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Determinants of Minimum Acceptable Diet Among Children Aged 6-23 Months in Somaliland: A Cross-Sectional Study Using
Mohamed Said Hassan1, Asma Abdirahman2
1College of Health Sciences, School of Medicine and Surgery Amoud University Borama Somalia.
Background And Aims:
Appropriate infant and young child feeding (IYCF) practices are critical for reducing undernutrition. In Somaliland, child stunting (21%) and wasting (11%) remain significant public health challenges (Somaliland Health and Demographic Survey [SHDS] 2020). This study evaluates the determinants of the minimum acceptable diet (MAD) among children aged 6-23 months to provide evidence for targeted nutritional interventions.
Methods:
Data from the SHDS 2020 were analyzed. The analytical sample comprised 3336 children aged 6-23 months with complete dietary recall data. MAD was calculated based on the updated WHO/UNICEF 2021 guidelines, requiring both minimum dietary diversity (MDD: ≥ 5 of 8 food groups) and minimum meal frequency (MMF). Covariates including child age, maternal age, education, and household wealth were selected based on theoretical relevance and prior literature. Multivariable logistic regression models, adjusted for the complex survey design using Stata 17, identified significant predictors. The analytic sample size used in the final regression was 3336 mother-child pairs.
Results:
IYCF practices remain suboptimal. Among children aged 6-23 months, only 6.3% (95% CI: 4.8-7.8) met the MAD criteria. The low prevalence of MAD appears primarily related to low dietary diversity (15.0%) rather than meal frequency (54.1%). In the multivariable model, child age, maternal education, and household wealth were significant predictors. Children in the richest quintile had 6.03 times higher odds of meeting MAD (AOR = 6.03, 95% CI: 2.82-12.90, p < 0.001) compared with those in the poorest quintile.
Conclusion:
MAD is strongly associated with socioeconomic status and maternal literacy. Public health strategies should guide policy toward the future evaluation of nutrition-sensitive agriculture and social protection programs to increase access to micronutrient-dense food groups.

