Paternal Engagement in Infant and Young Child Feeding: A Systematic Review and Meta-Analysis of Its Extent and...

Optimal infant and young child feeding (IYCF) is a critical intervention during the first 1000 days of life, yet in Ethiopia, caregiving roles remain heavily gendered, often excluding fathers. This systematic review and meta-analysis quantified the extent of paternal engagement in IYCF across Ethiopia and identified key associated factors. Following PRISMA guidelines, a comprehensive search of major databases and gray literatures identified 11 cross-sectional studies involving 6030 fathers. Using a random-effects model, the pooled prevalence of paternal engagement was 41% (95% CI: 25%-57%). Significant predictors of increased engagement included having an education above secondary level (AOR 4.27), smaller family size (AOR 4.03), first-born child (AOR 3.36), and positive perceptions toward IYCF (AOR 2.68). Other factors included positive cultural beliefs (AOR 2.35), good IYCF knowledge (AOR 2.21), and the child being male (AOR 2.09). This study calls for shifting Ethiopia's nutrition strategies from mother-centric to family-centric models by implementing father-inclusive, culturally sensitive programs. Training health extension workers to challenge gender norms through counseling and community dialog will address socio-cultural barriers, promote shared caregiving, and improve child feeding outcomes.