Variables of interest
IYCF core indicators: The eight core IYCF indicators consistent with WHO –1. early initiation of breastfeeding, 2. exclusive breastfeeding under 6 months, 3. continued breastfeeding at 1 year, 4. introduction to solid, semi-solid or soft foods, 5. minimum dietary diversity (MDD), 6. minimum meal frequency (MMF), 7. minimum acceptable diet (MAD) and, 8. consumption of iron rich or iron fortified food (9).
Early initiation of breastfeeding: This refers to children born in the last two years being placed on their mother’s breast within an hour after delivery. Exclusive breastfeeding (EBF) under 6 months This refers to infants under 6 months who are only given mother’s milk and no other food.
Continued breastfeeding at 1 year refers to children aged between 12 and 15 months who are still breastfedIntroduction to solid, semi-solid or soft foods: This is the introduction of solid, semi-solid or soft foods to infants aged between six and eight months.
MDD: Minimum dietary diversity refers to feeding children between 6 and 23 months with food from at least four of the seven food groups. These groups are 1. food made from cereal grains, roots and tubers, 2. legumes such as beans and peas, and nuts, 3. milk and other dairy products, 4. meat, 5, eggs, 6, foods rich in vitamin A and 7. Fruits and vegetables.
MMF: Minimum meal frequency is the minimum number of times of feeding or more for both breastfed and non-breastfed children aged between 6 and 23 months who have been introduced to solid, semi-solid, or soft foods (this includes milk feeds for non-breastfed children)
MAD: Children aged between 6 and 23 months of age on a a minimum acceptable diet which is a combination of MMF and MDD.
Consumption of iron rich or iron fortified food: This is the proportion of children aged between 6 and 23 months who are given iron-rich food or food fortified with iron which is specially prepared for infants and young children, and also food whichis fortified at home.
Household Food Insecurity Access Scale (HFIAS): HFIAS has been used to define food insecurity according to the Food and Nutrition Technical Assistance’s guideline. It provides a constant measure of the degree of food insecurity (access component) in a household (17).
The scale gives the level based on the lack of access due to poverty and not because of a shortage of supply (17). Assessment of the level of anxiety and uncertainty of participants regarding household food resources, satisfaction about the nature of the food and inadequacy of food consumption is done with a standard 9 question-questionnaire which inquires about worrying about food, inability to eat preferred foods, lack of food diverstity in diet, having to eat food that they dislike, eating less than needed, eating fewer meals in a day, not having food at home, going to bed hungry and going without food for a whole day and night (18) (19).
Geographical context: On the basis of geographical features, households were divided into different categories such as as haor, flash flood prone area, hilly area and plain land. These were practically defined by the program people who have been working in those regions for a substantial amount of time.
In the analysis, children aged below 24 months were targeted. STATA, version 14 was used for the statistical analyses. The different variables relevant for the analysis were selected after consulting previous survey questionnaires and demographic survey questionnaires ., Different types of statistical plots were used for data visualization. Descriptive statistics such as mean, standard deviation, frequency, proportion were used to see the distribution of data and primary analysis involved producing descriptive statistics using appropriate cut-off values for the different variables. Simple logistic regression was used to investigate bivariate relationship between IYCF and area of residence and other variables. Finally multiple logistic regression was used to determine strength of association (adjusted odds ratio). Statistical significance was considered based on p-value