The overall prevalence of appropriate complementary feeding was 11.4%, (95% CI: 8.8, 14.3). This was comparable to the result from Abiy Adi town, North Ethiopia where appropriate complementary feeding was 10.5% [10]. This might be due to similarities in study setup and indicators used to measure appropriate complementary feeding. The result is higher than the Ethiopia national level and South Ethiopia reported from EDHS 2011 in which prevalence of ACFP was 4.0% and 3.% [5]. However, the result was much lower than the findings from Kohat district Pakistan 18.2% Sirlinka, Zambia and Bangladesh where the prevalence of ACFP was above 20% [8, 11,12,13]. The disparity might be due to the fact that previous studies were used three indicators to calculate ACFP, whereas this study used four indicators [14, 15].
About 74.2% of mothers had started complementary foods at 6 months of child’s age, as recommended. It was higher than the findings from Deheli India 17.5% [16], United Arab Emirates 17% [17], Mekele 62.8% [18], Ethiopia with national levels 51% [5], Harare 54% [4] and Kohat district Pakistan 69.7% [13]. The result is nearly similar with finding from that of Abiy Adi 80% [10]. This high prevalence might be due to practice group through time, better maternal health care service utilization and extensive effort of health extension workers, health development army and women’s development group in the study area.
Minimum acceptable diet, a combination of minimum meal frequency and minimum dietary diversity, was 16.3% which is higher than Ethiopia national level 4% and SNNPR 2.3%, and Abiy Adi, North Ethiopia 11.9%. But, it was lower than the finding from Sirlanka 68%, Bangladesh 40%, Nepal 32%, Delhi, India19.7% [10,11,12, 19, 20]. The lower level of the result might be due to socio-cultural differences among the study area. The result is consistent with the findings from Tanzania (16.3% Vs 15.9%) [21].
MDD was observed only 16.5% of caregivers were fed their young child with food group four and more from seven food groups namely grains roots and tubers, legumes and nuts, dairy products, flesh foods, vitamin A reached foods, eggs and other fruits vegetables. Ergib Mekibib et al. also reported from northern Ethiopia that 17.8% of mothers fed their child from four and more food groups and the result of this study is lower than findings from Kamba Woreda SNNPR was 23.3%, Delhi, India 32.6% [19, 22].
The prevalence of MMF was higher than national level 4.3% and SNNPR 2.5%. Moreover, the level of minimum meal frequency in the study found to be 94.5%. The result was much higher than the national level 47.9% and SNNPR 48.9% [5].
The study revealed that ANC follow up and birth orders are factors significantly associated with appropriate complementary feeding practices. Mothers who followed antenatal care service were 3.2 times more likely to practice appropriate complementary feeding than those who did not follow the ANC service. This result is similar with the findings in Sirlinka, Nepal; Harare [11, 20, 23] ANC contacts were a significant predictor of appropriate complementary feeding practice. This might be due to the result of information and counseling that the mothers received from health care providers during their antenatal care. Birth order were found to be the predictors ACFP and this result is congruent with the findings from Kemba [22]. This might indicate the previous feeding experience that could enhance appropriate feeding practice.
In this study there were no association of index child age and, appropriate complementary feeding. This result were different findings from Ethiopia and Zambia, Tanzania; Indonesia [8, 21, 24]. This might be due to the difference in socio cultural understanding of mothers about young children can be able to digest all foods. In this study there was no association between education of caregiver’s and appropriate complementary feeding practice. This was disagreed with the findings from Indonesia, Ethiopia and Zambia, Kenya, Nepal and Sirlanka where maternal education is the predictors of appropriate complementary feeding [8, 10, 11, 20, 24, 25]. The possible explanations can be the difference in norms and cultures with geographical difference regarding female education.
Limitations of this study
The possible limitation of this study was that infant feeding practices are age-specific with narrow age ranges and characteristically assessed by mothers report on recall; this may lead to recall bias.