Trends and influencing factors of complementary feeding practices in Niger: An analysis of national surveys from 2000 - 2018

Abstract Background To examine the trends and influencing factors of complementary feeding (CF) practices among Nigerien children aged 6–23 months between 2000–2018. Methods Using the 2000 Multiple Indicator Cluster Survey (MICS), 2006 Demographic and Health Survey (DHS), 2012 DHS, and 2018 Standardized Monitoring and Assessment of Relief and Transitions (SMART) survey, we estimated the trends of four WHO-UNICEF CF indicators: timely introduction of complementary foods (INTRO), minimum meal frequency (MMF), minimum dietary diversity (MDD), and minimum acceptable diet (MAD). The analysis included youngest singleton infants and children aged 6–23 months living with their mothers. We identified risk factors associated with meeting the WHO-UNICEF CF indicators using modified Poisson regression models using DHS 2012. Results The proportion of infants and children meeting INTRO (53.7–81.8%), MMF (53.6–78.2%), MDD (9.7–24.1%), and MAD (5.8–13.0%) increased between 2012–2018. In 2012, older children and mothers who listened to the radio had a higher prevalence of meeting MMF, MDD, and MAD. Children of employed mothers had a higher prevalence of meeting INTRO, MDD, and MAD. Child vitamin A supplementation, child iron supplementation, and mothers watching TV were associated with MMF, MDD, and MAD respectively. Poorer wealth quintiles were associated with lower prevalence of meeting MDD and MAD. Conclusions The modifiable risk factors of suboptimal CF include child micronutrient supplementation, maternal employment, and household wealth. As CF practices remain inadequate in Niger, emphasis should be given to multisectoral strategies that target these modifiable risk factors.