Abstract
OBJECTIVE: Despite efforts to improve feeding practices globally, 48% of children do not meet the recommended minimum meal frequency. Thus, the aim of this study was to assess minimum meal frequency and its associated factors in children aged 6-23 months in cash crop districts of Kercha, Southern Ethiopia. DESIGN: A community-based cross-sectional design was used to conduct this study from 29 February 2024 to 29 March 2024. SETTING: Kercha district, Southern Ethiopia PARTICIPANTS: A total of 543 children aged 6-23 months were selected using a multistage sampling technique. PRIMARY OUTCOME: The primary outcome of this study was minimum meal frequency, defined as the percentage of children aged 6-23 months who consumed solid, semisolid or soft foods (including milk for non-breastfed children) at least the required number of times for their age in the previous day. SECONDARY OUTCOME: The secondary outcome of this study was factors associated with minimum meal frequency. Bivariable and multivariable multilevel mixed-effect logistic regression analyses were performed to find factors related to minimum meal frequency. Adjusted ORs (AORs) with 95% CIs and p values <0.05 were used to assess the strength and significance of the associations. RESULTS: A total of 539 (99.3%) children aged 6-23 months and their mothers participated in this study. The prevalence of minimum meal frequency was 62.3% (95% CI 58.1% to 66.4%) among children in the cash crop district of Kercha. The final model yielded an intracluster correlation coefficient of 7.3%, reflecting unexplained variations in the prevalence of minimum meal frequency among children at the kebele level. Factors associated with higher odds of meeting minimum meal frequency included being a first-born child (AOR 2.91, 95% CI 1.06 to 8.05), mothers (AOR 2.66, 95% CI 1.48 to 4.76) and fathers (AOR 3.43, 95% CI 1.98 to 5.95) with primary education, having mother attending postnatal visits (AOR 2.74, 95% CI 1.52 to 4.94), introducing additional food at 6 months (AOR 4.71, 95% CI 2.79 to 7.94), good maternal knowledge on child feeding (AOR 1.98, 95% CI 1.21 to 3.22) and living in the household with medium (AOR 2.98, 95% CI 1.59 to 5.53) and rich (AOR 2.39, 95% CI 1.37 to 4.18) wealth status. CONCLUSIONS: The study revealed that only three-fifths of children met the recommended minimum meal frequency. Birth order, introducing additional foods at 6 months, parental education, maternal postnatal visits, good maternal knowledge on child feeding and wealth were linked to minimum meal frequency. To improve child nutrition, it is crucial to enhance maternal education, increase access to postnatal healthcare and educate parents about the importance of introducing additional foods at 6 months.