Abstract
OBJECTIVES: In Ethiopia, where 40% of the population is under 15 years, evidence on adolescent nutrition is limited. We examined the dietary diversity and its determinants among in-school adolescent girls in 2 regions in southern Ethiopia. METHODS: We used household survey data from 162 in-school adolescent girls aged 10–14 y across 54 primary schools in one agrarian region (SNNP) and one pastoralist region (Somali), collected in October-November 2019. Multiple regression models were used to examine factors such as nutrition knowledge, food availability and food insecurity associated with the dietary diversity score, adjusted for age and geographic clustering. RESULTS: All of the adolescent girls were currently enrolled in school (grades 4–8), and most resided with their mothers (96.9%) and fathers (80.2%). Prevalence of thinness was 11.7% (body mass index (BMI)-for-age Z-score < −2SD), and 35.2% were mildly thin (BMI-for-age Z-score < -1SD). Dietary diversity was low, with 3.7 food groups (out of 10) consumed in the last 24 h. Also, 48.8% reported consuming sweets and sugar-sweetened beverages in the last 24 h. Nutrition knowledge among adolescents was moderate, with an average score of 4.8 out of 8 knowledge items. On occurrences of food insecurity in the past 30 days, they reported an average score of 1.1 (out of 9 items). However, household surveys revealed a high degree of food insecurity (56.2%). Adolescents also reported that only 3.6 food groups (out of 10) were available at home some/most/all of the time (that is, 3–7 days) over the past 7 days. Unsurprisingly, food availability at home (β = 0.30, P = 0.000) and food insecurity (β = −0.12, P = 0.013) followed by nutrition knowledge (β = 0.11, 0 = 0.031) were significantly associated with dietary diversity score. CONCLUSIONS: Understanding the factors influencing poor diets among adolescents will help to enhance the design of educational interventions to improve adolescent nutrition outcomes, a critical priority in Ethiopia. However, household food insecurity and household food availability are serious concerns in this context. FUNDING SOURCES: Bill & Melinda Gates Foundation, through Alive & Thrive, managed by FHI 360; and CGIAR Research Program on Agriculture for Nutrition and Health (A4NH), led by the International Food Policy Research Institute.