Eshete 

et al. Agric & Food Secur (2018) 7:66

https://doi.org/10.1186/s40066-018-0219-8 Agriculture & Food Security

RESEARCH Open Access

Determinants of inadequate minimum

dietary diversity among children aged
6–23 months in Ethiopia: secondary data
analysis from Ethiopian Demographic
and Health Survey 2016
Tewodros Eshete1*, Gemechu Kumera1, Yibelu Bazezew2, Abebe Mihretie3 and Tefera Marie2

Abstract 
Background:  Inadequate feeding practices are a significant reason for the onset of malnutrition in young children,
and their consequences are one of the major obstacles to sustainable socioeconomic development and poverty
reduction. Dietary diversity is one of the useful indicators to assess the nutrient adequacy and can examine how dif-
ferent food groups contribute to the nutrient adequacy of the diet in a specific area. Minimum dietary diversity is the
intake of at least four food types from the seven categories.
Methods:  Secondary data analysis of Ethiopian Demographic health survey of 2016 was conducted to explore
significant predictors that make children inappropriate to meet minimum dietary diversity. There were 2972 weighted
samples, and we have used “SVY” command by STATA 14.0 during data analysis to run the complex survey data. This
study has identified the possible factors of inadequate minimum dietary diversity of children.
Results:  The proportion of inadequate minimum dietary diversity in Ethiopia was found 85.1%. Frequency of reading
newspaper or magazine, frequency of listening to radio, father’s educational level and household wealth index were
found significant predictors to determine the minimum dietary diversity of children. Dairy products and grain, roots
and tubers account more than half of consumed foods. Among breastfed children who attained minimum dietary
diversity, majority of them were in the age group of 6–11 months.
Conclusions:  Minimum dietary diversity is still low in Ethiopia, and most of mothers feed their child the most and
easy accessible food rather than of diverse food. In the way of addressing the Sustainable Development Goal, Ethiopia
requires substantial improvement in complementary feeding practices. Appropriate infant and young child feeding
messages should to be developed and delivered through mass media.
Keywords:  Minimum dietary diversity, EDHS, Inappropriate complementary feeding, Food groups

Background Countries will not be productive in their endeavors to

Globally, inadequate feeding practices and their out- quicken economic development in any significant long
comes are still one of the real impediments to sustain- haul sense until optimal child growth and development,
able socioeconomic development and poverty reduction. particularly thorough appropriate feeding practices, are
ensured [1]. In addition, inappropriate feeding practices
are a significant reason for the onset of malnutrition in
*Correspondence: teddyeshet143@gmail.com young children [2].
1
Department of Public Health, College of Medicine and Health Sciences Adequate nutrition allows children to grow, develop,
(CMHS), Debre Markos University (DMU), Debre Markos, Ethiopia
Full list of author information is available at the end of the article learn, play, participate and contribute, while under

© The Author(s) 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License
(http://creat​iveco​mmons​.org/licen​ses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium,
provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creat​iveco​mmons​.org/
publi​cdoma​in/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Eshete et al. Agric & Food Secur (2018) 7:66 Page 2 of 8

