Faculty of Public Health, Department of Health, Behavior and Society, Institute of Health, Jimma University, Jimma, Ethiopia.
Department of Communication, Wayne State University, Detroit, Michigan, United States of America.
PLoS One. 2023 Nov 28;18(11):e0293267. doi: 10.1371/journal.pone.0293267. eCollection 2023.
Complementary feeding (CF) is the period when exclusive breastfeeding ends and the introduction of a wide range of foods while breastfeeding should continue until the child is at least 24 months of age. Sub-optimal complementary feeding practices of infants and young children persist due to different factors, which include knowledge, attitude, and self-efficacy of index mothers. Therefore, this study aimed to assess determinants of knowledge, attitude, and self-efficacy towards complementary feeding among rural mothers with index child in rural Ethiopia.
A community-based, cross-sectional study was conducted using multistage sampling techniques followed by systematic random sampling techniques. A structured interviewer-administered questionnaire was used. The Chi-square and Fisher's exact probability tests were used to assess the baseline differences in the CF knowledge, attitude, self-efficacy and socio-demographic characteristics of the intervention and control groups. An independent sample t-test was used to determine the mean differences. Multiple linear regression models were fitted to assess the predictors of complementary feeding knowledge, attitude, and self-efficacy. All tests were two-tailed, and a statistically significant association was considered at a p-value ≤ 0.05.
Overall, 516 mothers were interviewed. 52.5% of the mothers had high complementary feeding (CF) knowledge, whereas only 47.7% and 38.9% had favorable attitude and high self-efficacy, respectively. The socio-demographic characteristics of the intervention and control groups were overall similar. However, there was a significant difference in the child's sex (p = 0.021) and age (p = 0.002). Independent t-tests found no significant difference between the two groups in terms of the mean score of CF knowledge, attitude, and self-efficacy at baseline. Maternal educational status (p = 0.0001), number of ANC visits (p = 0.025), and CF information received (p = 0.011) were significant predictors of CF knowledge. Child sex (p = 0.021) and the number of ANC visits (p = 0.01) were significant predictors of CF attitude. Family size (p = 0.008) and household food security status (p = 0.005) were significant predictors of maternal CF self-efficacy.
Overall, half of the mothers had high knowledge. Whereas maternal attitudes and self-efficacy toward CF were low. Maternal educational status, the number of ANC visits, and the CF information received were predictors of CF knowledge. Likewise, child sex and the number of ANC visits were predictors of CF attitude. Family size and household food security status were predictors of CF self-efficacy. These findings imply that nutrition intervention strategies are mandatory, particularly to enhance maternal knowledge, attitude, and self-efficacy towards optimum complementary feeding.
补充喂养（CF）是指母乳喂养结束和引入广泛的食物的时期，同时应继续母乳喂养，直到孩子至少 24 个月大。婴儿和幼儿的补充喂养实践不理想，原因有很多，包括指数母亲的知识、态度和自我效能。因此，本研究旨在评估埃塞俄比亚农村地区有指数儿童的农村母亲对补充喂养的知识、态度和自我效能的决定因素。
采用基于社区的横断面研究，采用多阶段抽样技术，然后采用系统随机抽样技术。采用结构式访谈者管理的问卷进行调查。使用卡方检验和 Fisher 确切概率检验评估干预组和对照组 CF 知识、态度、自我效能和社会人口统计学特征的基线差异。使用独立样本 t 检验确定均值差异。使用多元线性回归模型评估补充喂养知识、态度和自我效能的预测因素。所有检验均为双侧检验，p 值≤0.05 时认为存在统计学显著关联。
总体而言，对 516 名母亲进行了访谈。52.5%的母亲具有较高的补充喂养（CF）知识，而仅有 47.7%和 38.9%的母亲具有良好的态度和较高的自我效能。干预组和对照组的社会人口统计学特征总体相似。然而，儿童的性别（p=0.021）和年龄（p=0.002）存在显著差异。独立 t 检验发现，两组在 CF 知识、态度和自我效能的平均得分方面在基线时没有显著差异。母亲的教育程度（p=0.0001）、接受 ANC 的次数（p=0.025）和接受的 CF 信息（p=0.011）是 CF 知识的显著预测因素。儿童的性别（p=0.021）和 ANC 就诊次数（p=0.01）是 CF 态度的显著预测因素。家庭规模（p=0.008）和家庭粮食安全状况（p=0.005）是母亲 CF 自我效能的显著预测因素。
总体而言，有一半的母亲具有较高的知识。而母亲对 CF 的态度和自我效能较低。母亲的教育程度、接受 ANC 的次数和 CF 信息的获取是 CF 知识的预测因素。同样，儿童的性别和 ANC 就诊次数是 CF 态度的预测因素。家庭规模和家庭粮食安全状况是 CF 自我效能的预测因素。这些发现表明，必须采取营养干预措施，特别是要增强母亲对最佳补充喂养的知识、态度和自我效能。
