Institute of Economic and Social Research, University of Zambia, Lusaka, Zambia.
World Vision International, Uxbridge, United Kingdom.
PLoS One. 2023 Oct 2;18(10):e0292052. doi: 10.1371/journal.pone.0292052. eCollection 2023.
Infant and young child feeding (IYCF) practices directly affect the nutritional status of children under two years of age, ultimately impacting their survival. However, ensuring that newborns and young children are fed according to the WHO-recommended practice has proven to be a challenge in many developing nations, especially in households that face food insecurity. This study aims to determine the association between IYCF practices and household food security's availability and access dimensions in rural Zambia. The study uses data from a cross-sectional survey of 2,127 mother-child pairs drawn from 28 rural districts in 8 out of the 10 Zambian provinces. Logistic regression analysis was used to examine the association of minimum dietary diversity, minimum meal frequency, and minimum acceptable diet with measures of household food security such as household dietary diversity score, and food insecurity experience scale, while controlling for confounding variables. The results show that children living in households classified as being food-secure based on the household dietary diversity score were significantly more likely to achieve appropriate feeding practices on all three IYCF measures, even after controlling for confounding factors. Notably, poor IYCF practices exist even in food-secure households, as most children in these households still need to receive a minimum acceptable diet. Although living in a household classified as food secure based on the access dimensions of household dietary diversity score and food insecurity experience scale is significantly associated with improvements in all three IYCF indicators even after controlling for confounding factors, the relationship does not hold for the availability measure of months of adequate household food provisioning. These findings highlight the need for targeting specific dimensions of household food security to solve child malnutrition, especially in rural areas. The focus should go beyond basic food availability, ensuring adequate diversity, and enhancing knowledge of appropriate feeding practices.
婴幼儿喂养(IYCF)实践直接影响两岁以下儿童的营养状况,最终影响其生存。然而,在许多发展中国家,确保新生儿和幼儿按照世界卫生组织推荐的做法喂养已被证明是一项挑战,尤其是在面临粮食不安全的家庭中。本研究旨在确定赞比亚农村地区 IYCF 实践与家庭粮食安全的获得和获取维度之间的关系。该研究使用了来自赞比亚 10 个省中的 8 个省的 28 个农村地区的 2127 对母婴的横断面调查数据。逻辑回归分析用于检验最小饮食多样性、最小膳食频率和最小可接受饮食与家庭饮食多样性评分和粮食不安全体验量表等家庭粮食安全措施之间的关联,同时控制混杂变量。结果表明,根据家庭饮食多样性评分被归类为粮食安全的家庭中的儿童,在所有三种 IYCF 措施上实现适当喂养实践的可能性显著更高,即使在控制了混杂因素之后。值得注意的是,即使在粮食安全的家庭中,也存在不良的 IYCF 实践,因为这些家庭中的大多数儿童仍需要接受最小可接受饮食。尽管根据家庭饮食多样性评分和粮食不安全体验量表的获取维度将家庭归类为粮食安全与所有三种 IYCF 指标的改善显著相关,即使在控制混杂因素后也是如此,但这种关系并不适用于家庭提供足够粮食的月份这一可用性措施。这些发现强调了需要针对家庭粮食安全的特定维度来解决儿童营养不良问题,特别是在农村地区。重点不应仅放在基本粮食供应上,而应确保粮食供应具有足够的多样性,并增强对适当喂养实践的认识。