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Poor complementary feeding (CF) challenges early childhood growth. We examined the trends and influencing factors of CF practices among children aged 6-23 months in Côte d'Ivoire. Using data from Demographic and Health Surveys (DHS, 1994-2011) and Multiple Indicator Cluster Surveys (MICS, 2000-2016), the trends and predictors of World Health Organization-United Nations International Children's Emergency Fund CF indicators including the timely introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD) and minimum acceptable diet (MAD) were determined. Using 2016 MICS data, we applied multivariate logistic regression models to identify factors associated with CF indicators. Between 1994 and 2016, the mean proportion of children aged 6-8 months achieving INTRO was 56.9% and increased by about 25% points since 2006. Over 2011-2016, the proportion of children aged 6-23 months meeting MMF, MDD and MAD increased from 40.2% to 47.7%, 11.3% to 26.0% and 4.6% to 12.5%, respectively. Older children and those from urban households had higher odds of meeting MDD and MAD. Maternal TV watching was associated with higher odds of meeting MDD. The secondary or higher education levels of mothers significantly predicted higher odds of meeting INTRO and MDD. Currently, breastfeeding was also positively associated with odds of meeting MMF and MAD. Children from poorer households had lower odds of meeting MMF, MDD and MAD. Despite the improvements, CF practices remain suboptimal in Côte d'Ivoire. Influencing factors associated with CF were distributed across individual, household and community levels, calling for future programmes and policies to implement multi-level strategies to improve young children's diet in Côte d'Ivoire.

OBJECTIVES: To examine the trends and influencing factors of suboptimal complementary feeding (CF) practices among children aged 6–23 months in Niger using national data from 2000 to 2018. METHODS: Using data from the 2000 Multiple Indicator Cluster Survey, 2012 Demographic and Health Surveys (DHS), and 2018 Standardized Monitoring and Assessment of Relief and Transitions survey in Niger, the trends and predictors of WHO-UNICEF CF indicators including timely introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD) were estimated. Using the most completed data in CF and influencing factors (available from 2012 DHS), multilevel logistic regression models were applied to identify factors at the individual, household and community levels that were associated with meeting INTRO, MMF, MDD, and MAD. RESULTS: The weighted proportion of children aged 6–8 months meeting INTRO increased from 56.0% in 2000 to 84.4% in 2018. The weighted proportion of children meeting MMF (51.3% to 77.9%), MDD (9.8% to 14.2%), and MAD (5.6% to 10.9%) also increased between 2012 - 2018. At the individual level, children with mothers who were employed had higher odds of meeting all four indicators as compared to those whose mothers were unemployed. Older child age and maternal exposure to media were significantly associated with higher odds of meeting MMF, MDD, and MAD. Maternal education and child birth weight greater or smaller than average (reference) were positively associated with the odds of meeting MMF and MAD, and antenatal iron supplementation and currently breastfeeding were positively associated with the odds of achieving MDD and MAD. At the household level, the odds of meeting MMD and MAD were higher among children from wealthier households. At the community level, the odds of meeting INTRO and MMF were higher among children from communities with greater access to health services. CONCLUSIONS: Despite the improvement in CF practices since 2000, only 10% of children from 6–23 months received minimum acceptable diets. Factors associated with CF were distributed across individual, household and community levels, suggesting the need for multi-level strategies to improve child nutrition in Niger. FUNDING SOURCES: UNICEF West and Central Africa Regional Office (Grant # 43279190).

OBJECTIVES: Poor complementary feeding practices pose a major challenge for early childhood growth and development in Côte d'Ivoire, where more than 20% children under five suffer from stunting. We aimed to examine the trends and risk factors of suboptimal complementary feeding among children aged 6–23 months in Côte d'Ivoire. METHODS: We estimated the country-level prevalence, trends, and risk factors of four complementary feeding indicators: introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). Data was extracted from Demographic and Health Surveys (1994 to 2011) and Multiple Indicator Cluster Surveys (2000–2016) to estimate the complementary feeding indicators for children between 6 to 23 months in Côte d'Ivoire. Multilevel logistic regression models were used to identify factors associated with these complementary feeding indicators in 2016. RESULTS: On average, 59.2% of children aged 6–8 months achieved INTRO between 1994–2016. In 2016, the proportion of children aged 6–8 months meeting INTRO was 65.5% showing an increase of around 15 percentage points from 2006. Between 2011 – 2016, the proportion of children aged 6–23 months meeting MMF, MDD, and MAD also increased from 40.2% to 47.7%, 11.3% to 26.0%, and 4.6% to 12.5%, respectively. Child age (MDD, MAD), maternal education (INTRO), and breastfeeding status (MMF, MAD) were significantly and positively associated with achieving at least one of the complementary feeding practices: INTRO, MMF, MDD, and MAD. Higher household wealth was significantly associated with greater odds of achieving all four complementary feeding criteria compared to poorer households CONCLUSIONS: Suboptimal complementary feeding practices remain a problem and disparities in complementary feeding still exist in Côte d'Ivoire. However, complementary feeding practices have improved in the past decade. Additional research is needed to understand the policy and programmatic efforts that may explain the promising trends of complementary feeding practices in Côte d'Ivoire. FUNDING SOURCES: UNICEF West and Central Africa Regional Office and Bill & Melinda Gates Foundation (Grant # 43279190).