Determinants of minimum acceptable diet among children aged 6–23 months in Eastern Ward, Buhoma Town Council, Kanungu District, Uganda: a cross-sectional study

Background Children aged 6–23 months are particularly vulnerable to undernutrition, as breast milk alone can no longer meet their nutritional needs, and as such, the quality and quantity of the complementary foods they eat become critical. To assess whether a child in this age group is being fed adequately, researchers and health programmes use a composite indicator called minimum acceptable diet (MAD), which includes two variables: how often a child is fed (minimum meal frequency, MMF) and how diverse their diet is (minimum dietary diversity, MDD). Methods We conducted a community-based cross-sectional analytical study among caregivers of children aged 6–23 months living in Eastern Ward, Buhoma Town Council, Kanungu District, Uganda. Data were collected using an interviewer-administered questionnaire capturing socio-demographic characteristics, infant and young child feeding (IYCF) knowledge, household food security, and a 24-hour dietary recall. MAD was defined based on whether the child met both MDD and MMF. Household food security was measured using the Household Food Insecurity Access Scale (HFIAS). Nutrition knowledge was assessed with a 13-item scale and categorized as sufficient (≥ 7) or insufficient (0–6). We used chi-square tests and crude odds ratios (COR) for bivariate analysis, and multiple logistic regression to identify independent determinants of MAD, with statistical significance set at 5%. Results Of 196 targeted participants, 147 caregivers were interviewed, and 126 questionnaires were valid for analysis. Overall, 89.7% of children met MMF, 21.4% met MDD, and 18.3% met MAD. In multivariable analysis, key determinants of meeting MAD were birth order (being third-born or later), higher weekly earnings, household food security, and sufficient caregiver nutrition knowledge. Conclusions The proportion of children aged 6–23 months who met MAD in Eastern Ward was low, largely driven by poor dietary diversity despite most children receiving meals frequently enough. Interventions to improve complementary feeding should combine community-based nutrition education and social behaviour change approaches with efforts to enhance household food security and access to affordable, diverse foods.