Appropriate nutrition is essential to support a child’s health and survival. Well-nourished children were able to grow and develop optimally according to their age. However, the world is still facing three faces of malnutrition which robs a child’s potential growth and development. By 2020, 149.2 million children under five years old are stunted, 45.4 million are wasted, and 38.9 million are overweight.2 The coronavirus disease 2019 (COVID-19) global pandemic and its economic fallout during 2020-2021 also significantly worsen the prevalence of childhood malnutrition.
Malnutrition is directly caused by inadequate nutritional intake and infectious diseases. Indirectly, it is influenced by improper parenting styles, food insecurity, family sociodemographic characteristics (such as poverty and low education), poor sanitation and health services access, and political and cultural conditions. Malnutrition reflects an unbalanced nutritional intake between intakes and needs. Inappropriate infant and child feeding practices occur most frequently during the transition period (6-23 months), from breast milk to solid food. If not treated immediately, malnutrition can delay children’s growth and development.
In most families, women are responsible for managing meals and caring for other family members, especially toddlers. Women’s Empowerment is a crucial determinant so that resources owned by the family can be optimized for appropriate IYCF according to WHO’s recommendation. Appropriate feeding practices for infants and children are assessed from three indicators, namely minimal food diversity, minimal feeding frequency, and minimal dietary recommendations.
The 2017 IDHS analysis of 4,923 infants (aged 6-23 months old) to see the associations between women’s empowerment and sociodemographic factors related to IYCF. The statistical analysis result shows that the determinants of fulfilling minimal food diversity for toddlers are the age of the child, the father’s occupation, the family wealth index, and the level of the mother’s empowerment. Infants aged 18-23 months old, fathers’ occupations in the non-agricultural sector (civil servants, private sector, and entrepreneurs), those coming from the highest wealth index family, and mothers with high levels of empowerment have a greater probability of achieving minimal dietary diversity. While the determinant for the fulfillment of the minimum eating frequency for toddlers is where the toddlers live. Toddlers in urban areas have a higher possibility to reach the minimum eating frequency compared to the ones living in rural areas. Furthermore, the child’s age, mother’s age, family wealth index, place of living, and women’s empowerment are significant determinants of minimum dietary recommendations. Children aged 18-23 months, living in urban areas, coming from families with the highest wealth index, and having mothers aged 45-49 years and with a high level of empowerment tend to be able to achieve the recommended minimum dietary recommendations.
The research revealed that the current IYCF practice among 6-23-month-old children in Indonesia is not yet adequate. Family sociodemographic characteristics include the child’s age, women’s age, occupation of husband/ spouse, wealth index, and residence, which remain significant factors in IYCF practice according to WHO recommendations for 6-23 months old children. This study also highlighted the significance of women’s empowerment for proper IYCF practice. Therefore, it is necessary to develop health promotion that empowers women as the key people responsible for their household feeding. So, their ability to manage household resources optimally to deliver IYCF as recommended by WHO for their children can be increased. Future research should also consider paternal factors, as they play a significant direct or indirect role in IYCF practice.
Author: Eka Mishbahatul Mar’ah Has, S.Kep., Ns., M.Kep.
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