Tebeje Tsion Mulat, Abebe Mesfin, Tesfaye Solomon Hailemariam, Seboka Binyam Tariku, Argaw Girum Shibeshi, Seifu Beminate Lemma, Mare Kusse Urmale, Aragaw Fantu Mamo
School of Public Health, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia.
Front Public Health. 2024 Nov 22;12:1468701. doi: 10.3389/fpubh.2024.1468701. eCollection 2024.
Worldwide, approximately half of all children are not provided the minimum meal frequency (MMF). Sub-Saharan Africa (SSA) had the lowest proportion of children aged 6-23 months who met the requirements of the complementary feeding indicators, including MMF. Ensuring adequate meal frequency poses a challenge in numerous developing countries, particularly in regions characterized by low household food security, such as SSA. Therefore, this study aimed to assess the pooled prevalence of MMF and its associated factors in SSA via the most recent demographic and health survey data.
A total of 100,526 weighted samples from demographic and health survey datasets of 35 SSA countries were used. A multilevel Poisson regression model with robust variance was applied to identify factors associated with MMF, and the model with the lowest deviance was the best-fitted model. An adjusted prevalence ratio with a 95% confidence interval (CI) was reported, and variables with a < 0.05 were considered statistically significant.
The pooled prevalence of MMF among children aged 6-23 months in SSA was 38.47% (95% CI: 34.97-41.97), which ranged from 21.41% in Liberia to 63.98% in Madagascar. According to the subgroup analysis, the pooled magnitude of MMF in central, west, east, and southern Africa was 36.42, 35.46, 39.97, and 50.69%, respectively. Marital status, maternal education level, sex of household head, working status, wealth index, media exposure, age of the child, postnatal check-up, breastfeeding status, residence, and SSA regions were significantly associated with minimum meal frequency.
Less than forty percent of infants and young children in SSA receive the minimum recommended meal frequency, which is relatively low. This presents a notable difficulty in efforts to prevent malnutrition and attain sustainable development goals related to health and nutrition on the continent. Therefore, priority should be given to empowering women, promoting breastfeeding and postnatal check-ups, targeting infants who just started complementary feeding, and spreading information through media.
在全球范围内，约有一半的儿童未达到最低进餐频率（MMF）。撒哈拉以南非洲地区（SSA）6至23个月龄儿童中，达到包括MMF在内的辅食喂养指标要求的比例最低。在许多发展中国家，确保足够的进餐频率是一项挑战，特别是在家庭粮食安全水平较低的地区，如SSA。因此，本研究旨在通过最新的人口与健康调查数据评估SSA地区MMF的合并患病率及其相关因素。
使用了来自35个SSA国家人口与健康调查数据集的总共100,526个加权样本。应用具有稳健方差的多水平泊松回归模型来识别与MMF相关的因素，偏差最低的模型为最佳拟合模型。报告了调整后的患病率比及95%置信区间（CI），P<0.05的变量被认为具有统计学意义。
SSA地区6至23个月龄儿童中MMF的合并患病率为38.47%（95%CI：34.97 - 41.97），范围从利比里亚的21.41%到马达加斯加的63.98%。根据亚组分析，中部、西部、东部和南部非洲MMF的合并患病率分别为36.42%、35.46%、39.97%和50.69%。婚姻状况、母亲教育水平、户主性别、工作状况、财富指数、媒体曝光、儿童年龄、产后检查、母乳喂养状况、居住地和SSA地区与最低进餐频率显著相关。
SSA地区不到40%的婴幼儿达到最低推荐进餐频率，这一比例相对较低。这在预防营养不良以及实现该大陆与健康和营养相关的可持续发展目标的努力中构成了显著困难。因此，应优先赋予妇女权力、促进母乳喂养和产后检查、针对刚开始辅食喂养的婴儿，并通过媒体传播信息。
