Trends and determinants of complementary feeding practices in Tanzania, 2004-2016.

Background: Following the successful implementation of the Millennium Development Goals (MDGs) strategy in Tanzania, improvements in child health indicators were observed. However, it remains unclear whether complementary feeding practices have improved given the renewed global agenda on child nutrition. This study investigated trends and socioeconomic and health service factors of complementary feeding practices in Tanzania for the period spanning from 2004 to2016.

Methods: The study was based on the Tanzania Demographic and Health Survey data for the years 2004-2005 ( n  = 2480), 2010 ( n  = 2275) and 2015-2016 ( n  = 2949) to estimate the trends in complementary feeding practices. Multivariate logistic regression models that adjusted for year of the survey, clustering and sampling weights were used to investigate the association between the modifiable study factors (socioeconomic and health service factors) and complementary feeding practices among children aged 6-23 months in Tanzania.

Results: Over the study period, minimum dietary diversity (MDD) and minimum acceptable diet (MAD) have worsened from 46% (95% confidence interval [95% CI] 41.5-50.7%) in 2004-2005 to 30% (95% CI 25.7-32.9%) in 2015-2016 and 16.9% (95% CI 14.9-18.9%) in 2004-2005 to 6.0% (95% CI 4.9-7.1%) in 2015-2016, respectively. Minimum meal frequency (MMF) remained unchanged, 37% in 2004-2005 and 2015-2016. The introduction of solid, semi-solid and soft foods improved from 79% (95% CI 74.5-83.9%) in 2004-2005 to 87% (95% CI 83.7-90.9%) in 2015-2016. Multivariate analyses revealed that higher maternal education and household wealth, mother's employment, health facility birthing and postnatal care (PNC) visit were associated with MDD, MAD and MMF. Traditional birth attendant-assisted births and PNC visits were associated with the introduction of complementary foods. In contrast, birthing in the health facility was associated with the delayed introduction of complementary foods.

Conclusion: Between 2004 and 2016, the prevalence and determinants of complementary feeding practices varied in Tanzania. Improving complementary feeding practices is feasible in Tanzania given the renewed focus on child nutrition in the country. Child nutrition policy interventions should target all mothers, particularly mothers from low socioeconomic background and those with limited access to health services to maximise results.