, Bahirdar Zuria Woreda, Ethiopia.
Department of Human Nutrition, Institute of Public Health, University of Gondar, College of Medicine and Health Sciences, P.O. Box 196, Gondar, Ethiopia.
Int J Equity Health. 2020 Jan 28;19(1):14. doi: 10.1186/s12939-019-1120-1.
Adequate dietary diversity is vital for the survival, growth and development of infants and children. Inadequate dietary diversity is the major cause of micronutrient deficiency in Sub-saharan Africa, including Ethiopia, where only less than one-fourth of the children aged 6-23 months obtain adequate diversified diet. Thus country implemented a strategy known as the Sustainable Undernutrtion Reduction (SUR) programs to alleviate the problem. However, empirical evidences are scarce on the impact of the program on children aged 6-23 months. Therefore, this study aimed to compare the level of dietary diversity among children aged 6-23 months in districts covered and not covered by SURE program in West Gojjam zone.
A community based comparative cross-sectional study was conducted in three districts of West Gojjam zone, Ethiopia, from February 29 to April 20, 2019. A total of 832 mother and child pairs were selected by the simple random sampling technique. A pretested and structured interviewer-administered questionnaire was used to collect data. A binary logistic regression model was fitted to identify factors associated with dietary diversity. Crude odds and adjusted odds ratios with 95% confidence intervals (CI) were calculated to assess the strength of associations and significance of the identified factors for dietary diversity score.
The overall proportion of adequate dietary diversity among children aged 6-23 months was 29.9% (95% CI: 27.0-33.0), whereas in SURE covered and uncovered districts it was 33.4% (95%CI: 29.0-38.and 26.4%(95% CI: 22.0, 31.0), respectively. ANC (Antenatal care) (AOR = 1.7; 95% CI: 1.16, 2.55) and postnatal care services (AOR = 2.1; 95% CI: 1.38, 3.28), participating in food preparation programs (AOR = 1.9; 95% CI: 1.19, 2.96), GMP (AOR = 2.74,95%CI:1.80, 4.18), vitamin A supplementation (AOR = 2.10,95%CI:1.22, 3.61) and household visits by health extension workers (AOR = 2.0; 95% CI: 1.25, 3.21) were significantly associated with dietary diversity.
The proportion of adequate dietary diversity was higher among children in the program than those out of the program. ANC visits, PNC follow-ups, women's participating in food preparation programs and household visits by health extension workers were significantly associated with dietary diversity. Therefore, and strengthening and scaling up the program to non covered districts and providing health and nutrition counseling on Infant and Young Child Feeding (IYCF) during ANC and PNC services are recommended for achieving the recommended dietary diversity.
充足的饮食多样性对婴儿和儿童的生存、生长和发育至关重要。在撒哈拉以南非洲，包括埃塞俄比亚在内，饮食多样性不足是导致微量营养素缺乏的主要原因，只有不到四分之一的 6-23 个月大的儿童获得了充足的多样化饮食。因此，该国实施了一项名为可持续减少营养不良（SUR）的战略，以缓解这个问题。然而，关于该计划对 6-23 个月大的儿童的影响的实证证据很少。因此，本研究旨在比较在西戈贾姆地区覆盖和未覆盖 SUR 计划的地区，6-23 个月大的儿童的饮食多样性水平。
这是一项在埃塞俄比亚西戈贾姆地区的三个区进行的基于社区的比较性横断面研究，时间为 2019 年 2 月 29 日至 4 月 20 日。采用简单随机抽样技术，共选取了 832 对母婴。使用经过预测试和结构访谈员管理的问卷收集数据。使用二项逻辑回归模型来确定与饮食多样性相关的因素。计算粗比值比和调整比值比及其 95%置信区间（CI），以评估相关因素对饮食多样性评分的关联强度和显著性。
6-23 个月大的儿童中，饮食多样性充足的总体比例为 29.9%（95%CI：27.0-33.0），而在 SUR 覆盖和未覆盖的地区，这一比例分别为 33.4%（95%CI：29.0-38.0）和 26.4%（95%CI：22.0，31.0）。产前护理（ANC）（AOR=1.7；95%CI：1.16，2.55）和产后护理服务（AOR=2.1；95%CI：1.38，3.28）、参与食品制备计划（AOR=1.9；95%CI：1.19，2.96）、GMP（AOR=2.74，95%CI：1.80，4.18）、维生素 A 补充剂（AOR=2.10，95%CI：1.22，3.61）和卫生推广工作者的家访（AOR=2.0；95%CI：1.25，3.21）与饮食多样性显著相关。
在该计划中的儿童中，饮食多样性充足的比例高于不在该计划中的儿童。ANC 访问、PNC 随访、妇女参与食品准备计划以及卫生推广工作者的家访与饮食多样性显著相关。因此，建议加强和扩大该计划至未覆盖的地区，并在 ANC 和 PNC 服务期间提供婴儿和幼儿喂养（IYCF）方面的健康和营养咨询，以实现推荐的饮食多样性。
