Trends in and predictors of animal source food consumption among 6-23 months age children in Tigrai, Northern Ethiopia: evidence from three consecutive ethiopian demographic and health surveys, EDHS 2005-2016.

Despite numerous interventions, child undernutrition continues as a problem of global concern. Although consumption of animal source foods has shown positive associations with child undernutrition, no much evidence exists on its trends and predictors among children in Tigrai. This study aimed to investigate the trends in and predictors of consumption of animal source foods among children 6-23 months of age in Tigrai. This study used complex data of 756 children extracted from three consecutive Ethiopian Demographic and Health Surveys. Data were analyzed using STATA 14.0 by accounting for sampling weight and cluster and strata variables. Multivariable logistic regression was used to determine the independent predictors of animal source foods consumption. Odds ratio and 95% confidence interval were used to measure strength of association at a statistical significance of p < 0.05. Although statistically not significant (p-trend = 0.28), animal source foods consumption increased from 31.3% to 2005 through 35.9% in 2011 to 41.5% in 2016. For every month increase in the age of a child, a 9% increment in the odds of animal source food consumption was observed. Muslim children showed 3.1 times higher odds of animal source food consumption than Orthodox Christians. The likelihood of animal source foods consumption were 33% lower among children born to mothers who didn't attend formal education as compared to their counterparts. A unit increase in the number of household assets and number of livestock led to a 20% and 2% increase in the odds of animal source foods consumption, respectively. Animal source foods consumption showed a statistically non-significant increase over the three consecutive Ethiopian Demographic and Health Surveys. This study found out that consumption of animal source foods might be increased through pro-maternal education policies, programs with household asset increasing schemes, and pro-livestock projects. Our study also highlighted the need for considering religion as one important player when planning or undertaking ASF programs.

Gebretsadik GG ，Tadesse Z ，Ambese TY ，Mulugeta A ... -  《-》

Magnitude and determinants of animal source food consumption among children aged 6-23 months in Ethiopia: secondary analysis of the 2016 Ethiopian demographic and health survey.

Undernutrition puts children in a physical and cognitive disadvantage. Animal source foods (ASFs) are important components of nutritious diets and play a significant role in increasing dietary diversity and minimizing the risk of undernutrition among children. Ethiopia still suffers from child undernutrition and there's no adequate information regarding consumption of ASFs. The objective of this study was to determine the magnitude and determinanats of ASF consumption among children 6-23 months of age. A total weighted sample of 2861 children drawn from the 2016 Ethiopian demographic and health survey was analyzed using "SVY" command of STATA 14.0. Multivariable logistic regression was used to determine the independent determinants of ASF consumption. The strength of the association was measured by odds ratio and 95% confidence interval and p-value < 0.05 was considered statistically significant. Nearly half (46.5%) of the children reported consuming any type of ASF. Religion, child age, number of household assets, number of livestock owned by a household, and ownership of land usable for agriculture were significant determinants of the outcome variable. The odds of ASF consumption were six times, twice, and 70% lower in orthodox children compared to other (catholic, traditional, or others), muslim, and protestant children, respectively. Household ownership of assets and livestock led to an increase in consumption of ASF by 19 and 2%, respectively. Children aged 18-23 months were more likely to consume ASF as compared to the younger age group (6-8 months old children). In the contrary, children from households that own land usable for agriculture were 33% less likely to consume ASFs as compared to those from households that do not own. In Ethiopia, only nearly half of children aged 6-23 months consume any type of ASF. The findings of this study imply that ASF consumption can be increased through integrated actions that involve community and religious leaders and programs focused on empowering households' capability of owning other socioeconomic entities including assets and livestock. This study also may contribute to the growing body of research works on the importance of ASF provision in preventing child undernutrition.

Gebretsadik GG ，Adhanu AK ，Mulugeta A 《BMC PUBLIC HEALTH》

Animal Source Food Consumption in Young Children from Four Regions of Ethiopia: Association with Religion, Livelihood, and Participation in the Productive Safety Net Program.

Potts KS ，Mulugeta A ，Bazzano AN 《Nutrients》

Socio-economic and spatial inequalities in animal sources of iron-rich foods consumption among children 6-23 months old in Ethiopia: A decomposition analysis.

