Infant and Young Child Feeding Practice and Associated Factors among Mothers/Caretakers of Children Aged 0-23 Months in Asella Town, South East Ethiopia

Research Article

J Fam Med. 2017; 4(5): 1122.

Infant and Young Child Feeding Practice and Associated Factors among Mothers/Caretakers of Children Aged 0-23 Months in Asella Town, South East Ethiopia

Sasie SD¹*, Oljira L² and Demena M²

¹Federal Ministry of Health, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

²Haramaya University College of Health and Medical Sciences, Department of Public Health, Harar, Ethiopia

*Corresponding author: Sileshi Demelash Sasie, Research and Training Center of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia

Received: July 01, 2017; Accepted: July 26, 2017; Published: August 02, 2017


Background: The global strategy for infant and young child feeding describes essential actions to protect, promote and support appropriate infant and young child feeding. Finding in the area of infant and young child feeding practice is low in Ethiopia. The aim of this study was to describe infant and young child feeding practices at Asella Town.

Methods: A community based cross-sectional study was conducted between October and November 2015 using both quantitative and qualitative methods. A questionnaire was administered to 421 mothers/caregivers of children aged 0-23 months. Focused group discussions were conducted in selected communities to assess parents practice to infant and young child feedings.

Result: Timely initiation and exclusive breast feed was 86.3% and 70% respectively. Minimum meal frequency (MMF) and minimum dietary diversity (MMD) was 53.8% and 23.6% respectively. Sex of child (AOR=1.5(1.13, 3.2)), place of delivery (AOR=1.77(1.02, 3.06)) and culturally acceptable time for initiation of complementary feeding (AOR=4(1.75, 9.47)) was significantly associated with IYCF practice.

Conclusion: The IYCF practice of mothers/caregivers is good in the Town. However there is a need to develop health education intervention, targeting behavior change in the urban area regarding IYCF practices are essential.

Keywords: Infant; Young child; Feeding practice; Urban community


CSA: Central Statistical Agency; EBF: Exclusive Breastfeeding; EHNRI: Ethiopian Health and Nutrition Research Institute; HEW: Health Extension Workers; HU: Haramaya University; IYCF: Infant and Young Child Feeding; MMF: Minimum Meal Frequency; PI: Principal Investigators; SPSS: The Statistical Package for the Social Sciences; UNICEF: United Nations International Children’s Emergency Fund; WB: World Bank; WHO: World Health Organization


Infant and young child feeding the first two years of life is base for growth and development of children’s [1]. The first 1000 days of life from conception through the first two years of life is a window of opportunity due to the profound positive effect optimal nutrition have on the developing child and a damage sustained during this period is often permanent [2].

The global strategy for infant and young child feeding describes essential actions to protect, promote and support appropriate infant and young child feeding. It focuses on the importance of investing in this crucial area to ensure that children grow to their full potential free from the adverse consequences of compromised nutritional status and preventable illnesses [3]. Under nutrition usually occurs at the age of 3-18 months making the child’s first two years of life are considered a critical window of opportunity for the prevention of growth retardation and under nutrition [4]. So at this age group appropriate interventions should be taken to ensure that children reach their full growth potential and to prevent irreversible stunting and acute under nutrition [5].

A 6.3 million Children under age five died in 2013, nearly 17000 every day [6] and worldwide about 10.9 million children less than five years die each year mostly due to preventable causes such as undernutrition, diarrhea, pneumonia, measles, malaria and HIV/AIDS [7]. The disease burden can be attributed to under-nutrition whereas malnutrition has been responsible, directly or indirectly, for 60% of the 10.9 million deaths annually amongst children under five year .Over 67% of these deaths are associated with inappropriate feeding practices and occur during the first year of life. Poor feeding practices are, therefore, are a major threat to social and economic development as they are among most serious obstacles to attaining and maintaining health of this important age group [8].

In 2013, the under five-mortality rate in low-income countries was 76 deaths per 1000 live births while it was 6% in developed countries. Reducing these inequities across countries and saving more children’s lives by ending preventable child deaths are important priorities [9]. Malnutrition in sub-Saharan Africa contributes to high rates of childhood morbidity and mortality [10]. Fortunately, the EBF rate in sub-Saharan Africa has increased from 22% to 30% [11]. However, these rates are still low a focus should be given to prevent the lives of children from danger that is from morbidity, mortality and irreversible damages. This was the result of poor adherence to IYCF raises threat to child causing high morbidity and mortality [12].