nutrition robs children of their futures and leaves young minimum dietary diversity assesses food intake among
lives hanging in the balance. Stunting is one of the main children age 6–23 months from at least four food groups.
reasons that may make children never grow to their full Using four food groups as the cutoff is linked with better-
height, and their brains may never develop to their full quality diets for both non-breastfed and breastfed chil-
cognitive potential [3]. Universally, 151 million children dren [5].
younger than 5 years old were stunted (too short for their Dietary diversity is one of the useful indicators to assess
age) during 2017, with 75% of such children living in the the nutrient adequacy. It is also able to examine how dif-
WHO African Region or World Health Organization ferent food groups contribute to the nutrient adequacy
(WHO) South East Asia Region. During the year of 2017, of the diet in a specific area [6]. Besides, dietary diversity
51 million children under the age of five were wasted (too is a significant predictor of stunting which enables inter-
light for their height) which is also a major cause of bur- ventions aimed at improving it can play a pivotal role in
den preventing children who survive from reaching their reducing the long-term burden of stunting among infants
full development potential [4]. and young children [7]. Generally, the nutritional status
Except if massive improvements in child nutrition are of children can significantly be determined by the dietary
made, it will be hard to accomplish the ambitious Sus- diversity [8].
tainable Development Goals (SDGs) which target by Most of developing countries are poorly practicing
2030 to end all types of malnutrition, including achiev- complementary feeding and are even worsening in some
ing, by 2025, the universally agreed targets on reduction of them [9]. In 2005, Productive Safety Net Program
of stunting and wasting in children younger than 5 years (PSNP) was established by the government of Ethiopia,
of age, and address the nutritious needs of adolescent world food program and development partners collabo-
girls, pregnant and lactating women and older persons ratively to increase families’ long-term resilience to food
[4]. shortages. The birth of PSNP is gone for empowering the
Because of the rapid rate of growth and development rural poor confronting chronic food insecurity to oppose
during the first 2 years (“critical window”), nutrient needs shocks, make resources and move toward becoming sus-
per body weight of infants and young children are high tenance independent. The impact of PSNP was assessed
which makes breast milk insufficient to provide all the in 2008 and showed some positive effect on a livelihood
needs [2]. Complementary feeding is defined as the pro- and food security [10].
cess starting other foods and liquids, along with breast All things considered, Ethiopia has been attacked by El
milk, when breast milk is no longer sufficient to meet Nino related drought since 2015 which greatly increased
the nutritional requirements of infants. Even though food insecurity level and malnutrition rate particularly
breastfeeding may continue beyond 2  years, the target worsen in some regions. One of the worst droughts in
range for complementary feeding is generally taken to be decades (El Nino) brings failure of the main rainy season
6–23 months of age [5]. which is vital for producing more than 80% of Ethiopia’s
World Health Organization published document in agricultural yield—in a main sector that more than 80%
2008 presented fifteen indicators to assess infant and of the country’s populations rely on [11, 12]. The cur-
young child feeding practice that includes eight cores rent study aimed to explore the predictors of poor com-
(early initiation of breastfeeding, exclusive breastfeed- plementary feeding by using MDD and provide some
ing under 6 months, continued breastfeeding at first year, critical insights for policy makers as well as helps further
introduction of solid, semisolid or soft foods, minimum research to explore the current situation, trends and rea-
dietary diversity, minimum meal frequency, minimum sons for failure of interventions.
acceptable diet and consumption of iron-rich or iron-
fortified foods) and seven optional indicators (children Methods
ever breastfed, continued breastfeeding at second years, Source of data
age-appropriate breastfeeding, predominant breastfeed- The present study examined the 2016 Ethiopia Demo-
ing under 6  months, duration of breastfeeding, bottle- graphic and Health Survey (2016 EDHS), which is the
feeding and milk feeding frequency for non-breastfed fourth in a series of Demographic and Health Surveys
children). Indicators for dietary diversity (a proxy for conducted in Ethiopia in 2000, 2005 and 2011. The
adequate micronutrient-density of foods and liquids 2016 EDHS sample is stratified and was selected in
other than breast milk), feeding frequency (a proxy for two stages. Administratively, Ethiopia is divided into
adequate energy intake from non-breast milk sources) 11 geographic regions. Each region was stratified into
and minimum acceptable diet among breastfed and urban and rural areas, which yielded 21 sampling strata.
non-breastfed children aged between 6 and 23  months In the first stage, 645 enumeration areas (EAs) were
were categorized as the cores list. From these indicators, selected with probability proportional to the EA size
Eshete et al. Agric & Food Secur (2018) 7:66 Page 3 of 8

