Promising Trends of Complementary Feeding Practices in Côte D’lvoire: An Analysis of Nationally Representative Survey Data Between 1994–2016

Abstract 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).