Iron-Rich Food Consumption and Predictors Among Children Aged 6 to 23 Months in Ethiopia: A Frequentist and Bayesian...

Iron deficiency is a major public health issue in Ethiopia, especially in children aged 6 to 23 months. The 6 to 23 months period marks the introduction of complementary feeding alongside breast milk, when nutritional needs surge but intake often falls short, leading to high vulnerability. This study aimed to assess the weighted iron-rich food consumption, trends, and predictors among children aged 6-23 months old in Ethiopia. This study used Ethiopian Demographic and Health Survey (EDHS-2005-2019) data with a total weighted sample size of 7445 among children aged 6-23 months old. Bayesian multilevel logistic regression analysis using a Markov chain Monte Carlo simulation was conducted to identify predictors of good iron-rich food consumption. The overall weighted proportion of iron-rich food consumed among children aged 6-23 months in Ethiopia was 16.85% [95% CI: 15.01%, 18.86%]. In Ethiopia, children aged 6-23 months increased their intake of iron-rich food from 10.29% [95% CI: 8.19%, 12.86%] in EDHS 2005 to 13.13% [95% CI: 11.11%, 15.47%] in EDHS 2011 and very sharply increased to 21.27% [95% CI: 18.54%, 24.29%] in EDHS 2016 and slightly increased to 23.77% [95% CI: 19.66%, 28.44%] in EDHS 2019. The findings indicated that being 12-23 month-old children, having married parents, children born to mothers who completed primary education, secondary education, a higher education, being born to poorer family, middle wealth quintile, the richer family, richest family, and having antenatal care visits 1-3, ≥ 4 antenatal care visits were positively associated with iron-rich food consumption. Nevertheless, children born to mothers ≥ 35 years old, residing in pastoral areas, and metropolitan areas were negatively significantly associated with good iron-rich food intake among children. The weighted proportion of 16.85% indicates persistently low intake nationally, far below WHO minimum dietary diversity recommendations (≥ 50% for complementary feeding), signaling a high anemia risk in this vulnerable group. Significant associations (e.g., higher maternal education, wealthier quintiles, more ANC visits) underscore how enabling factors boost complementary feeding practices. Ethiopia should pursue strategies to boost iron-rich food consumption.