and with independent selection in each sampling stra- source of drinking water [13], wealth index and exposure
tum. An EA is a geographic area that covers an average to media were considered as key household characteris-
of 181 residential households as determined in the 2007 tics, whereas the nature of residence (urban or rural) was
Population and Housing Census. In the second stage considered as community-level variable. As health ser-
of selection, a fixed number of 28 households for every vice characteristics antenatal visits, place of delivery and
cluster were selected with an equal probability system- timing of post-natal care were included. The information
atic selection from the newly created household listing. about variables had been described in detail in the EDHS
The survey had a total of 18,008 households selected report [14].
for the sample, of which 17,067 were available. Of the
available households, 16,650 were successfully inter- Statistical analysis
viewed which provides a response rate of 98%. In the Complementary feeding indicator (outcome variable)
interviewed households, there were 16,583 eligible was dichotomized with category 1 for not meeting the
women for individual interviews. Successful inter- indicator criteria and category 0 for meeting the indicator
views were conducted among 15,683 women, yielding a criteria. After the data cleaning is conducted intensively,
response rate of 95%. Women who had no less than one the outcome variable was examined against different set
child living with them who was born in 2014 or later of independent variables (individual, parental, house-
were asked questions about the types of liquids and hold, healthcare and community-level characteristics)
foods the child had consumed during the day or night to identify factors associated with not meeting the indi-
before the interview. Mothers who had more than one cator criteria. Data analysis was performed by consider-
child born in 2014 or a later year were asked questions ing sampling weight, and the survey “SVY” commands
about the youngest child living with them [14]. Our of Stata version 14.0 were used for adjustments of DHS’
analysis was done among last born living children aged complex sampling design when estimating confidence
6–23  months, living with the respondent (ever mar- intervals. The analysis of factors is conducted using sam-
ried women of 15–49  years and usual residents), total pling weights which denote the inverse of the probability
weighted sample size was 2972. that the observation is included because of the sampling
design. Bivariate logistic regression was used to examine
the impact of each independent variable on the outcome.
Variables Variables that satisfied the cutoff point of p value ≤ 0.25
Outcome variable became candidate for the multiple logistic regression
The MDD is defined as the proportion of children aged model. But those variables with statistical significance of
6–23  months who consumed foods from at least four p < 0.05 remained in the final model. To look to the final
food groups out of the seven referenced food groups model fitness, Hosmer and Lemeshow goodness-of-fit
within a 24-h time. The seven food groups are: 1—grains, test was used [15]. Multicollinearity among independent
roots and tubers, 2—legumes and nuts, 3—dairy prod- variables was also assessed using variance inflation factor
ucts, 4—flesh foods (meat, fish, poultry and liver/organ (VIF).
meats), 5—eggs, 6—vitamin A-rich fruits and vegetables
and 7—other fruits and vegetables [4]. In the present Results
study, those children between 6 and 23 months who have In our study, the minimum dietary diversity was 14.9%
taken at least four food groups in the last 24  h before which is slightly higher than the EDHS report of 13.8%.
interview are considered as they achieved the MDD ade- Since Ethiopia is one of the developing countries where
quately. Therefore, the outcome variable is categorized most of mothers living in rural areas, majority (88.35%) of
as (“0”—adequate minimum dietary diversity, “1”—inad- our respondents were living in there. Majority of the chil-
equate minimum dietary diversity). dren born were female 1575 (53.03%) and aged between
12 and 17  months (36.73%). Most of mothers (52.25%)
Explanatory variables aged between 25 and 34 years old and those who have not
The explanatory variables were found from different get into any formal education took the majority (62.02%).
literature and grouped as characteristics of the child, Most of mothers (57.43%) have not directly engaged in
parental, family/household, healthcare services and the income generating occupations. But, agricultural works
community. The child characteristics included sex, age remained highly prevalent work among mothers (21.60%)
[5], birth order and having common childhood illnesses, and fathers (61.47%) of children aged 6–23  months.
and the paternal characteristics included for each par- The current study has revealed that mother’s exposure
ent’s educational level, literacy level, working status and to mass media was low. From the interviewed mothers
mother’s age, and maternal marital status. The household 1.77% reads newspaper, 13.73% listen to radio and 9.03%
Eshete et al. Agric & Food Secur (2018) 7:66 Page 4 of 8

