Geda Nigatu Regassa, Feng Cindy Xin, Janzen Bonnie, Lepnurm Rein, Henry Carol J, Whiting Susan J
Center for Population Studies, College of Development Studies, Addis Ababa University, Sidist Kilo Campus, PO Box 1176, Addis Ababa, Ethiopia.
School of Public Health, Health Science E-wing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada.
Arch Public Health. 2021 Mar 16;79(1):35. doi: 10.1186/s13690-021-00555-x.
Undernutrition among children is a priority area of public health concern in Ethiopia. The purpose of this study was to examine disparities in Infant and Young Child Feeding (IYCF) practices among children 6-23 months.
Data were drawn from the 2016 Ethiopian Demographic and Health Surveys (EDHS). A total of 3240 children aged 6-23 months were used for the present analysis. The outcome variable was IYCF practice score (ranging 0-7) which was constructed based on the linear and combined effects of four sets of variables: breastfeeding, avoidance of bottle feeding, diet diversity score and minimum feeding frequency. IYCF practice score was further recoded into three categories. Proportional odds regression was used to assess the determinants of IYCF category.
The proportional odds regression analysis showed that IYCF scores significantly decreased by 5% (Adjusted Odds Ratio (AOR) = 0.95; 95% CI: 0.93-0.97) for every unit increase in the child's age. Households with fathers of primary and secondary and above level education were 1.37 times (95% CI: 1.14-1.66) and 1.67 times (95% CI: 1.26-2.23) more likely to be in the high IYCF category than in the poor IYCF category. The likelihood of being in the high IYCF practice category decreased for non-working mothers by 30% (AOR = 0.70; 95% CI: 0.59-0.83) compared to those working in gainful employment. The chance of being in the high IYCF practice category decreased by 29% for households with no access to radio (AOR = 0.71; 95% CI: 0.59-0.85). Those with medium and rich/richer wealth category were 1.54 times (95% CI: 1.22-1.94) and 1.40 times (95% CI: 1.11-1.75) more likely to belong to high IYCF practice category than being in poor IYCF category. For every unit increase in health service utilization, the chance of falling in higher IYCF category increases by 1.15 times (95% CI: 1.08-1.23). The chance of falling in higher IYCF practice category decreases for rural residents by 37% (AOR = 0.63; 95% CI: 0.47-0.84) compared to those residing in urban areas.
For a child, the first two years is the time span during which linear faltering of growth is most prevalent and the period when the process of becoming stunted is almost complete. This study recommends improving access to women for gainful employment, provision of economic support to poor rural women, education and promotion of nutrition messages using most accessible media and boosting the positive role of fathers in child feeding practices.
儿童营养不良是埃塞俄比亚公共卫生关注的重点领域。本研究旨在调查6至23个月儿童在婴幼儿喂养(IYCF)方式上的差异。
数据取自2016年埃塞俄比亚人口与健康调查(EDHS)。本分析共纳入3240名6至23个月的儿童。结果变量为IYCF方式得分(范围0 - 7),该得分基于四组变量的线性和综合效应构建:母乳喂养、避免奶瓶喂养、饮食多样性得分和最低喂养频率。IYCF方式得分进一步重新划分为三类。采用比例优势回归评估IYCF类别决定因素。
比例优势回归分析显示,儿童年龄每增加一个单位,IYCF得分显著降低5%(调整优势比(AOR)= 0.95;95%置信区间:0.93 - 0.97)。父亲为小学及初中及以上学历的家庭,处于高IYCF类别的可能性分别比处于低IYCF类别的家庭高1.37倍(95%置信区间:1.14 - 1.66)和1.67倍(95%置信区间:1.26 - 2.23)。与有收益性工作的母亲相比,无工作的母亲处于高IYCF方式类别的可能性降低30%(AOR = 0.70;95%置信区间:0.59 - 0.83)。无法收听广播的家庭处于高IYCF方式类别的可能性降低29%(AOR = 0.71;95%置信区间:0.59 - 0.85)。中等财富类别和富裕/更富裕财富类别的家庭,属于高IYCF方式类别的可能性分别比处于低IYCF类别的家庭高1.54倍(95%置信区间:1.22 - 1.94)和1.40倍(95%置信区间:1.11 - 1.75)。卫生服务利用率每增加一个单位,处于更高IYCF类别的可能性增加1.15倍(95%置信区间:1.08 - 1.23)。与城市居民相比,农村居民处于更高IYCF方式类别的可能性降低37%(AOR = 0.63;95%置信区间:0.47 - 0.84)。
对于儿童而言,头两年是生长线性发育迟缓最普遍的时期,也是发育迟缓过程几乎完成的时期。本研究建议增加妇女获得有收益性工作的机会,为贫困农村妇女提供经济支持,利用最易获取的媒体进行营养信息教育和宣传,并增强父亲在儿童喂养方式中的积极作用。