title: Determinants of suboptimal complementary feeding practices among children aged 6-23 months in four anglophone West African countries.
abstract: Suboptimal complementary feeding practices have a detrimental impact on a child's growth, health and development in the first two years of life. They lead to child malnutrition, which contributes to the high prevalence of stunting (38%) and underweight (28%) reported for children <5 years of age in Sub-Saharan Africa. This study analysed complementary feeding practices in four anglophone West African countries (Ghana, Liberia, Nigeria and Sierra Leone) using the most recent Demographic and Health Surveys. The study covered 12 623 children aged 6-23 months from four anglophone West African countries (Ghana: 822 children: Liberia: 1458 children, Nigeria: 8786 children and Sierra Leone: 1557 children). Four complementary feeding indicators were examined against a set of individual-, household- and community-level factors, using multiple regression analysis. Multivariate analyses found that lack of post-natal contacts with health workers, maternal illiteracy and geographical region were common determinants of delayed introduction of solid, semi-solid or soft foods across all four countries. Predictors for minimum dietary diversity, minimum meal frequency and minimum acceptable diet included children aged 6-11 months, administrative/geographical region, poorer household income and limited access to media. The authors recommend that the four anglophone West African countries studied should prioritise efforts to improve complementary feeding practices in order to reduce child morbidity and mortality. Interventional studies on complementary feeding should target those from poor and illiterate households.
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: D000293:Adolescent; D000328:Adult; D000354:Africa, Western; D004032:Diet; D004522:Educational Status; D004739:England; D005248:Feeding Methods / Q000706:statistics & numerical data; D005260:Female; D005869:Ghana; D006266:Health Education; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007225:Infant Food; D007227:Infant Nutritional Physiological Phenomena / Q000502:physiology*; D007802:Language; D007988:Liberia; D000067010:Literacy / Q000706:statistics & numerical data; D008297:Male; D008402:Mass Media; D008423:Maternal Age; D008875:Middle Aged; D009549:Nigeria; D009751:Nutritional Requirements; D009752:Nutritional Status; D009753:Nutritive Value; D011203:Poverty; D012424:Rural Population; D012807:Sierra Leone; D055815:Young Adult
keywords: West Africa; acceptable diet; child development; child growth; complementary feeding; dietary diversity; meal frequency; nutrition; paediatric