In this community-based cross-sectional study, the overall prevalence of hygienic complementary feeding practice among mothers who had children aged 6-24 months was found to be 33.6%, 95% CI: (29.7, 37.6) and factors such as, living in urban areas, presence of hand washing facility near the latrine, presence of separate area to store raw and cooked foods and presence of three-compartment dishwashing system were significant predictors of hygienic complementary feeding practice.
The prevalence of hygienic complementary feeding practice in this study was lower than the prevalence (38.9%) reported by a study conducted in Bahir Dar Zuria District, Northwest Ethiopia [26]. This might be due to the differences in the study setting as Bahir Dar Zuria district is located near the capital city of Amhara National Regional State, Bahir Dar city; mothers/ caregivers might have better information and water and sanitation access compared to the current study area. Access to better information and water and sanitation services helps mothers/caregivers to improve the habit of good hygienic complementary practice.
Similarly, this prevalence was lower than the prevalence (39.6%) reported by a cross-sectional study conducted in rural Kebeles of Harari Region, Ethiopia[31].This might be due to the differences in the measurement of the outcome variable. In the study conducted in the Harari region, the sum of the three-point score scale (always, sometimes, and never) was used to measure the status of hygienic complementary feeding practice. However, in this study, this three-point scale was dichotomized into “Yes” or “No” responses coded as 1 and 0 respectively and added to measure the outcome variable.
Similarly, the result in this study was much lower than the prevalence (51%) reported by a study
done in Abobo district, Southwestern Ethiopia on the model and non-model household mothers[32]. This discrepancy might be due to differences in the measurement of good hygienic practice and the comparative nature of the previous study includes the model households which have a higher tendency to adopt good food hygiene behaviors.
The study also revealed that urban residence, presence of hand washing facility near the latrine, presence of separate area to store raw and cooked foods, and presence of three-compartment dishwashing facilities showed statistically significant association with hygienic complementary feeding practice among mothers who had children aged 6-24 months.
In this study, living in urban areas was a significant predictor of good hygienic complementary feeding practice among mothers with children aged 6-24 months. The odds of good hygienic complementary feeding practice were higher in mothers/caregivers who lived in urban areas compared to mothers/caregivers living in a rural area. A similar finding was reported by a cross-sectional study conducted in Bahir Dar Zuria District, Northwest Ethiopia[26]. This might be due to mothers in urban areas might have access to information and an adequate supply of water which helps them in improving the habit of good hygienic practices.
In this study, the presence of a hand washing facility near the latrine was associated with good hygienic complementary feeding practice. This finding is supported by a study conducted in Bahir Dar Zuria District, Northwest and Abobo district Southwestern, Ethiopia[26, 32]. The reason for this association is the presence of a hand washing facility near the latrine inevitably promotes hand washing after visiting the toilet which helps to adopt hygienic practices in day-to-day activities especially during food preparation.
Similarly, mothers/caregivers who had a separate area to store raw and cooked foods had higher odds of good hygienic practices during complementary feeding. This is because the presence of a separate storage area forready-to-eat and raw foods might have an important role in avoiding unintentional cross-contamination from raw food staff to cooked ones.
The odds of hygienic complementary feeding practice were higher among mothers/caregivers who had three-compartment dishwashing facility compared to their counterparts. This might be due to the presence of a three-compartment dishwashing facility promotes the proper way of washing food utensils which in turn play important role in improving hygienic food preparation.
Strength and limitations: The community-based nature of the study could be taken as the strength of this study. However, the possibility of social desirability bias could be taken as the limitation of this study. Moreover, this study share drawbacks of the cross-sectional study design as this can’t determine the temporal relationship between the predictor variable and the outcome variable.
Conclusions and recommendations
The prevalence of good hygienic practice during complementary feeding among mothers who had children aged 6-24 months was still low in the study area. This study also revealed that the observed prevalence of hygienic practice during complementary feeding was very low compared to previous studies in Ethiopia. The study also revealed urban residence, presence of hand washing facility near the latrine, presence of separate area to store raw and cooked foods, and presence of three-compartment dishwashing facilities showed statistically significant association with hygienic complementary feeding practice among mothers who had children aged 6-24 months.
District health office should design a health education program for both urban and rural mothers with 6-24 months children about the importance of hand washing facilities near the latrine, separate area to store raw and cooked foods, and three-compartment dishwashing system in developing the habit of safe and hygienic preparation of foods.
The low prevalence of hygienic complementary feeding practices can be improved by providing training for mothers and the women’s health development armies’ weekly discussion agendas should include the plan to raise issues related to hygienic complementary feeding to make possible sharing of information and increase the awareness of mothers. Therefore, the health extension workers should design training programs on hygienic food preparation especially during complementary feeding.