title: Comparisons of complementary feeding indicators among children aged 6-23 months in Anglophone and Francophone West African countries.
abstract: Stunting, a consequence of suboptimal complementary feeding practices, continues to be a significant public health problem in West Africa. This paper aimed to compare rates of complementary feeding indicators among children aged 6-23 months between four Anglophone and seven Francophone West African countries. The data used for this study were the most recent Demographic and Health Surveys of the various countries, namely Ghana, Liberia, Nigeria, Sierra Leone (Anglophone countries), Benin, Burkina Faso, Cote d'Ivoire, Guinea, Mali, Niger and Senegal (Francophone countries) conducted between 2006 and 2013. The analyses were limited to last-born children aged 6-23 months and covered 34 999 children: 12 623 in the Anglophone countries and 22 376 children in the Francophone countries. Complementary feeding indicators were examined using the method proposed by the World Health Organization (WHO) in 2008. Introduction of solid, semi-solid or soft foods among children aged 6-23 months in the Anglophone countries ranged from 55.3% (Liberia) to 72.6% (Ghana). The corresponding rates for the Francophone countries ranged from 29.7% (Mali) to 65.9% (Senegal). The average rate of minimum dietary diversity for the Anglophone countries was 32.0% while that of the Francophone countries was only 10.6%. While the minimum meal frequency rates ranged between 42.0% (Sierra Leone) and 55.3% (Nigeria) for the Anglophone countries, the corresponding rates for the Francophone countries ranged between 25.1% (Mali) and 52.4% (Niger). Both the Anglophone and the Francophone countries reported alarmingly low rates of minimum acceptable diet, with the two groups of countries averaging rates of 19.9% (Anglophone) and 5.5% (Francophone). The rates of all four complementary feeding indicators across all the 11 countries fell short of the WHO's requirement for optimal complementary feeding practices. Intervention studies using cluster-randomised controlled trials are needed in order to improve the nutritional status of young children in West Africa.
authors.affiliation: School of Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
authors.forename: Abukari I
authors.initials: AI
authors.lastname: Issaka
authors.affiliation: School of Science and Health, University of Western Sydney, Penrith, New South Wales, Australia.
authors.forename: Kingsley E
authors.initials: KE
authors.lastname: Agho
authors.affiliation: School of Science and Health, University of Western Sydney, Penrith, New South Wales, Australia.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Page
authors.affiliation: School of Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
authors.forename: Penelope L
authors.initials: PL
authors.lastname: Burns
authors.affiliation: School of Medicine, University of Western Sydney, Penrith, New South Wales, Australia.
authors.forename: Garry J
authors.initials: GJ
authors.lastname: Stevens
authors.affiliation: Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Dibley
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D004739:England; D005602:France; D006130:Growth Disorders / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007802:Language; D009751:Nutritional Requirements; D009752:Nutritional Status; D014944:World Health Organization
keywords: West Africa; acceptable diet; child nutrition; complementary feeding; dietary diversity; meal frequency