Of the 81 caregivers with children 6–8 months of age, 95.06% introduced solid, semi-solid or soft foods in a timely fashion, relatively higher than the national prevalence, which stood at 78.8% [10]. However, a study in China amongst persons in rural settings, comparable to this study, obtained similar findings where 95. 4% of the infants aged 6–8 months received solid, semi-solid or soft foods appropriately [27].
Minimum Dietary Diversity was too low at 4.43%, a proportion significantly lower than that for Uganda at 30% [10]. The MDD was exceedingly low, similar to other studies done after the COVID-19 pandemic traversed the globe. Kundu et al.[28] and Minja et al.[29] explained that MDD was heavily associated with the earning potential of HHs and in rural areas where most HHs earned low incomes, and in the presence of the pandemic that negatively impacted income earning, MDD was, in turn, very low. Amongst the food groups, grains, roots and tubers were consumed by most children (93.5%), while eggs were the least consumed at 6%. Similarly, a study carried out in Northern Uganda also found that cereals were more consumed than foods of animal origin, which the people attributed to grains being cheaper to purchase and easier to access than foods of animal origin [3].
The study findings revealed that at the settings level, caregivers that gained income in non-formal or agricultural ventures such as begging and remittances, among others, were more likely to meet the requirements for MMF for their children compared to caregivers working in the agricultural sector. Similarly, studies carried out in Poland, Austria, and Southern Benin reported that parents or caregivers, particularly mothers who were employed or heavily involved in income-generating activities, were less likely to have their children meet the MMF requirements [18, 29]. Our study findings further indicate that caregivers who belonged to village livelihood groups were less likely to achieve minimum meal frequency for their children than those in the MIYCAN group. This is because caregivers in the livelihood group were more involved in income-generating activities, which decreased the time to care for the children and hampered meeting requirements for MMF [18, 29]. On the other hand, caregivers in the MIYCAN groups regularly received nutrition training, a factor documented to favour meeting the requirements of the optimal complementary feeding practices [15, 23].
At the interpersonal level, caregivers in large HHs were less likely to offer their children an acceptable and diverse diet than those living in small HHs. Studies in Ethiopia, Australia, and Benin also concluded that HHs with more than seven residents usually had sub-optimal complementary feeding practices because of the food insecurity brought on by income limitations; the low incomes cannot ably support the large household sizes [18,19,20]. In addition, unmarried caregivers were more likely to have continued breastfeeding their children by one year than married caregivers. This finding differed from what studies in Kenya, and Southern Benin discovered, where married caregivers were more likely to meet the requirements for OCFPs [18, 30]. However, Scott et al. [31] concluded that partners could be deterrents to continued breastfeeding, and mothers that did not have partners would breastfeed longer because they had the time to dedicate to their children and also issues such as sagging breasts and losing the interest of your partner were not a worry [32] promoting longer durations of breastfeeding.
At the intrapersonal level, caregivers older than 29 years were more likely to promptly introduce solid, semi-solid, and soft foods to their children than their younger counterparts. Other studies with similar findings concluded that a mother's age was a predictor for complementary feeding practices because older mothers were more experienced and knowledgeable in taking care of their children compared to their younger, less knowledgeable counterparts [15, 23]. Caregivers for children aged between 12–17 months were more likely to meet the MMF requirements for their children compared to caregivers with children in the 6–11 months age bracket. A study with similar findings explained that children within the former age bracket had likely settled into the pattern of the family meals, which were the prescribed number of times a child that age should be fed, lending to meeting the MMF requirements [33].
Recommendations
Increased advocacy by nutrition champions and organisations for augmented funding to the nutrition sector; to support the direct implementation of the IYCF guidelines and Multisectoral Nutrition Action Plans. The government and policymakers must strengthen existing initiatives and develop new intervention measures to increase the citizenry's socioeconomic position, education status, and occupational opportunities for better CFPs. More research in other regions of the country on factors associated with IYCF.