watches television at least once in a week. Most (57.05%) Table 1 

Individual, parental, household, healthcare
of Ethiopian mothers of children aged 6–23  months and  community-level characteristics of  living children
provide complementary feeding using improved water aged between 6 and 23 months, Ethiopia, 2016
sources, and also majority of mothers were living below Characteristics n %
the middle level of household wealth index. Majority of
the respondents (66.3%) waits more than 2 years to give Child characteristics
birth to their living youngest child. Ethiopia still has a Sex of child
work to do in institutional delivery because around 62%  Male 1396 46.97
of delivery was conducted in home. Almost one-third  Female 1576 53.03
of mothers gave birth to child without having any ante- Age of child (months)
natal care visit in the health institution. Besides, post-  6–11 1044 35.14
natal check-up within 2  months after delivery was not  12–17 1091 36.73
conducted for majority (88.43%) of mothers. Table 1 has  19–23 836 28.13
shown different individual, parental, household, health- Birth order
care and community-level characteristics of last children  Firstborn 547 18.4
who are living with their mother and aged between 6 and  Second to fourth 1284 43.2
23 months.  Five or more 1141 38.4
Minimum dietary diversity rate among children Diarrheaa
aged 6–23  months was also described with their cur-  No 2394 80.54
rent breastfeeding status. There was high rate of MDD  Yes 573 19.28
among breastfeeding children in the all age classifica- Cough
tion [(6–11  months), (12–17  months), (18–23  months)].  No 2267 76.29
Among breastfed children who attained MDD, majority  Yes 705 23.71
of them were in the age group of 6–11  months next in Parental characteristics
18–23  months which accounts 9.6% and 7.25%, respec- Mother’s age (years)
tively. The least (5.8%) were in 12–17 months age group.  15–24 805 27.08
From those children who attained the MDD and not  25–34 1553 52.25
breastfeeding, majority rate (5.5%) was from the age  35–49 614 20.67
group of 18–23 months. The least MDD rate was scored Mother’s education
among children aged 6–11 months who were not breast-  No education 1844 62.02
feeding during the interview (Table 2).  Primary education 904 30.40
By controlling for possible confounders, variables  Secondary and higher 225 7.58
which remained in the final model were frequency of Mother’s occupation
reading to newspaper or magazine, frequency of listening  Not working 1707 57.43
to radio, father’s educational level and household wealth  Non agricultural works 590 19.84
index. Those children whose mothers read to news-  Agricultural works 642 21.60
paper or magazine at least once in a week had 81% less  Others 33 1.13
chance to be inadequate for MDD. Furthermore, statisti- Mother’s literacy
cally significant result has shown that the odds of being  Cannot read at all 2203 74.11
inadequate to minimum dietary diversity among children  Able to read only parts of sentence 356 11.98
whose mothers read to newspaper or magazine less than  Able to read whole sentence 413 13.91
once in a week was 56% less likely (AOR = 0.44; 95% CI Mother’s marital status
0.23, 0.83) than those children’s mother who do not read  Currently married 2838 95.49
at all. Likewise, the odds of being inadequate to MDD  Formerly married 134 4.51
among children who had mothers that listen to radio at Reads newspaper or magazine
least once in a week was 57% less likely than (AOR = 0.43;  Not at all 2777 93.45
95% CI 0.30, 0.62) those children who had mothers that  Less than once a week 142 4.78
did not listen at all. Those fathers who had attained pri-  At least once a week 53 1.77
mary education had 41% less likely (AOR = 0.59; 95% CI Listen to radio
0.37, 0.94) odds of having children who are inadequate to  Not at all 2177 73.25
minimum dietary diversity than fathers who did not go  Less than once a week 387 13.02
to formal education. The odds of having inadequate mini-  At least once a week 408 13.73
mum dietary diversity among children living in richest
Eshete et al. Agric & Food Secur (2018) 7:66 Page 5 of 8

Table 1  (continued) Table 1  (continued)

Characteristics n % Characteristics n %

Watches television Minimum dietary diversity

 Not at all 2446 82.27  Adequate minimum dietary diversity 443 14.9
 Less than once a week 258 8.70  Inadequate minimum dietary diversity 2529 85.1
 At least once a week 268 9.03 Total 2972
Father’s education a
  For having diarrhea recently 5 respondents responded “I don’t know”
 No education 1254 42.18
 Primary 1177 39.62
 Secondary and higher 385 12.96
household was 60% (AOR = 0.40; 95% CI 0.21, 0.76) less
 Don’t know and missing 136 5.26
likely than children who were living in poorest household
Father’s occupation
(Table 3).
 Not working 219 7.38
Based on our criteria of beta coefficient change greater
 Non agricultural works 678 22.82
than twenty percent, there was no significant confounder
 Agricultural works 1827 61.47
or interaction observed. The significance level of Hos-
 Others and missing 248 8.33 mer–Lemeshow test for goodness of fit was 0.33. Since
House hold characteristics the probability is greater than 0.05, we fail to reject the
Source of drinking water null hypothesis and shows that there is no significant dif-
 Improved 1696 57.05 ference between the observed and model-predicted val-
 Un improved 1276 42.95 ues. Therefore, our final model fit the data well. The final
Household wealth index model of this study showed that the mean value of VIF
 Poorest was 1.45 which indicated there was no multicollinearity
 Poorer 627 21.09 in the final model (Fig. 1).
 Middle 666 22.41
 Richer 544 18.31
 Richest 434 14.61
Discussion
Healthcare characteristics
The present study has analyzed the nationally representa-
Preceding birth interval
tive data from the 2016 Ethiopia Demographic health
 No preceding birth 549 18.5
survey and reveals the important gaps in meeting the
  < 24 months 451 15.2
minimum dietary diversity criteria by WHO for chil-
  ≥ 24 months 1972 66.3
dren aged 6–23  months. We have found prevalence of
Antenatal care visit
minimum dietary diversity rate as 14.9% which is slightly
higher than the national EDHS report of 2016 [14].
 None 1002 33.71
This can be due to the reason that for analyzing to the
 1–3 times 870 29.28
factors and to give equal chance for all respondents we
 4 and above 987 33.21
have cleaned the data set based on important variables
I don’t know and missing 113 3.80
(Table 4).
Mode of delivery
One of the factors that the current study has identified
 Non-Cesarean section 2897 97.48
is the impact of mother’s access to mass media. Those
 Cesarean section 75 2.52
mothers who read newspaper or magazine at least once
Place of delivery
in a week have low chance to be inadequate in meeting
 Home 1845 62.05
minimum dietary diversity of their young infant. This
 Health facility 1068 35.95
finding is concurrent with the study conducted in Nepal
 Other 59 2.00
and India [16, 17]. Besides, mothers who listen to a radio
Post-natal check-up within 2 months
within a week are also able to feed different food groups
 No 2628 88.43
to their child and meet the minimum dietary diversity
 Yes 232 7.79
intake. Listening to radio is found a significantly affect-
 I don’t know and missing 112 3.78
ing factor in an Indian study conducted using secondary
Community-level factors
analysis of the national family health survey [17]. Another
Residence
study conducted in North West Ethiopia and Bangladesh
 Urban 346 11.65
also came up with the same finding that shows mother’s
 Rural 2626 88.35
exposure to mass media remains positively associated
Eshete et al. Agric & Food Secur (2018) 7:66 Page 6 of 8

