Promising trends and influencing factors of complementary feeding practices in Côte d'Ivoire: An analysis of nationally representative survey data between 1994 and 2016

Abstract

Poor complementary feeding (CF) challenges early childhood growth. We examined the trends and influencing factors of CF practices among children aged 6-23 months in Côte d'Ivoire. Using data from Demographic and Health Surveys (DHS, 1994-2011) and Multiple Indicator Cluster Surveys (MICS, 2000-2016), the trends and predictors of World Health Organization-United Nations International Children's Emergency Fund CF indicators including the timely introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD) and minimum acceptable diet (MAD) were determined. Using 2016 MICS data, we applied multivariate logistic regression models to identify factors associated with CF indicators. Between 1994 and 2016, the mean proportion of children aged 6-8 months achieving INTRO was 56.9% and increased by about 25% points since 2006. Over 2011-2016, the proportion of children aged 6-23 months meeting MMF, MDD and MAD increased from 40.2% to 47.7%, 11.3% to 26.0% and 4.6% to 12.5%, respectively. Older children and those from urban households had higher odds of meeting MDD and MAD. Maternal TV watching was associated with higher odds of meeting MDD. The secondary or higher education levels of mothers significantly predicted higher odds of meeting INTRO and MDD. Currently, breastfeeding was also positively associated with odds of meeting MMF and MAD. Children from poorer households had lower odds of meeting MMF, MDD and MAD. Despite the improvements, CF practices remain suboptimal in Côte d'Ivoire. Influencing factors associated with CF were distributed across individual, household and community levels, calling for future programmes and policies to implement multi-level strategies to improve young children's diet in Côte d'Ivoire.

Keywords: Côte d'Ivoire; Demographic and Health Surveys; Multiple Indicator Cluster Surveys; complementary feeding; multivariable logistic regression models; risk factor analysis; trends.

Figure 1

Trends of INTRO, MMF, MDD and MAD in Côte d'Ivoire from 1994 to 2016 (data presented in this figure were extracted from five nationally representative survey reports: the 1994 and 2011 Côte d'Ivoire DHS reports and the 2000, 2006 and 2016 Côte d'Ivoire MICS reports). DHS, Demographic and Health Surveys; INTRO, timely introduction of complementary foods; MAD, minimum acceptable diet; MDD, minimum dietary diversity; MICS, Multi‐Indicator Cluster Survey; MMF, minimum meal frequency.