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SUMMARY: Dietary diversity is the number of individual food items or food groups consumed over a given period of time. Lack of diversity is a severe problem among poor populations in the developing countries, because diets are primarily based on starchy staples and does not include animal products. Infants and young children mostly need diversified foods. Children aged 6-23 months are at a higher risk to suffer from under nutrition. It is the transition period, a child moves from mother's milk to solid foods as its major source of nutrition. When introduced to solid foods, the child may suffer from indigestion, infection, inadequate food and lack of food diversity. This can result in childhood under nutrition. The transition period from exclusive breastfeeding to two years is a critical window for physical and mental growth and development of the child. During this period, appropriate, safe, and diversified food feeding is crucial. The purpose of the study was to describe the factors associated with minimum dietary diversity and wasting of children aged 6-23 months in Bardaghat municipality, Nawalparasi district. Minimum dietary diversity was measured by IYCMDD score whereas wasting was measured by weight for length Z score less than -2 SD. The study was a community based, cross-sectional descriptive study based on the face to face interview with mothers of children. The questionnaire was adapted from NDHS and IYCF indicators. The sample size was 270 pairs of mothers or care giver with their children aged 6- 23 months. Data entry was done by using Epidata 3.1, and analysis was done by using IBM SPSS 22.0 version. For anthropometry analysis, WHO anthropometry nutrition survey tool was used. Descriptive findings shows that almost 50% of the mothers were below 25years and 25-34 years while only 7.8% mothers were above 35 years. . Most of the mothers were Hindu (90.4%). Majority of the mothers were housewife and fathers were in foreign employment. Most of the children were from age group 12-17 months. Number of male children was slightly higher than female. Highest wealth quintile household consisted 36.3% while lowest wealth quintile household consisted 19.3%. Home garden was available in 60% of household. Growth monitoring was done by 75.9% children and PNC services achieved by 90% of mothers. Only 20% of mothers were initiated breast feeding within one hour. Exclusive breast feeding for six months was done by 45.9% of mothers. Fifty percentages of children were introduced solid and semisolid food in at six month. Tap water was major source of drinking water. Less than half household were treated water before consumption. Common type of toilet used was piped sewer latrine. Minimum dietary diversity is 54.1 percent and low dietary diversity is 45.9 percent. All the children were given staples foods followed by Legumes and nuts (90%). Children were provided 58.9% of dairy products, 17.8% flesh food, 28.5% eggs, 71.1% vitamin A rich fruits and vegetables and 13% other fruits and vegetables. Prevalence of wasting, underweight and stunting was found to be 18.1%, 10% and 10.3%. Among wasting, 14.4% were moderately wasted and 3.7% were severely wasted. Among underweight, 8.5% were moderately underweight and 1.5% were severely underweight. Among stunting, 8.1% were moderately stunted and 2.2% were severely stunted. In bivariate analysis, father's education , father's occupation, child age, wealth index, availability of home garden, growth monitoring, times of growth monitoring, PNC care, times of PNC care, IYCF information from media promotion, colostrum feeding, introduction of solid/semisolid food and feeding times were significantly associated with minimum dietary diversity. In bivariate analysis, child sex, available of home garden, growth monitoring, IYCF information from relatives, exclusive breast feeding, hand washing before feeding the child and method of water treatment were significantly associated with wasting. Further, Multivariate analysis shows that the children from high wealth household were more 2.5 times more likely to have minimum dietary diversity than children from low wealth household (AOR=2.459; CI: 1.144-5.286).Moreover, This study shows that, the children whose mother got IYCF information from media promotion were twice more likely to have minimum dietary diversity than children whose mother didn't get any IYCF information from media promotion (AOR=2.354; CI: 1.052-5.267). Furthermore, Minimum dietary diversity was strongly associated with wasting in this study. The children who had low dietary diversity were four times more likely to be wasted than the children who had minimum dietary diversity (AOR=4.014; CI: 2.1167.616). Emphasis should be given on health education and further research regarding feeding practices and nutritional status. Moderate acute malnutrition should be screened early and timely counseling must be done, so that severe acute malnutrition cannot develop. Further research incorporating qualitative design could be carried out to explore factors related with dietary diversity and wasting. |
