Alemu Tewodros Getaneh, Techane Masresha Asmare, Wubneh Chalachew Adugna, Assimamaw Nega Tezera, Belay Getaneh Mulualem, Tamir Tadesse Tarik, Muhye Addis Bilal, Kassie Destaye Guadie, Wondim Amare, Terefe Bewuketu, Tarekegn Bethelihem Tigabu, Ali Mohammed Seid, Fentie Beletech, Gonete Almaz Tefera, Tekeba Berhan, Kassa Selam Fisiha, Desta Bogale Kassahun, Ayele Amare Demsie, Dessie Melkamu Tilahun, Atalell Kendalem Asmare
Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Arch Public Health. 2022 Jun 6;80(1):152. doi: 10.1186/s13690-022-00905-3.
Minimum dietary diversity is the consumption of five or more food groups from the eight World Health Organization recommended food groups. Adequately diversified diet, in terms of amount and composition, is critical for optimal growth, development, and long-term health outcomes in the first 2 years. Understanding the regional variation of dietary diversity and the underlying factors is crucial for developing and implementing interventions. However, the use of spatial approaches in dietary studies has not been widely established. Therefore, this study aimed to explore the spatial patterns and determinates of minimum dietary diversity practice among 6-23 months children in Ethiopia.
Secondary data analysis was conducted based on the Demographic and Health Surveys data conducted in Ethiopia. A total weighted sample of 1578 children aged 6-23 months was included for this study. The Global Moran's I was estimated to look into the regional variation of dietary diversity and hotspot and cold spot areas. Further, multivariable multilevel logistic regression was used for factor analyses. Adjusted Odds Ratio with 95% CI was used to declare the strength and significance of the association.
Overall, 87.4% (95% CI: 85.7 to 88.9%) of children in 2019 had inadequate Minimum dietary diversity. We identified statistically significant clusters of high inadequate dietary diversity (hotspots) notably observed in Somali, Afar, Eastern and western Amhara, western Tigray, Benishangul, and Northeastern and western parts of the southern nations, nationality and peoples' regions. Inadequate dietary diversity was significantly higher among young children, uneducated mother, married women, younger mother, no postnatal check, community with higher level of poverty and community level uneducated woman.
According to the findings of this study inadequate Minimum dietary diversity for children as measured by World Health Organization dietary assessment shows high. Children's dietary diversity was distributed non-randomly in different districts across Ethiopia's regions. The findings of the study provided critical evidence about dietary diversity and associated factors. Hence, policy should focused on improve education status of Mother, boosting economic status of the community, increased maternal continuum of care and focused on young children nutrition may advance dietary diversity.
最低膳食多样性是指从世界卫生组织推荐的8种食物类别中摄入5种或更多食物类别。在数量和构成方面，充分多样化的饮食对于头两年的最佳生长、发育和长期健康结果至关重要。了解膳食多样性的区域差异及其潜在因素对于制定和实施干预措施至关重要。然而，空间方法在膳食研究中的应用尚未得到广泛确立。因此，本研究旨在探讨埃塞俄比亚6至23个月儿童最低膳食多样性实践的空间模式和决定因素。
基于在埃塞俄比亚进行的人口与健康调查数据进行二次数据分析。本研究纳入了1578名6至23个月儿童的总加权样本。估计全局莫兰指数以研究膳食多样性的区域差异以及热点和冷点地区。此外，使用多变量多水平逻辑回归进行因素分析。采用调整后的比值比及95%置信区间来表明关联的强度和显著性。
总体而言，2019年87.4%（95%置信区间：85.7%至88.9%）的儿童最低膳食多样性不足。我们确定了在索马里、阿法尔、阿姆哈拉东部和西部以及提格雷西部、贝尼尚古尔以及南部民族、国籍和人民地区的东北部和西部显著观察到的高膳食多样性不足的统计学显著聚类（热点）。幼儿、未受过教育的母亲、已婚妇女、年轻母亲、未进行产后检查、贫困程度较高的社区以及社区层面未受过教育的妇女中，膳食多样性不足的情况显著更高。
根据本研究的结果，以世界卫生组织膳食评估衡量的儿童最低膳食多样性不足情况严重。埃塞俄比亚各地区不同县儿童的膳食多样性分布并非随机。该研究结果提供了有关膳食多样性及其相关因素的关键证据。因此，政策应侧重于提高母亲的教育水平、提升社区的经济状况、增加孕产妇连续护理，并关注幼儿营养，这可能会促进膳食多样性。
