A Multilevel Analysis of Factors Associated with Minimum Acceptable Diets Among Children Aged 6-23 Months in Lesotho: A Study of The Lesotho Multiple Cluster Indicator Study of 2018
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Background The World Health Organization’s Infant and Young Children Feeding Guidelines (IYCF) has been adopted as an international acceptable complementary feeding guideline known as the Minimum Acceptable Diet (MAD). MAD is a combination of Minimum Meal Frequency (MMF) and Minimum Dietary Diversity (MDD). MAD is not met in many countries in the world. This study aimed to determine the prevalence and multilevel determinants of a minimum acceptable diet among children aged 6–23 months in Lesotho. Methods We conducted a multilevel logistic regression using data from the Lesotho Multiple Cluster Indicator Study of 2018. Results In Lesotho only 22.7% [CI: 19.6 26.2] of children aged 6–23 months received MAD. At individual level, higher odds of receiving MAD were observed among females (WAR = 1.43; CI: 1.1 1.3) and children aged 9–23 months (WAR = 1.67; CI: 1.3 2.2). At household level, only maternal age of 20–25 and 35–39 were statistically significant to MAD; on the other hand, the odds of receiving MAD were higher for children with maternal age of 30–34 (WAR = 1.15; CI: 0.8 1.7) and 40+ (WAR = 1.13; CI: 0.6 2.0). Moreover, at community level, children in communities with high proportions of poor households had lower odds of receiving MAD (WAR = 0.64; CI: 0.5 0.8) and children in communities with high proportions of maternal media exposure had higher odds of receiving MAD (WAR = 1.53: CI:1.1 2.2). Conclusion At individual level, child sex and age were determinants of MAD. At household level maternal age was a determinant of MAD, maternal age in this case indicates that knowledge and experience in childcare contributed to better dietary intake for children aged 6–23. At community level, lack of care resources, food availability and knowledge acquisition were determinants of MAD. Therefore, strategies and programs to improve MDD nationwide should be done at community level.
