption were assessed and significance was declared using a p-value threshold of <0.05. Adjusted odds ratio (AOR) with 95% confidence interval (CI) was reported.
Results:
The prevalence of inadequate MDD was 80.3% with distinct spatial variation. Spatial distribution showed that; Gabon, Cameron, Ethiopia, Democratic Republic of Congo, Chad, Mali, Burkina Faso, Ivory Coast, Liberia, and Senegal had a very high burden of inadequate MDD. Factors like children's age, maternal age, educational status, antenatal care (ANC)/ postnatal care (PNC) visits, no media exposure, wealth status, maternal stunting and wasting, and distance from health facilities were associated with inadequate MDD in SSA. The risk of anemia, stunting, and wasting were significantly associated with inadequate MDD among children in SSA.
Conclusion:
The prevalence of inadequate MDD in SSA is high. Spatial distribution revealed that inadequate MDD was prevalent in most areas of the Western, Northern, Eastern, and Central parts of SSA. Maternal and children's age, educational status, ANC/ PNC visits, no media exposure, wealth status, maternal stunting and wasting, and distance from health facilities were determinants of inadequate MDD in SSA. The spatial clustering of inadequate MDD in certain regions of SSA, suggests the need for geographically targeted interventions to address the determinants of inadequate MDD in these high-burden areas. The study revealed strategies should focus on promoting frequent ANC/ PNC visits, improving maternal nutrition, reducing poverty, and improving maternal employment status to reduce inadequate MDD among children. This study highlights a significant association between MDD and anemia, stunting, and wasting in children aged 6--23 months. To address these critical issues, it is essential to improve MDD among children, as this intervention can play a vital role in achieving SDG target 2.2, which aims to end all forms of malnutrition by 2030.
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