In Ethiopia only half (52%) of infants under six months of age were exclusively breastfed and only 4% of breastfed children in Ethiopia are receiving four or more food groups daily and are receiving the minimum number of feedings. Seventy five percent of children under six months are predominantly breastfed and 66% under the age of two receive age-appropriate breastfeeding [13]. Exclusively breastfed infants are less likely to become ill with diarrhea, and less likely to die from diarrhea or other infections. In addition, an EBF infant was less likely to develop pneumonia, meningitis, and ear infections than non-breastfeed infants [14]. IYCF recommendations are given to promote child survival through interventions that are cost effective. Only child morbidity and mortality are reduced when mothers, families and caregivers comply and practice well with the national IYCF recommendations [15]. The findings from Delhi India complementary feeding prevalence was (17.5%) [16]. A study done in Ethiopia also shows that complementary feeding practice is not the same in different parts of the regions. A community based crosssectional study, which is conducted in Mekelle in 2013, shows that complementary feeding prevalence was 62.8% [17] while in Harar in 2012 the prevalence was 54.4% [18]. Therefore, this study would fill the gap of current situation in mother’s practices and related factors to national IYCF recommendations.


Study area, design and data collection

The study was conducted in the South East Ethiopia, in Asella Town which is 175km from Addis Ababa in, December, 2015.

The study design was a community based cross-sectional study using quantitative and qualitative methods of data collection.

All feeding practices for children were elicited using the 24-hour recall method, except for initiation of breastfeeding and exclusive breast-feeding, for which, historic recall was used. Research assistants were trained over a two day period and the quantitative study was conducted between October and November 2015.

Study sample

The mothers/caretakers of children 0-23 months were the primary targets. For the qualitative parts of the data, six FGD was conducted among mothers, fathers and grand mothers of age less than 60 years of children’s aged 0-23. Two FGD for each was conducted. Each group had 6-12 participants.

Sample size and sampling

The sample size was determined using complementary feeding prevalence rates of Harar Town, 54.4% [18], at 95% CI and considering a non-response rate of 10%, the minimum required sample size was estimated to be 421.


Among a total of eight and then households were selected by randomly. Proportional to population size allocation technique was used in the determination of the number of study participants included in each selected kebeles. The selection was conducted using simple random sampling methods by drawing lottery. FGD was conducted among mothers, fathers and grand mothers of age less than 60 years of children’s aged 0-23. Each group had 6-12 participants. These participants were selected purposively.

Data management and analysis

Quantitative data analysis: The data were entered in to EPI info version 3.5.4 software and then exported and analyzed by SPSS version 20 for windows. The bivariate analysis was done to see the association between dependent and independent variable at p value <0.2 to build a multiple variable model. Finally multivariate logistic regression analysis was employed to control for possible confounding effects and to assess the separate effects of each variable at p-value of < 0.05 to declare statistical associations.

Qualitative data analysis: Data from focus group discussions was transcribed from Afan Oromo to English, responses were arranged in general categories that were identified in the discussion guide then it was coded. Common themes were identified, inferences were made from each theme, the transcript and notes were cleaned and saved in plain text file, and conclusion was drawn then triangulated with the data from the questionnaire.


Ethical clearance was obtained from Institutional Health Research Ethics Review Committee (IHRERC) Haramaya University and permission was obtained from the Asella Town Health Bureau. Written consent to participate in the study was secured before conducting the interview and discussion.


Mothers’/care takers and husbands’ demographic and socio-economic characteristics

Of four hundred and twenty one (421) sampled mothers, 410 were successfully included in the study making the response rate of 97.4%. Biological mothers accounted for 393(95.8%) of caregivers, while 17(4.2%) were other caregivers such as grandmothers and sisters. The child’s birth order ranged from 1-6 and majority 245(59.8%) of the children were subsequent born while only 165(40.2%) were first born. Majority 376(91.6%) of the children were born at health facility by health professionals (Table 1).