Determinants of dietary diversity among children aged 6–23 months in Mwenezi District, Zimbabwe

Abstract

Poor dietary diversity during the complementary feeding period has detrimental effects on children’s growth, health, and development. During this period, a lack of a diverse diet increases the risk of malnutrition, morbidity, and mortality. Ensuring dietary diversity is critical to promoting child survival, adequate growth, and development. The study aimed to identify determinants of dietary diversity among children aged 6-23 months in Mwenezi district of Zimbabwe. The study examined determinants of dietary diversity at the child, caregiver, household, and community levels. The study was a quantitative cross-sectional design with a sample size of 417 children selected through multi-stage random sampling. As children are not able to report their food intake, their caregivers responded on their behalf. Data was gathered by five trained field assistants using an interviewer-administered questionnaire and was analyzed using Statistical Package for Social Sciences (SPSS 20 for windows). The study established a very low minimum dietary diversity, (21.3%) in Mwenezi district. Except for staples (grains, roots, and tubers), the consumption of other food groups was below 50%. Consumption of vitamin A-rich fruits, eggs, and dairy products were least consumed by children, ranging from 7-16%. Determinants at the child level were age, sex, and birth weight. Caregiver knowledge of IYCF was the only caregiver level determinant identified. Household level determinants included poultry possession, possession of a nutrition garden, and joint decision-making by both spouses while community level determinants were presence of child growth monitoring services and village savings and lending associations. Interventions to improve the quality of diets consumed by children ought to target child, caregiver, household and community levels for synergy and greater impact. These interventions should purpose to increase caregivers’ knowledge of age specific child feeding practices while also creating a conducive and supportive socio-economic environment for caregivers to plan and prepare diverse diets. A comprehensive social and behaviour change program using the care group model, employing a ‘‘whole of family approach’’ to improve feeding behaviors and practices, empowering women and engaging men to support joint decision making, production of a wide range of crops and vegetables and small animals will improve consumption of diverse diets by children in Mwenezi district.