Low levels and determinants of appropriate complementary feeding practices among children aged 6-23 months from Tigray, Ethiopia: a community-based cross-sectional study

Introduction: Complementary feeding is considered appropriate when introduced timely at 6 months of age, and where it fulfils the minimum meal frequency, minimum dietary diversity and minimum acceptable diet. Sufficient evidence is available on the different individual indicators of appropriate complementary feeding.

Objective: This study was conducted to assess the prevalence and determinants of appropriate complementary feeding practices among children aged 6-23 months in Tigray, Northern Ethiopia.

Design and setting: A community-based cross-sectional study was conducted in 52 districts of Tigray.

Participants: A total of 5321 children aged 6-23 months were included using stratified two-stage random sampling.

Results: Approximately 19% of children received appropriate complementary feeding. Maternal residence in urban areas (adjusted OR (AOR) 1.26; 95% CI 1.062 to 1.489), maternal education (AOR 1.34; 95% CI 1.111 to 1.611), antenatal care (ANC) visits (AOR 1.75; 95% CI 1.343 to 2.281), household food security (AOR 2.81; 95% CI 2.367 to 3.330) and provision of colostrum to newborns (AOR 1.76; 95% CI 1.139 to 2.711) were found predictors of appropriate complementary feeding. Moreover, children in the 12-17 and 18-23 months age groups were 1.3 (AOR 1.30; 95% CI 1.083 to 1.551) and 1.7 (AOR 1.73; 95% CI 1.436 to 2.072) times more likely to receive appropriate complementary feeding respectively, compared with children aged 6-11 months.

Conclusions: Appropriate complementary feeding practices among children aged 6-23 months remain unacceptably low in Tigray. Recommendations to improve nutrition outcomes include counselling on age-appropriate complementary feeding, education for girls and women, targeting families through food security initiatives, provision of nutrition education on appropriate complementary feeding practices during ANC visits, supporting mothers to initiate breastfeeding within the first hour of delivery and crafting context-based messaging for rural families.