Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia.
Department of Health Promotion, School of Public Health College of Medicine Health Sciences, Wollo University, Dessie, Ethiopia.
Sci Rep. 2024 Nov 1;14(1):26294. doi: 10.1038/s41598-024-73840-8.
A diversified diet in early childhood that comprises plant and animal source foods contributes to better health outcomes throughout the life course. However, inadequate infant and young child-feeding practices are serious public health problems in Africa. Evidence on the magnitude and determinants of inadequate animal source food consumption (ASF) in sub-Saharan Africa (SSA) is not yet well established. Hence, this study aimed to estimate the pooled magnitude and determinants of ASF consumption in SSA. A total weighted sample of 92,309 children aged 6-23 months from the Demographic and Health Survey dataset of 35 SSA countries was used for this study. A multilevel mixed-effect model was fitted. The intra-class correlation coefficient (ICC) and likelihood ratio (LR) tests were used to assess the presence of the clustering effect. The model comparison was made using deviance information criteria (DIC). A p-value of p < 0.05 was used to declare statistical significance. The pooled magnitude of ASF consumption among children aged 6-23 months in SSA was 23.7% (95% CI: 23.4, 23.9). Across the SSA regions, the Southern Africa region had the highest consumption of ASF (51.35%), and the lowest was from the Eastern Africa region (21.41%). Younger children aged 6-9 months (AOR = 3.39; 95% CI: 3.14, 3.65), mothers who had no formal education (AOR = 1.46; 95% CI: 1.37, 1.56), children from mothers with no media exposure (AOR = 1.17; 95% CI: 1.11, 1.24), children from the poorest households (AOR = 2.59; 95% CI: 2.36, 2.84), rural residence (AOR = 1.20; 95% CI: 1.12, 1.28), living in low-income countries (AOR = 2.43; 95% CI: 2.03, 2.90), and children from the East Africa region (AOR = 1.24; 95% CI: 1.14, 1.35) were among the significant predictors for not consuming ASF. In this study, ASF consumption was markedly low. Almost three-fourths of children aged 6-23 months in SSA did not consume ASF in the previous day. Age of the child, ANC visits, maternal educational status, maternal marital status, media exposure, and household wealth index were significant individual-level predictors of ASF consumption, whereas the place of residence, country's income level, and regions of SSA were found to be significant community-level predictors of ASF consumption. Thus, the study highlighted that policymakers, governments, and their partners should demonstrate rigorous efforts to improve dietary diversification with due consideration to the identified predictors of ASF.
在儿童早期,饮食多元化,包含动植物来源的食物,有助于在整个生命周期实现更好的健康结果。然而,婴儿和幼儿喂养方法不当是非洲的一个严重公共卫生问题。关于撒哈拉以南非洲(SSA)地区动物来源食品(ASF)摄入不足的程度和决定因素的证据尚未得到充分确立。因此,本研究旨在估计 SSA 地区 ASF 摄入不足的综合程度和决定因素。本研究使用了来自 35 个 SSA 国家的人口与健康调查数据集的 92309 名 6-23 个月大的儿童的加权总样本。采用多水平混合效应模型进行拟合。使用组内相关系数(ICC)和似然比(LR)检验来评估聚类效应的存在。使用偏差信息准则(DIC)进行模型比较。p 值小于 0.05 被认为具有统计学意义。6-23 个月大的 SSA 地区儿童 ASF 的摄入比例为 23.7%(95%置信区间:23.4,23.9)。在 SSA 各地区中,南部非洲地区 ASF 的摄入量最高(51.35%),而东部非洲地区的摄入量最低(21.41%)。年龄较小的 6-9 个月儿童(AOR=3.39;95%置信区间:3.14,3.65)、母亲未接受正规教育(AOR=1.46;95%置信区间:1.37,1.56)、母亲未接触媒体(AOR=1.17;95%置信区间:1.11,1.24)、来自最贫困家庭的儿童(AOR=2.59;95%置信区间:2.36,2.84)、居住在农村(AOR=1.20;95%置信区间:1.12,1.28)、来自低收入国家(AOR=2.43;95%置信区间:2.03,2.90)和来自东部非洲地区的儿童(AOR=1.24;95%置信区间:1.14,1.35)是 ASF 摄入不足的显著预测因素。在这项研究中,ASF 的摄入量明显较低。近四分之三的 SSA 地区 6-23 个月大的儿童在前一天没有摄入 ASF。儿童年龄、ANC 就诊次数、母亲教育程度、母亲婚姻状况、媒体接触情况和家庭财富指数是 ASF 摄入的重要个体水平预测因素,而居住地点、国家收入水平和 SSA 地区是 ASF 摄入的重要社区水平预测因素。因此,该研究强调,政策制定者、政府及其合作伙伴应做出积极努力,改善饮食多样化,并充分考虑 ASF 的这些确定预测因素。