Iron deficiency anaemia is the most common type of anaemia in young children which can lead to long-term health consequences such as reduced immunity, impaired cognitive development, and school performance. As children experience rapid growth, they require a greater supply of iron from iron-rich foods to support their development. In addition to the low consumption of iron-rich foods in low- and lower-middle-income countries, there are also regional and socio-economic disparities. This study aimed to assess contributing factors of wealth-related inequality and geographic variations in animal sources of iron-rich food consumption among children aged 6-23 months in Ethiopia. We used data from the Ethiopian Mini Demographic and Health Surveys (EMDHS) 2019, a national survey conducted using stratified sampling techniques. A total of 1,461 children of age 6-23 months were included in the study. Iron-rich animal sources of food consumption were regarded when parents/caregivers reported that a child took at least one of the four food items identified as iron-rich food: 1) eggs, 2) meat (beef, lamb, goat, or chicken), 3) fresh or dried fish or shellfish, and 4) organs meat such as heart or liver. Concentration indices and curves were used to assess wealth-related inequalities. A Wagstaff decomposition analysis was applied to identify the contributing factors for wealth-related inequality of iron-rich animal source foods consumption. We estimated the elasticity of wealth-related inequality for a percentage change in socioeconomic variables. A spatial analysis was then used to map the significant cluster areas of iron-rich animal source food consumption among children in Ethiopia. The proportion of children who were given iron-rich animal-source foods in Ethiopia is 24.2% (95% CI: 22.1%, 26.5%), with figures ranging from 0.3% in Dire Dawa to 37.8% in the Oromia region. Children in poor households disproportionately consume less iron-rich animal-source foods than those in wealthy households, leading to a pro-rich wealth concentration index (C) = 0.25 (95% CI: 0.12, 0.37). The decomposition model explained approximately 70% of the estimated socio-economic inequality. About 21% of the wealth-related inequalities in iron-rich animal source food consumption in children can be explained by having primary or above education status of women. Mother's antenatal care (ANC) visits (14.6%), living in the large central and metropolitan regions (12%), household wealth index (10%), and being in the older age group (12-23 months) (2.4%) also contribute to the wealth-related inequalities. Regions such as Afar, Eastern parts of Amhara, and Somali were geographic clusters with low iron-rich animal source food consumption. There is a low level of iron-rich animal source food consumption among children, and it is disproportionately concentrated in the rich households (pro-rich distribution) in Ethiopia. Maternal educational status, having ANC visits, children being in the older age group (12-23 months), and living in large central and metropolitan regions were significant contributors to these wealth-related inequalities in iron-rich animal source foods consumption. Certain parts of Ethiopia such as, Afar, Eastern parts of Amhara, and Somali should be considered priority areas for nutritional interventions to increase children's iron-rich animal source foods consumption.

Belay DG ，Wassie MM ，Alemu MB ，Merid MW ，Norman R ，Tessema GA ... -  《-》

Low awareness and affordability are major drivers of low consumption of animal-source foods among children in Northern Ethiopia: A mixed-methods study.

Animal-source foods (ASFs), contain high amounts of essential nutrients that are readily absorbed by the body. However, children in resource-constrained settings often have limited access to these nutritious foods. This study aimed to investigate the reasons for the low consumption of ASFs among children in the Amhara region of Ethiopia. A community-based mixed-methods study was conducted, using exploratory qualitative methods supplemented by the analysis of secondary data from the Ethiopian Demographic and Health Survey (EDHS). The qualitative study employed a multiphase stepwise design and the maximum variation purposive sampling technique, enroling a diverse range of participants such as mothers and/or caregivers, household heads, religious and community leaders, health and nutrition experts, and others. The qualitative data were analysed using a thematic framework analysis method, while the quantitative data were analysed using SPSS v22 statistical software. Multivariable logistic regression analysis was performed to identify the predictors of ASFs among children under 5 years of age in the region. Despite the large and diverse livestock populations available, only 13.2% of children consumed at least one animal-source food (ASF) in the prior day. The most consumed ASFs were dairy and eggs, whereas beef, organ meat, and seafood were the least consumed. Household demographics such as residence, literacy level, paternal age, and household wealth quintiles influenced the overall consumption of ASFs. The main reasons for the low consumption of ASFs among children were unaffordability and poor awareness among caregivers. In addition, religious misconceptions, price hikes, limited availability during certain seasons, low productivity, insufficient support from health professionals, and time constraints for caregivers were also mentioned as significant barriers to ASF consumption in the area. The consumption of ASFs among children in Ethiopia, particularly in the Amhara region, remains very low. This is mainly due to the caregivers' levels of awareness and unaffordability of ASFs. It is recommended that behavioural and sociocultural interventions be implemented that target caregivers to improve the consumption of ASFs among children.

Zerfu T ，Duncan A ，Baltenweck I ，McNeill G ... -  《-》