Individual and community-level factors associated with animal source food consumption among children aged 6-23 months in Ethiopia: Multilevel mixed effects logistic regression model

Hassen Ali Hamza; Abdu Oumer; Robel Hussen Kabthymer; Yeshimebet Ali; Abbas Ahmed Mohammed; Mohammed Feyisso Shaka; Kenzudin Assefa

doi:10.1371/journal.pone.0265899

Individual and community-level factors associated with animal source food consumption among children aged 6-23 months in Ethiopia: Multilevel mixed effects logistic regression model

PLoS One. 2022 Apr 5;17(4):e0265899. doi: 10.1371/journal.pone.0265899. eCollection 2022.

Authors

Hassen Ali Hamza¹, Abdu Oumer², Robel Hussen Kabthymer³, Yeshimebet Ali⁴, Abbas Ahmed Mohammed⁵, Mohammed Feyisso Shaka³, Kenzudin Assefa²

Affiliations

¹ Quality Improvement Unit Coordinator at Mekane-selam General Hospital, Mekane-selam, Ethiopia.
² Department of Public Health, College of Medicine and Health Sciences, Wolkite University, Southwest, Ethiopia.
³ School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
⁴ School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
⁵ Department of Midwifery, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.

Abstract

Background: Diversified diet in childhood has irreplaceable role for optimal growth. However, multi-level factors related to low animal source food consumption among children were poorly understood in Ethiopia, where such evidences are needed for decision making.

Objectives: To investigate the magnitude and individual- and community-level predictors of animal source food (ASF) consumption among children aged 6-23 months in Ethiopia.

Methods: We utilized a cross-sectional pooled data from 2016/19 Ethiopia Demographic and Health Surveys. A stratified two-stage cluster design was employed to select households with survey weights were applied to account for complex sample design. We fitted mixed-effects logit regression models on 4,423 children nested within 645 clusters. The fixed effect models were fitted and expressed as adjusted odds ratio with their 95% confidence intervals and measures of variation were explained by intra-class correlation coefficients, median odds ratio and proportional change in variance. The deviance information criterion and Akaike information Criterion were used as model fitness criteria.

Result: in Ethiopia, only 22.7% (20.5%-23.9%) of children aged 6-23 months consumed ASF. Younger children aged 6-8 months (AOR = 3.1; 95%CI: 2.4-4.1), home delivered children (AOR = 1.8; 1.4-2.3), from low socioeconomic class (AOR = 2.43; 1.7-3.5); low educational level of mothers (AOR = 1.9; 95%CI: 1.48-2.45) and children from multiple risk pregnancy were significant predictors of low animal source consumption at individual level. While children from high community poverty level (AOR = 1.53; 1.2-1.95); rural residence (AOR = 2.2; 95%CI: 1.7-2.8) and pastoralist areas (AOR = 5.4; 3.4-8.5) significantly predict animal source food consumption at community level. About 38% of the variation of ASF consumption is explained by the combined predictors at the individual and community-level while 17.8% of the variation is attributed to differences between clusters.

Conclusions: This study illustrates that the current ASF consumption among children is poor and a multiple interacting individual- and community level factors determine ASF consumption. In designing and implementing nutritional interventions addressing diversified diet consumption shall give a due consideration and account for these potential predictors of ASF consumption.

MeSH terms

Animals
Cross-Sectional Studies*
Ethiopia
Female
Humans
Logistic Models
Multilevel Analysis
Pregnancy
Socioeconomic Factors

Grants and funding

The authors received no specific funding for this work. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.