Table 2  Types of foods given to children aged 6–23 months a day before the interview, EDHS, 2016
Food groups Age of a child (months) N

6–11 12–17 18–23

n % n % n %

Grain, roots and tubers 519 28 734 39.7 596 32.3 1849
Legumes and nuts 186 30 233 38 194 32 613
Dairy products 403 35.4 411 36.1 324 28.5 1138
Flesh foods 46 18.4 122 48.8 82 32.8 250
Eggs 154 31.3 189 38.4 149 30.3 492
Vitamin A-rich fruits and vegetables 206 25.1 346 42.1 269 32.8 822
Other fruits and vegetables 142 28.1 204 40.3 160 31.6 506
Total 1514 2239 1774 5057

Table 3  Minimum dietary diversity among  children aged with improving minimum dietary diversity of children
between 6 and 23 months, Ethiopia, 2016 [18, 19].
Minimum dietary diversity Sample size n %
Being richest in household wealth index has been
shown negatively associated with inadequate minimum
Minimum dietary diversity, breastfeed 981 102 9.6 dietary diversity of a child. Similarly, household wealth
(6–11 months)
was found as predictor of minimum dietary diversity in
Minimum dietary diversity, non-breastfeed 63 18 3.5
(6–11 months)
the four South Asian countries where variable is availa-
Minimum dietary diversity, breastfeed 999 179 5.8
ble, indicating the important role of household resources
(12–17 months) in determining complementary feeding of children [9]. In
Minimum dietary diversity, non-breastfeed 93 19 4.9 our study, especially children who were living in a richest
(12–17 months) household had significantly less chance to be inadequate
Minimum dietary diversity, breastfeed 638 88 7.25 in meeting the recommended minimum dietary diversity.
(18–23 months)
This was in line with other study conducted in Ethiopia
Minimum dietary diversity, non-breastfeed 198 36 5.5
(18–23 months)
using the 2011 DHS [20].
Moreover, in the present study education level of
fathers has been assessed and became statistically asso-
ciated with meeting the recommended diversity of food.
Variable VIF 1/VIF
Compared to no education, as the education level of the
fathers increased, the children were more likely to get
reading_fr~y
the recommended minimum dietary diversity. The same
1 1.28 0.779701
finding was also found in Nepalese study [21]. This shows
2 1.14 0.877813
that educated fathers can understand the education mes-
listning_f~y sage that they got from different mass media like radio or
1 1.29 0.777955 newspaper which more likely enable them to be engaged
2 1.36 0.737564 in achieving their children to the minimum dietary diver-
father_edu~n sity. Since EDHS is using cross-sectional study design, the
1 1.69 0.590851 limitations of this study were causal inferences between
2 1.87 0.533791 associated factors and inadequate MDD cannot be made.
wealth_index
2 1.19 0.839580 Conclusion
3 1.25 0.801498 The study revealed different predictors that were signifi-
4 1.28 0.781264 cantly associated with the selected WHO recommended
5 2.14 0.467723 complementary feeding practice indicator (minimum

