Status of Infant and Young Child Feeding
(IYCF) and Malnutrition among
Children aged 6-23 months
Md. Ahedulla
Roll no: 22023
Session: 2022-2023
MPH (Community Nutrition)
Department of Nutrition and Biochemistry
National Institute of Preventive and Social Medicine
Introduction
• Infant and Young Child Feeding (IYCF) and malnutrition are critical
issues for child health and development in low-income countries (Black
et al.,2013). In Bangladesh, where malnutrition remains a significant
public health concern, IYCF practices have been identified as a key
determinant of child malnutrition (NIPORT et al.,2019). Khulna division
is one of the most vulnerable areas in Bangladesh where child
malnutrition is prevalent due to a lack of awareness and poor IYCF
practices (BDHS,2017-2018).
• According to Bangladesh Demographic and Health Survey (BDHS),
only 32% of mother in rural area of our country is following IYCF
WHO guideline and 34% is following proper feeding the children aged
6-23 months.
• The prevalence of stunting 33% under five children is still in rural area
of Bangladesh and 26% in Khulna Division. (BDHS,2017-18).
Justification
• During this period, the nutritional needs of children are high,
and poor nutrition and health can cause lifelong negative
impacts on nutrition status and health outcomes and increase
child mortality. Undernutrition, in the form of stunting, wasting
and micronutrient deficiencies, is associated with 45 % of child
deaths globally. (Black et al.,2013). With these combined
impacts, economists estimate that stunting can reduce a
country’s gross domestic product (GDP) by 3% per year.
(World Bank ,2006)
• Low dietary diversity (less than four groups) in children was a
risk factor of stunting (Choudhury et al., 2017).
Justification
• Poor breastfeeding and improper complementary feeding
techniques are the main causes of bad feeding behaviors. In
addition, the introduction of solid foods is frequently
postponed or done improperly, which causes additional
vitamin deficits and malnutrition.
Research Question
• What is the current status of Infant and Young Child
Feeding (IYCF) and how common is malnutrition among
children aged 6-23months?
General objective
• To assess the status of Infant and Young Child
Feeding (IYCF) and malnutrition among
children aged 6-23 months.
Specific objectives
• To determine the timing of complementary feeding
introduction
• To assess the status of dietary diversity children aged 6-23
months
• To estimate the current situation of stunting, wasting, and
underweight among children aged 6-23 months.
• To assess the socio-demographic status.
Operational Definition
• Infant and Young Child Feeding (IYCF): Infant and Young
Child Feeding (IYCF) is a set of well-known and common
recommendations for appropriate feeding of new-born and
children under two years of age (UNICEF)
• Malnutrition: Malnutrition refers to deficiencies, excesses or
imbalances in a person’s intake of energy and/or nutrients
(WHO)
List of variables
Dependent Variable:
Malnutrition among children aged 6-23 months.
Independent Variables:
A. Socio-demographic status
• Child age
• Sex
• Mother’s age
• Educational level
• Occupation
• Family income
• Family members
Variables Continue…
B. Variables related to complementary feeding:
• Introduction of complementary feeding
• Continued breast feeding at 1 year
Variables Continue…
C . Variables related to food diversity after 6 months :
• Minimum Dietary Diversity (MDD)
• Minimum Meal Frequency (MMF)
• Minimum Acceptable Diet (MAD)
Variables continue…
D. Variables related to anthropometric measurement:
• Weight for age
• Height for age
• Weight for heigh
Conceptual Framework:
Infant and Young
Child Feeding (IYCF)
Practices
i. Initial breast
feeding after
birth Socio-demographic
ii. Exclusive breast status
feeding first six i. Age
months Malnutrition ii. Sex
iii. Complementar among children iii. Mother’s
y feeding after aged 6-23 Education
6 months months iv. Family income
iv. Introduction of i. Weight for age
v. Family
solid, semi-solid ii. Height for age
iii. Weight for
members
food or soft vi. Father’s
height
foods Occupation
v. Diversity of
foods
vi. Frequency of
meals
Methodology
• Study design: Cross-sectional study
• Study place : Narail Sadar Upazila .
