Adherence to complementary feeding guidelines and associated factors among caregivers of children 6-23 months in Lamwo District

Abstract

Introduction: Undernutrition is unacceptably high in developing countries such as Uganda. For instance, stunting levels were at 33% in 2011 and were worse in rural areas such as Lamwo district with an even higher prevalence of stunting at 41%. Appropriate complementary feeding is one of the crucial interventions in curbing these levels of malnutrition, however, the factors associated with adherence to complementary feeding are unknown in rural Lamwo district. This study assessed the level of adherence to complementary feeding guidelines and its associated factors among mothers and caregivers of children 6-23 months using the theory of planned behavioural constructs.

Methods: This was a household cross sectional study among 350 respondents. Data was collected using an interviewer administered questionnaire. Univariable and multivariable logistic regression was used for statistical analysis.

Results: Only 40.1% (140/349) of our study respondents were adherent to complementary feeding guidelines. The odds of adherence to complementary feeding were higher among caregivers with children aged 6-8 months (AOR=4.68, 95% CI 1.91-11.48), children whose fathers had attained either secondary or tertiay education (AOR= 2.27, 95% CI 1.22-4.19), caregivers with two children under five years (AOR= 5.46, 95% CI 1.46-20.36), those belonging to the poorest wealth quintile (AOR=3.00, 95% CI 1.37-6.57) and those who showed willingness to recommend initiation of complementary feeding at six months to another mother (AOR= 1.34 95% CI 1.06-1.70). Other factors such as the influence of socio norms and the precieved behavioural control factors were found to not be associated with adherence to complementary feeding.

Conclusions: Adherence to complementary feeding guidelines was very low in Lamwo indicating the urgent need for interventions to improve adherence with subsequent reduction in rates of undernutrition. Interventions such as education on the guidelines for complementary feeding and behaviour change communication involving all the stakeholders in infant and young child feeding could be an effective intervention in this setting.