Factors associated with infant and young child feeding practices among mothers of children 0-23 months attending Banadir Hospital in Wadajir District, Somalia

Abstract

Understanding the prevailing feeding practices of infants and young children is crucial for implementing or improving health and nutrition programs in a country. In Somalia, the prevalence of Malnutrition is high. The minimum acceptable diet among children below two years stands at only 9% and exclusive breastfeeding at 39.6%. Mothers do not practice optimal IYCF with many children succumbing due to complications related to malnutrition as a result of poor practices. This study therefore aimed at assessing the factors associated with optimal infant and young child feeding practices among mothers attending a Banadir Hospital in Wadajir district, Somalia. This was a descriptive cross-sectional study involving the collection of quantitative data from 421 mothers at Banadir Hospital in Wadajir district, Somalia. Systematic random sampling was used to select study participants. Data was collected using pre-tested semi-structured questionnaires developed from reviewed literature. The data entry and cleaning were performed using Kobo Collect, a mobile data collection platform. It was then exported to STATA version 14 for analysis. Proportions, frequencies, measures of central tendency (mean, median, mode), and measures of association (P values, Odds Ratios, and confidence intervals) were used to describe the study subjects. The majority of the study participants 41.8% (176/421) had no form of education, and 44.1% (186/421) were peasants with an average monthly income of 380 US dollars. Slightly over half 55.1% (232/421) reported optimal infant and young child feeding practices. Only 10.6% (44/421) continued breastfeeding for 2 years and 15.2% (64/421) practiced the minimum dietary diversity within the last 24 hours. The odds of practicing optimal IYCF were 83% lower [AOR=0.17, CI=0.07-0.39, P<0.001] among study participants whose spouses were aged above 40 years compared to those whose spouses were aged less than 25 years, at a 95% confidence interval. Odds of practicing optimal IYCF were 2.53 higher [AOR=2.53, CI=1.36-4.71, P=003] among study respondents whose spouses had reached high school and above compared to those who had no form of education. Study participants whose monthly income was above 500 US dollars [AOR=3.63, CI=1.45-9.07, P=0.006] were 3.63 times more likely to practice optimal IYCF compared to those whose monthly income was less than 150 US dollars. Study participants who were married were 1.97 times more likely [AOR=1.97, CI=1.07-3.66, P=0.032] to have optimal IYCF practices compared to those who were divorced. Study participants who had high knowledge of IYCF [AOR=7.61, CI=4.27-13.59, P<0.001] had 7.61 higher odds of practicing optimal IYCF as compared to those with low knowledge. Study participants who reported that there were some cultural beliefs in the community in line with IYCF [AOR=0.59, CI=0.0.41-0.97, P=0.011] were 0.41 times less likely to practice optimal IYCF compared to those who reported not to have some cultural beliefs in their community. Inappropriate IYCFP was prevalent in the study area (44.9%). This prevalence is not acceptable to ensure good health and better nutritional status of children and to achieve the 3rd SDG. Exclusive breastfeeding for six months, timely initiation of breastfeeding after delivery, complementary feeding after six months, continued breastfeeding for up to 2 years, and minimum dietary diversity were the least practiced. Age of spouse, education level of spouse, couple’s monthly income, marital status, knowledge of IYCF practices, and cultural beliefs were predictors significantly associated with optimal IYCF practices among study participants upon multivariable regression analysis. Strategies to improve IYCF practices should therefore be hinged on these predictors.