title: Trends in complementary feeding indicators in Nigeria, 2003-2013.
abstract: OBJECTIVE
  The study aimed to examine secular trends and determinants of changes in complementary feeding indicators in Nigeria.
  
  
  METHODS
  Data on 79 953 children aged 6-23 months were obtained from the Nigeria Demographic and Health Surveys (NDHS) for the period spanning 2003-2013. The surveys used a stratified two-stage cluster sample of eligible mothers aged 15-49 years from the six geopolitical zones of Nigeria. Trends in complementary feeding indicators and socioeconomic, health service and individual characteristics including factors associated with complementary feeding indicators were examined using multilevel logistic regression analyses.
  
  
  RESULTS
  Minimum dietary diversity for children aged 6-23 months worsened from 26% in 2003 to 16% in 2013. Minimum meal frequency improved from 43% in 2003 to 56% in 2013 and minimum acceptable diet worsened from 11% to 9%. Among educated mothers, there was a decreasing prevalence of the introduction of solid, semisolid and soft foods in infants aged 6-8 months (67% in 2003 to 57% in 2013); minimum dietary diversity (33% in 2003 to 24% in 2013) and minimum acceptable diet (13% in 2003 to 8% in 2013). Mothers with a higher education level and mothers who reported more health service contacts were more likely to meet the minimum dietary diversity. Similarly, the odds for minimum acceptable diet were higher among mothers from higher socioeconomic status groups and mothers who reported frequent health services use.
  
  
  CONCLUSIONS
  Complementary feeding practices in Nigeria declined over the study period and are below the expected levels required to ensure adequate growth and development of Nigerian children. National policies and programmes that ensure sustainability of projects post-MDGs and higher health service coverage for mothers, including community-based education initiatives, are proposed to improve complementary feeding practices among Nigerian mothers.
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia.
authors.forename: Felix A
authors.initials: FA
authors.lastname: Ogbo
authors.affiliation: Centre for Health Research, School of Medicine, Western Sydney University, Penrith, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Page
authors.affiliation: Office of the Director General, National Agency for the Control of AIDS, Abuja, Federal Capital Territory, Nigeria.
authors.forename: John
authors.initials: J
authors.lastname: Idoko
authors.affiliation: School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Claudio
authors.affiliation: School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.
authors.forename: Kingsley E
authors.initials: KE
authors.lastname: Agho
mesh_terms: D000293:Adolescent; D000328:Adult; D005247:Feeding Behavior; D005260:Female; D006266:Health Education / Q000379:methods*; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000706:statistics & numerical data*; D007227:Infant Nutritional Physiological Phenomena; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000193:education*; D009549:Nigeria; D009751:Nutritional Requirements / Q000502:physiology*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: EPIDEMIOLOGY; NUTRITION & DIETETICS; PRIMARY CARE