Factors associated with minimal meal frequency and dietary diversity practices among infants and young children in the predominantly agrarian society of Bale zone, Southeast Ethiopia: a community based cross sectional study

Background Poor infant and young child feeding (IYCF) practices in the first 2 years of age are among major causes of childhood malnutrition, in developing countries including Ethiopia. It results in irreversible outcomes of stunting, poor cognitive development, and significantly increases risks of many chronic and infectious diseases. This study was intended to assess factors associated with minimum meal frequency and minimum dietary diversity practice among children aged 6-23 months in the predominantly agrarian society of Bale zone, Southeast Ethiopia. Methods A community based cross sectional study was employed from January to June 2016. An interviewer administered, pretested and structured questionnaire was used to collect data. Multi-stage sampling followed by a systematic random sampling technique was used to include study subjects. Data was entered using Epi info version 3.5.3 and analyzed by SPSS version 20. In the logistic regression, both bivariate and multivariate analyses were carried out to identify factors associated with minimum meal frequency and minimum dietary diversity scores. All variables with P-values of <0.2 in the bivariate were earmarked for the multivariate analysis. Both Crude Odds Ratio (COR) and Adjusted Odds Ratio (AOR) were computed at 95% Confidence Interval (CI) to determine the strength of associations. In the multivariate analysis, variables at P-Values of <0.05 were considered as statistically significant with minimum meal frequency and dietary diversity practice. Result A total of 801 infants and young children aged 6-23 months and their mothers participated in the study. The overall prevalence of minimum meal frequency and minimum dietary diversity practice was 68.4% [95% CI: 0.652, 0.716] and 28.5% [95% CI: 0.254, 0.316], respectively. Child age (AOR = 0.29; 95% CI: 0.28, 0.94) and parity of mother (AOR = 2.8; 95% CI: 1.11, 7.50) were independently associated with minimal meal frequency. On the other hand, mothers educational level (AOR = 0.52; 95% CI: 0.28, 0.94), child illness in the past 1 week (AOR = 0.44; 95% CI: 0.26, 0.73) and maternal counselling on IYCF practice during postnatal care (PNC) visits (AOR = 2.6; 95% CI: 1.59, 4.45) were factors statistically associated with dietary diversity practice in the study area. Conclusion and recommendations Compliance to recommended minimum meal frequency and diversified diets was low in this study community. Minimum meal frequency was associated with the age of child and parity of mother. But, mothers' education, child illness in the past 1 week, and maternal counseling on IYCF during PNC visits were factors associated with minimum dietary diversity practice. Improving the level of maternal and child health care utilization, increasing the educational level of mothers and providing health and nutrition counseling on IYCF during maternal PNC service visits are vital interventions to improve IYCF practices in the predominantly agrarian society of Bale zone, Southeast Ethiopia.