Breastfeeding Rate, Food Supplementation, Dietary Diversity Among Children Aged 6-59 Months, and Associated Factors in Papua New Guinea

Abstract

Background: Along the socioeconomic changes in the past decades, Papua New Guinea (PNG) has undergone significant food transition. Little is known about the influence of household and maternal socioeconomic demographic factors on dietary intake and diversity among children under 5 years of age (CU5). Objective: This study aimed to examine breastfeeding rate, food supplementation, dietary intake, and diversity among children aged 6-59 months and to identify associations with household and maternal socioeconomic demographic factors in PNG. Method: Data from 2,943 children were extracted from the Comprehensive Health and Epidemiological Surveillance System database, operated by the PNG Institute of Medical Research and used to estimate breastfeeding rate, food supplementation, and dietary intake of CU5 in a typical week. Dietary diversity score (DDS) was used as a proxy indicator to measure nutrient adequacy. Associations of DDS with household and maternal socioeconomic and demographic factors were examined using multivariate logistic regression analysis. Result: The breastfeeding rate among children aged 6-8 months was 85% (70% in urban and 90% in rural sectors), and 50% of children of this age group were fed with supplementary foods. Twenty percent of children aged 6-23 months were currently breastfed and received solid, semisolid, and soft foods three times or more per day. Forty-eight percent of children aged 6-59 months had a total DDS below the average level (23 scores). Place of residence, mother's education, and household wealth were associated with dietary diversity among studied children. Children in urban areas are 10% more likely to have a lower level of total DDS than those in rural areas (OR: 1.11 [0.79-1.56]; p-value: 0.5). Children whose mothers had a primary education level were 1.6-fold more likely to have a lower level of total DDS than children whose mothers had vocational training or college education (OR: 1.63 [0.68-3.92]; p-value: 0.28). Children from the poorest households were 1.2-fold more likely to have a lower DDS than those from the richest households (OR: 1.22 [0.79-1.87]; p-value: 0.37). Discussion: A range of factors has been identified, contributing to the eating behaviors among CU5 in PNG, in which mother's education and household wealth are among the most important determinants of childhood dietary diversity as they have a direct effect on accessibility to and affordability of a variety of foods at the household level. Conclusion: Evidence-based integrated and comprehensive approaches are needed to improve women education and household wealth, contributing to the improvement of food diversity among young children in PNG.

Keywords: CHESS; Papua New Guinea; breastfeeding; dietary diversity; food supplementary.

Figure 1

Conceptual framework for analyzing breastfeeding, food intake, and dietary diversity among children under 5 years old in PNG, PNGIMR's CHESS, 2020.

Figure 2

Geographic coverage and surveillance sites of PNGIMR's CHESS, 2020.

Figure 3

Flow diagram of child participation and selection for data analysis, PNGIMR's CHESS, 2020.

Figure 4

Distribution of child participants by total dietary diversity scores by province, PNGIMR's CHESS, 2020.