The period from birth to two years of age is a “critical window” of opportunity for the promotion of optimal growth, health and behavioral development of children. Poor child feeding patterns combined with household food insecurity can lead to malnutrition which is a major public health problem in developing countries like Ethiopia. A community based cross-sectional study that involved 575 participants from rural Sidama was conducted from February to March 2011. A two-stage stratified sampling procedure was employed to select the required households. Multivariable logistic regression analyses were performed to compare stunting by feeding patterns and other characteristics. Only 14.4% of mothers fed their children optimally. Prevalence of stunting was higher for infants aged 6 to 8 months (43%) than for those in 0-5 months (26.6%) or 9-23 months (39%) category. Women who did not receive antenatal care(ANC) during pregnancy were 1.5 times more likely to practice pre-lacteal feeding and 2.8 and 1.9 times more likely to feed their children below minimum dietary diversity and minimum meal frequency, respectively (P=0.01). Mothers older than 18 years during the birth of index child were 86% less likely to feed their child below minimum meal frequency than their younger counterparts (P=0.01). Children who started complementary food either before or after the recommended 6 months time, were more likely to be stunted (P=0.01). The feeding practices of most mothers did not meet WHO recommendations. Behavior change communication about the importance of optimal complementary feeding and ANC attendance should be strengthened through extensive use of the Health Extension Workers to reduce the level of child stunting in the study area.

Good nutrition and appropriate child feeding are vital in early stages of child development, particularly in the first 1000 days of life. To assess the adoption of infant and young child feeding practices of World Health Organization, dietary intake, and level of undernutrition in children <2 years of age. Baseline cross-sectional study was conducted (January-June 2013) in purposively selected rural communities of Halaba and Zeway, Ethiopia (N = 383 mother–child pairs, randomly selected). Overall prevalence of stunting, wasting, and underweight was 45%, 9%, and 28% in Halaba, and 33%, 7%, and 15% in Zeway, respectively; higher levels of stunting (54% in Halaba and 36% in Zeway) were observed in 6 to 24 months; stunting and underweight, but not wasting, differed by age (P < .001) in Halaba. Median dietary diversity score in both communities was 2 with 61% to 65% of children consuming 0 to 2 food groupings. Except protein in all age and iron in 12 to 24 months, median intake of energy, iron, zinc, and calcium (and associated nutrient densities) was below the estimated needs that should come from complementary foods in both communities (in subsample). Early initiation of breast-feeding and exclusive breast-feeding was 63% and 86% in Halaba and 92% and 93% in Zeway, respectively (P < .001). Children receiving minimum acceptable diet were 6% and 9% in Halaba and Zeway, respectively. The high levels of stunting and suboptimal feeding practices as well as low dietary diversity scores, energy, and nutrient intake in both communities, particularly in Halaba, indicate a need to improve/strengthen nutrition strategies for complementary feeding children in these areas.

Addressing maternal and child undernutrition is a priority for the National Nutrition Program of Ethiopia. In a cross-sectional design, we selected mother-child pairs (n = 630) from Halaba, south Ethiopia (n = 413, two communities) and Zeway, Oromiya region (n = 217, one community). These communities were previously included in a project to improve agricultural practices. We aimed to estimate the level of maternal and child undernutrition in the two study sites and compare findings to regional/national reports. We also examined associations with gender, household-structure and nutrition/health related variables. Households were selected using simple random sampling based on list of households obtained from local health posts. Mothers were interviewed via questionnaire. Anthropometric measurements were taken from mothers-child pairs. Maternal undernutrition (% BMI<18.5) ranged from moderate (14% Zeway) to high (22% Halaba). In the children, stunting and underweight were very high (54% and 42% stunting, 36% and 21% underweight, in Halaba and Zeway, respectively). Up to 95% of Halaba and 85% of Zeway mothers reported “same as usual” or “less than usual” consumption patterns during their most recent pregnancy compared to periods of non-pregnancy. Mothers reported (61% in Halaba, 18% in Zeway) abstaining from consumption of certain nutritious foods for cultural reasons. Gender and socio-economic-demographic structure of the households, including imbalance of power, control of farm produce, physiological density, household size and dietary habits during pregnancy showed significant associations with maternal and child undernutrition (p<0.05). The levels of child and maternal undernutrition, particularly in children, were unexpected and of concern, given that a national nutrition program has been in place since 2008. The study provides insights for policy makers to improve women’s education, reproductive health services for better family planning, and strengthen nutrition/health programs designed to target vulnerable segments of the population in these and other rural communities and districts with similar structure and demographics in Ethiopia.

Objective: We conducted a six-month nutrition education intervention focused on the consumption of pulses and other foods to assess the effect on knowledge, attitude and practice (KAP) as well as the nutritional status of children and mothers from two pulse-growing communities in Halaba, south Ethiopia. Methods: About 200 mother–child pairs in each of two purposively selected communities participated in this intervention study. A six-month nutrition education programme, involving interactive monthly community meetings and home visits, was offered to one of the two communities and the other served as a control/comparison. This study incorporated the use of Health Belief Model constructs to assess the KAP/perceptions of mothers surrounding pulse and other food consumptions, as well as nutrition-related issues before and after the intervention. Objective measures included dietary diversity scores (DDSs), one-day weighed dietary intakes and nutritional status measures based on anthropometric information. Demographics and socioeconomic information were also collected at baseline and endline. Results: Significant improvements (p < 0.05) were found in the intervention group on the KAP and perceptions of pulse nutrition benefits among mothers, DDSs and pulse and animal source food consumption indexes for mothers and children and the mean body-mass-index-for-age Z-score and wasting among children. Conclusions: Community-based nutrition education interventions involving monthly interactive community meetings and home visits in pulse-growing communities from a resource-poor country like Ethiopia can be effective in improving mothers’ knowledge of pulse nutrition and consumption frequency, leading to improvements in the DDSs of children and mothers while decreasing child underweight and wasting.

Food insecurity and hunger are major challenges in many Ethiopian communities with repercussions on health and nutrition outcomes in vulnerable household members. The level and contextual risk factors of household food insecurity and hunger were assessed in households (n=630) from three rural communities of Ethiopia (Halaba or Zeway) using the Household Food Insecurity Access Scale and Household Hunger Scale. Multiple classification analysis was employed to explore the effects of key demand (e.g. household size, livestock) and supply (e.g. land size, frequency of production) factors and community (geographic location) as well as institutional (participation in food security programs) factors on food insecurity and hunger. Household food insecurity was unacceptably high in both districts (95% in Halaba & 67% in Zeway). Household hunger was 38% in Halaba and 18% in Zeway. Both food insecurity and hunger were significantly greater in Halaba (p<0.001), indicating an effect of geographic location. Both supply and demand factors were significant in determining household food insecurity and hunger (p<0.01); however, supply factors such as women’s access to land, land size and wealth had greater influence than the demand factors. Levels of food insecurity and hunger in both communities were very high and of serious concern. We recommend increasing the food supply, and its subsequent accessibility, for households through enhancing women’s access to land, improving income through savings and wealth accumulation, introducing more inclusive programs for women’s participation and reducing household work-burden by significantly enhancing productivity of cultivable land.