Mean VIF 1.45

Fig. 1  Multicollinearity test for predictors in the final model
significantly associated with inadequate minimum dietary diversity of
children 6–23 months, EDHS 2016
Eshete et al. Agric & Food Secur (2018) 7:66 Page 7 of 8

Table 4 Bivariate and  multivariate logistic regression between  different level predictors and  inadequate minimum
dietary diversity of children aged 6–23 months, EDHS 2016
Characteristics COR Risk for inadequate minimum dietary diversity
95% (CI) p value AOR 95% (CI) p value

Reads newspaper or magazine < 0.001

Not at all [R]
Less than once a week 0.22 (0.13, 0.38) 0.000 0.44 (0.23, 0.83) 0.012
At least once a week 0.07 (0.03, 0.19) 0.000 0.19 (0.07, 0.46) 0.000
Listen to radio < 0.001
Not at all [R]
Less than once a week 0.47 (0.29, 0.74) 0.001 0.72 (0.42, 1.24) 0.245
At least once a week 0.23 (0.16, 0.33) 0.000 0.43 (0.30, 0.62) 0.000
Father’s education < 0.001
No education [R]
Primary 0.46 (0.28, 0.75) 0.002 0.59 (0.37, 0.94) 0.028
Secondary and higher 0.25 (0.15, 0.40) 0.002 0.62 (0.36, 1.09) 0.102
Household wealth index < 0.001
Poorest [R]
Poorer 0.58 (0.31, 1.06) 0.081 0.66 (0.37, 1.17) 0.156
Middle 0.56 (0.31, 1.02) 0.059 0.79 (0.44, 1.41) 0.433
Richer 0.41 (0.22, 0.75) 0.004 0.69 (0.38, 1.27) 0.240
Richest 0.16 (0.08, 0.29) 0.000 0.40 (0.21, 0.76) 0.005

dietary diversity). After lots of variables have been small-scale producers, particularly women, by ensuring
assessed significantly, associated factors were: reading access to public services such as infrastructure, financial
frequency of newsletter or magazine, listening frequency services, information and training of appropriate feed-
to radio, father’s educational level and household wealth ing practice. National governments must provide access
index. Minimum dietary diversity is still low in Ethiopia, to education and strengthen social safety nets to ensure
and the most common food groups consumed were dairy that all members of society have income security and
products and grain, roots and tubers. This shows the gap can access essential foods and health care. International
that mothers feed their child the most and easy accessi- or local donors should play their pivotal role by funding
ble food rather than of diverse food. This study also came efforts to achieve the SDGs.
up with the result that increment in the household wealth
had a good impact to feed the child to the diverse food
Abbreviations
groups for better growth and development. By increasing AOR: adjusted odds ratio; CI: confidence interval; COR: crude odds ratio; DHS:
the accessibility, awareness creation using radio, newspa- demographic health survey; EAs: enumeration areas; EDHS: Ethiopia demo-
per or magazine was one of the significant game changer graphic health survey; MDD: minimum dietary diversity; PSNP: Productive
Safety Net Program; SDGs: Sustainable Development Goals; SVY: survey; WHO:
methods to improve the inappropriate complementary World Health Organization; VIF: variance inflation factor.
feeding practice.
Since increasing dietary diversity at the national level is Authors’ contributions
TE conceived the study, designed, wrote the paper, conducted data analysis,
an effective measure to childhood malnutrition reduction drafted and finalized the manuscript for publication. GK, YB, AM and TM
and improving the nutritional status of children [8, 22], assisted with critical reviewing papers. All authors read and approved the final
this study suggests the possible targets of future inter- manuscript.

ventions to improve minimum dietary diversity in Ethio- Author details

pia. National governments should build the capacity of 1
 Department of Public Health, College of Medicine and Health Sciences
(CMHS), Debre Markos University (DMU), Debre Markos, Ethiopia. 2 Depart-
ment of Midwifery, College of Medicine and Health Sciences (CMHS), Debre
Markos University (DMU), Debre Markos, Ethiopia. 3 Department of Midwifery,
College of Medicine and Health Sciences (CMHS), Debre Birhan University
(DMU), Debre Birhan, Ethiopia.
Eshete et al. Agric & Food Secur (2018) 7:66 Page 8 of 8

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