Minimum meal frequency and associated factors among children aged 6-23 months in Sub-Saharan Africa: a multilevel analysis of the demographic and health survey data.

Worldwide, approximately half of all children are not provided the minimum meal frequency (MMF). Sub-Saharan Africa (SSA) had the lowest proportion of children aged 6-23 months who met the requirements of the complementary feeding indicators, including MMF. Ensuring adequate meal frequency poses a challenge in numerous developing countries, particularly in regions characterized by low household food security, such as SSA. Therefore, this study aimed to assess the pooled prevalence of MMF and its associated factors in SSA via the most recent demographic and health survey data. A total of 100,526 weighted samples from demographic and health survey datasets of 35 SSA countries were used. A multilevel Poisson regression model with robust variance was applied to identify factors associated with MMF, and the model with the lowest deviance was the best-fitted model. An adjusted prevalence ratio with a 95% confidence interval (CI) was reported, and variables with a p < 0.05 were considered statistically significant. The pooled prevalence of MMF among children aged 6-23 months in SSA was 38.47% (95% CI: 34.97-41.97), which ranged from 21.41% in Liberia to 63.98% in Madagascar. According to the subgroup analysis, the pooled magnitude of MMF in central, west, east, and southern Africa was 36.42, 35.46, 39.97, and 50.69%, respectively. Marital status, maternal education level, sex of household head, working status, wealth index, media exposure, age of the child, postnatal check-up, breastfeeding status, residence, and SSA regions were significantly associated with minimum meal frequency. Less than forty percent of infants and young children in SSA receive the minimum recommended meal frequency, which is relatively low. This presents a notable difficulty in efforts to prevent malnutrition and attain sustainable development goals related to health and nutrition on the continent. Therefore, priority should be given to empowering women, promoting breastfeeding and postnatal check-ups, targeting infants who just started complementary feeding, and spreading information through media.

Tebeje TM ，Abebe M ，Tesfaye SH ，Seboka BT ，Argaw GS ，Seifu BL ，Mare KU ，Aragaw FM ... -  《Frontiers in Public Health》

Individual and community level determinants of minimum meal frequency among breastfeeding children aged 6-23 months in Ethiopia: a multilevel analysis of 2019 Ethiopian Demographic Health Survey data.

Minimum meal frequency (MMF) is a vital indicator of whether a child's energy needs are being met. Previous studies in Ethiopia on MMF have primarily focused on individual factors, often using basic logistic regression models with limited scope and small sample sizes. In contrast, this study aims to identify the key determinants of MMF among breastfed children aged 6-23 months in Ethiopia, examining both individual and community-level factors through multilevel logistic regression analysis, utilizing nationally representative data. The study utilized a community-based cross-sectional design with a sample of 1,245 6-23 month breastfed children in Ethiopia, using data from the 2019 Ethiopian Mini Demographic Health Survey. Mixed effect logistic regression was used to identify factors associated with MMF. Adjusted odds ratios (AOR) with 95% confidence intervals were used to assess variable associations, while Intra-cluster correlation (ICC), median odds ratio (MOR), and proportional change in variance (PCV) were employed to gauge random variation. The proportion of 6-23-month breastfeeding children with MMF was found to be 55.9% (95% CI: 53.2, 58.6). In mixed effect logistic regression; breastfeeding initiation time within days after birth [AOR = 0.44; 95%CI: (0.24, 0.80)], maternal primary educational level [AOR = 1.46; 95%CI: (1.03, 2.05)], maternal higher level education [AOR = 2.43; 95%CI: (1.22, 4.81)] and children from wealthiest household wealth index [AOR = 2.13; 95%CI: (1.04, 4.33)] were individual-level factors and children from city-based regions [AOR = 1.75; 95%CI: (1.10, 2.77)] was community level factors significantly associated with MMF. The final model indicates that 50.8% of the variation in MMF was explained by combined factors at both individual and community levels and also the variation across clusters remained statistically significant (ICC = 8.1% and variance = 0.29 with p < 0.001). Minimum meal frequency is a proxy for meeting energy requirements and it is a key indicator of infant and young child feeding (IYCF) practice. According to this study finding, the prevalence of MMF among 6-23-month children in Ethiopia was found to be low. The study also suggest that time of breastfeeding initiation, women's educational level, household wealth index, and contextual region were factors significantly associated with MMF. It is recommended that IYCF strategies should be implemented widely through women's education and empowerment and promoting early initiation of breast feeding to increase the proportion of children to be fed with MMF appropriate for their age.

Melak D ，Abeje ET ，Bayou FD ，Getaneh FB ，Asmare L ，Endawkie A ，Gedefie A ，Muche A ，Mohammed A ，Ayres A ... -  《Frontiers in Public Health》

Prevalence and determinants of intimate partner sexual violence among pregnant women in sub-Saharan Africa: Evidence from the most recent DHS data 2015-2022.

Tekeba B ，Tamir TT ，Zeleke GA ，Zegeye AF ... -  《-》

Multilevel multinomial regression analysis of factors associated with birth weight in sub-Saharan Africa.

Birth weight significantly determines newborns immediate and future health. Globally, the incidence of both low birth weight (LBW) and macrosomia have increased dramatically including sub-Saharan African (SSA) countries. However, there is limited study on the magnitude and associated factors of birth weight in SSA. Thus, thus study investigated factors associated factors of birth weight in SSA using multilevel multinomial logistic regression analysis. The latest demographic and health survey (DHS) data of 36 sub-Saharan African (SSA) countries was used for this study. A total of a weighted sample of 207,548 live births for whom birth weight data were available were used. Multilevel multinomial logistic regression model was fitted to identify factors associated with birth weight. Variables with p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel multinomial logistic regression analysis, the adjusted Relative Risk Ratio (aRRR) with the 95% confidence interval (CI) was reported to declare the statistical significance and strength of association. The prevalence of LBW and macrosomia in SSA were 10.44% (95% CI 10.31%, 10.57%) and 8.33% (95% CI 8.21%, 8.45%), respectively. Maternal education level, household wealth status, age, and the number of pregnancies were among the individual-level variables associated with both LBW and macrosomia in the final multilevel multinomial logistic regression analysis. The community-level factors that had a significant association with both macrosomia and LBW were the place of residence and the sub-Saharan African region. The study found a significant association between LBW and distance to the health facility, while macrosomia had a significant association with parity, marital status, and desired pregnancy. In SSA, macrosomia and LBW were found to be major public health issues. Maternal education, household wealth status, age, place of residence, number of pregnancies, distance to the health facility, and parity were found to be significant factors of LBW and macrosomia in this study. Reducing the double burden (low birth weight and macrosomia) and its related short- and long-term effects, therefore, calls for improving mothers' socioeconomic status and expanding access to and availability of health care.

Bezie MM ，Tesema GA ，Seifu BL 《Scientific Reports》

Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.

Elwenspoek MM ，Thom H ，Sheppard AL ，Keeney E ，O'Donnell R ，Jackson J ，Roadevin C ，Dawson S ，Lane D ，Stubbs J ，Everitt H ，Watson JC ，Hay AD ，Gillett P ，Robins G ，Jones HE ，Mallett S ，Whiting PF ... -  《-》