A total of 1,174 children aged 6-59 months who had at least the common childhood illness in the last two weeks were included for analysis. The mean age (±SD) of the mothers were 29.06 (± 6.58 years) and 1,017(86.6%) were married (Table 1).
A quarter (26.0%) of children were born in a health institution, and 696(59.3%) were currently breastfed. Eight hundred forty (71.6%) subjects initiated complementary feeding between 6 to 8 months. Two-thirds, 768 (65.4%), of the mothers attended at least one ANC follow-up and 108 (9.6%) of the mothers had PNC visits. One-fourth (28.8%) of the children had watery diarrhea prior to 2 weeks before data collection (Table 2).
Dietary diversity and meal frequency practices
The proportion of children who received a minimum dietary diversity was 27 % (95% CI: 24.4, 29.7%). A meal frequency among breastfed and non-breastfeed children was 83.9% (95% CI: 81.9, 85.9%) and 57.8 % (95% CI: 54.9, 60.5%), respectively. Cereals and roots were provided to the greatest portion of the children (95.7%), and only 24 (2%) of the children were given vitamin A source foods (Figure 1).
Factors associated with dietary diversity and meal frequency
The result of multivariate analysis revealed that ANC visits, food source and place of birth were statistically and independently associated with dietary diversity practice in the study area. Similarly, child age and preparation of complementary foods were statistically associated with a minimum meal frequency.
Accordingly, children whose mothers had ANC visit had 1.6 times (AOR = 1.64; 95% CI: 1.18, 2.27) more likely to have diversified diet compared to their counterparts. Similarly, higher odds of diversified diet were noted among sick children whose mothers gave birth at health facility (AOR = 2.6; 95% CI: 1.85, 3.55), whereas and children from households using home gardening as prime food source had lower odds of adequate dietary diversity than children from households securing food mainly through purchasing from market (Table 3).
On the other hand, increased odds of having adequate meal frequency was illustrated among ill children whose mothers prepared food for their child alone (AOR = 1.9; 95% CI: 1.28, 2.69) compared to counterparts. However, the odds of adequate meal frequency was lower among children aged 6–23 months compared to those aged 24– 59 months (AOR = 0.1, 95% CI: 0.06, 0.15)(Table 4).
Table 1: Parental level Socio-demographic characteristics among children aged 6–59 months at Dabat HDSS, site northwest Ethiopia, 2016
Variables
|
Frequency
|
Percentage
|
Maternal religion
|
|
|
Orthodox Christian
|
1150
|
98
|
Muslim
|
24
|
2
|
Residence
|
|
|
Urban
|
133
|
11.3
|
Rural
|
1041
|
88.7
|
Marital status
|
|
|
Married
|
1017
|
86.6
|
Single
|
109
|
9.3
|
Divorced
|
30
|
26
|
Windowed
|
10
|
0.9
|
Separated
|
8
|
0.7
|
Maternal educational status
|
|
|
Unable to read and write
|
899
|
76.6
|
Abel to read and write
|
35
|
3.0
|
Primary education
|
166
|
14.1
|
Secondary education
|
61
|
5.2
|
Higher education
|
13
|
1.1
|
