Infant and young child feeding (IYCF) practices in Ethiopia and Zambia and their association with child nutrition: Analysis of demographic and health survey data

Abstract

Data from the 2005 Ethiopia Demographic and Health Survey (EDHS) and the 2007 Zambia Demographic Health Survey (ZDHS) were analyzed to examine the association between World Health Organization (WHO) recommended IYCF indicators and nutritional status among children 0-23 months of age in Ethiopia and Zambia. A total of 1810 and 2512 children within this age group from Ethiopia and Zambia, respectively, were included in the analysis. Exclusive breast-feeding among children 0-5.9 months of age is low in both Ethiopia (43 %) and Zambia (51 %). Timely introduction of complementary food is lower in Ethiopia (61 %) compared to Zambia (90 %). Only 7 percent of children between 6-23 months of age consumed diets that met the minimum dietary diversity requirement of four or more food groups consumed per day compared to 37 % in Zambia. Multiple linear and logistic regression analyses using appropriate measures to account for the complex survey design were applied to examine the associations between IYCF practices and child anthropometry. Linear regression results show that exclusive breast-feeding (EBF) is positively associated with weight-for-height z-score (WHZ) (effect size (ES) 0.65; p<0.001) and weight-for-age z-score (WAZ) (ES 0.28; p<0.01) in Zambia. In Ethiopia, EBF under 6 months of age is negatively associated with height-for-age zscore (HAZ) (ES 0.81; p<0.01). Timely introduction of complementary food between 6-8 months of age was positively associated with HAZ (ES 1.19; p<0.01) in Zambia. Higher dietary diversity score was associated with higher HAZ (ES 0.23, p<0.001 in Ethiopia; ES 0.12, p<0.01 in Zambia) and WAZ (ES 0.17, p<0.001 in Ethiopia; ES 0.04, p<0.10 in Zambia) in both countries. The findings demonstrate the need to reinforce age- appropriate IYCF practices to address child undernutrition. Special attention is needed to improve the complementary feeding practices, particularly diet diversity for children 6-23 months of age, while sustaining a focus on EBF among children under 6 months of age, in order to improve overall nutritional status of young children in Ethiopia and Zambia.