• Study period: 1st January 2023 to 31st December 2023
• Study population: Children aged 6-23 months who reside in
Narail Sadar Upazila.
Methodology Continue…
Selection criteria:
Inclusion criteria:
• Children aged 6-23 months who reside in Narail Sadar
Upazila.
Exclusion criteria:
• Severely ill children or mothers
• Mother is unable to provide informed consent.
• Households that refuse to participate in the study.
Methodology Continue…
Sample Size determinations:
n = (Z^2 * p * (1-p)) / d^2
where:
n = required sample size
Z = Z-value for the desired confidence level (e.g.for 95% confidence
level, Z = 1.96)
p = estimated proportion of Minimum Acceptable diet (MAD) 34%
(BDHS,2017-2018)
d = desired margin of error 5%
Now,
n = (1.96^2 * 0.34 * (1-0.34)) / 0.05^2
n = 344.8
Considering 10% non-response rate, the total sample size will be
n=379
Therefore, a sample size of at least 379 households children aged 6-
23 months could be sufficient for the study.
Methodology Continue…
Sampling technique:
Convenience Sampling
Data collection instruments:
• Semi-structured questionnaire
Data collection tools:
• weighing scales, length/height boards, and
MUAC tape.
Data collection technique:
• Face to face interview
• Anthropometric measurement
Pre-testing: The developed questionnaire will be first pre-tested
and modification will be done accordingly and the questionnaire
will be finalized.
Methodology Continue…
Data Management Plan:
• Initially data will be checked for completeness and correctness
in order to exclude missing or inconsistent data.
• Then data will be entered into the computer using Statistical
Package for Social Science(SPSS).
Data Analysis Plan:
• Then data will be analyzed by using the Statistical Package for
Social Science(SPSS).
• Descriptive data will be analyzed by simple frequency
distribution ( mean , standard deviation, percentage).
• Data will be presented using frequency table, graph and chart.
Ethical Issues
• The protocol will be approved by protocol approval
committee of NIPSOM.
• Ethical clearance of the study will be obtained from the
Institutional Review Board (IRB) of NIPSOM.
• Permission of concerned authority of the mentioned hospital
will be taken.
• Informed written consent will be taken from each and every
participant.
• Privacy and confidentiality will be maintained strictly.
• Participants will have all rights to withdraw from the study.
• They will be assured that there would be no harm to them
during study as there is no invasive procedure will be applied.
References
1. Black, R. E., Victora, C. G., Walker, S. P., Bhutta, Z. A.,
Christian, P., de Onis, M., ... & Uauy, R. (2013). Maternal and
child undernutrition and overweight in low-income and middle-
income countries. The Lancet, 382(9890).P(427-451)
2. Choudhury, N., Raihan, M. J., Sultana, S., Mahmud, Z., Farzana,
F. D., Haque, M. A., … Ahmed, T. (2017). Determinants of age-
specific undernutrition in children aged less than 2 years—The
Bangladesh context. Maternal & Child Nutrition, 13(3), e12362.
3. National Institute of Population Research and Training
(NIPORT), Mitra and Associates, & ICF International.(2019)
Bangladesh demographic and health survey 2017-18: key
indicators. Dhaka, Bangladesh and Rockville, Maryland, USA:
NIPORT, Mitra and Associates, and ICF.
https://dhsprogram.com/pubs/pdf/PR106/PR106.pdf
References…
4. WHO,UNICEF.(2022).Progress on breastfeeding undermine
by aggressive formula milk marketing. [Internet]. UNICEF,
Geneva / New York / Dhaka.
5. World Bank. (2006).Repositioning Nutrition as Central to
Development : A Strategy for Large Scale Action[Internet].World
Bank,Washington,DC.
Thank you