Table 2: Socio demographic and health care level related characteristics among children aged 6–59 months at Dabat HDSS site, northwest Ethiopia, 2016
Variables
|
Frequency
|
Percentage
|
Age of the child
|
|
|
6-23
|
517
|
44.0
|
24-59
|
657
|
56.0
|
Sex of the child
|
|
|
Female
|
595
|
50.7
|
Male
|
579
|
49.3
|
ANC service
|
|
|
Yes
|
777
|
66.2
|
No
|
397
|
33.8
|
Birth place
|
|
|
Health institution
|
305
|
26.0
|
Home
|
869
|
74.0
|
Birth order
|
|
|
First
|
160
|
13.6
|
Second to fifth
|
698
|
59.5
|
Above fifth
|
316
|
26.9
|
Currently breast feed
|
|
|
Yes
|
696
|
59.3
|
No
|
478
|
40.7
|
Postnatal care service
|
|
|
Yes
|
108
|
9.6
|
No
|
1066
|
90.8
|
Time of complementary feeding initiation
|
|
|
<6months
|
87
|
7.4
|
6-8months
|
840
|
71.6
|
9months and above
|
247
|
21.0
|
Source of complementary food
|
|
|
Home Garden
|
838
|
71.4
|
Market
|
336
|
28.6
|
Current illness
|
|
|
Watery diarrhea
|
303
|
25.8
|
Dysentery
|
97
|
8.3
|
RTI
|
367
|
31.3
|
AFI
|
374
|
31.9
|
Ear problem
|
35
|
2.7
|
Table 3: Bivariate and multivariate analysis of factors associated with minimal dietary diversity among children aged 6–59 months at Dabat HDSS, site northwest Ethiopia, 2016
Variables
|
Minimum dietary diversity
|
Crude OR(95%CI)
|
Adjusted OR(95% CI)
|
Adequate
|
Inadequate
|
Food security
|
|
|
|
|
Secured
|
234
|
677
|
0.75(0.99-1.80)
|
0.80(0.57,1.08)
|
In secured
|
83
|
180
|
1
|
|
Food source
|
|
|
|
|
Home garden
|
169
|
669
|
0.32(0.24,0.42)
|
0.40(0.29,0.52)**
|
Market
|
148
|
188
|
1
|
1
|
ANC service
|
|
|
|
|
Yes
|
245
|
532
|
2.20(1.61,2.91)
|
1.60(1.18,2.27)**
|
No
|
72
|
333
|
1
|
1
|
Complementary food preparation
|
|
|
|
Prepared alone
|
105
|
211
|
1.51(1.14,2.00)
|
1.30(0.95,1.81)
|
Prepared with others
|
212
|
646
|
1
|
|
Current breast feeding
|
|
|
|
|
Yes
|
176
|
520
|
0.80(0.62,1.05)
|
0.60(0.43,0.78)**
|
No
|
141
|
337
|
1
|
|
Place of birth
|
|
|
|
|
Health institutions
|
141
|
164
|
3.40(2.55,4.47)
|
2.60(1.85,3.55)**
|
Home
|
176
|
693
|
1
|
|
|
|
|
|
|
|
**significant at p-value < 0.05 59312/73320
Table 4: Bivariate and multivariate analysis of factors associated with minimal meal frequency among children aged 6–59 months at Dabat HDSS site, northwest Ethiopia, 2016
Variables
|
Meal frequency
|
Crude OR(95%CI)
|
Adjusted OR
(95% CI)
|
Adequate
|
Inadequate
|
Child age
|
|
|
|
|
6-23 months
|
352
|
165
|
0.1(0.05,0.13)
|
0.1(0.06,0.15)*
|
24-59 months
|
633
|
24
|
1
|
1
|
Residence
|
|
|
|
|
Urban
|
100
|
33
|
0.5(0.35,0.82)
|
0.7(0.40,1.32)
|
Rural
|
885
|
156
|
1
|
1
|
ANC follow up
|
|
|
|
|
Yes
|
642
|
135
|
0.7(0.53,1.05)
|
1.1(0.76,1.66)
|
No
|
343
|
54
|
1
|
1
|
Initiation of CF
|
|
|
|
|
Timely
|
692
|
156
|
0.7(0.45,0.94)
|
0.8(0.55,1.24)
|
Not timely
|
293
|
41
|
1
|
1
|
Preparation of CF
|
|
|
|
|
Prepared alone
|
765
|
93
|
3.6(2.60,4.95)
|
1.9(1.29,2.69)*
|
Prepared with others
|
220
|
96
|
1
|
1
|
Postnatal care services
|
|
|
|
|
Yes
|
89
|
19
|
0.9(0.53,1.49)
|
1.4(0.75 ,2.44)
|
No
|
896
|
170
|
1
|
1
|
*indicate significant at p- value less than 0.05 in multivariable logistic analysis, ANC=antenatal care and CF=complementary feeding