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Abstract：
BACKGROUND: Poor infant and child feeding practices, in combination with increased rates of infectious diseases, are the main immediate causes of malnutrition during the first two years of life. Non-breastfed children require milk and other dairy products, as they are rich sources of calcium and other nutrients. As far as our search is concerned, there is no evidence on the pooled magnitude and determinants of minimum milk feeding frequency among non-breastfed children in sub-Saharan Africa conducted using the most recent indicators for assessing infant and young child feeding practices published in 2021. Therefore, this study is intended to determine the magnitude and associated factors of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan Africa using the most recent guideline and demographic and health survey dataset.
METHODS: Data from the most recent health and demographic surveys, which were carried out between 2015 and 2022 in 20 sub-Saharan African countries, were used. The study comprised a weighted sample consisting of 13,315 non-breastfed children between the ages of 6 and 23 months. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.
RESULTS: The pooled magnitude of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan African countries was 12.39% (95% CI: 11.85%, 12.97%). Factors like maternal educational level [AOR = 1.61; 95% CI (1.35, 1.91)], marital status of the mother [AOR = 0.77; 95% CI (0.67, 0.89)], maternal working status [AOR = 0.80; 95% CI (0.71, 0.91)], media exposure [AOR = 1.50; 95% CI (1.27, 1.77)], wealth index [AOR = 1.21; 95% CI (1.03, 1.42)], place of delivery [AOR = 1.45; 95% CI (1.22, 1.72)], ANC visit attended during pregnancy [AOR = 0.49; 95% CI (0.39, 0.62)], PNC checkup [AOR = 1.57; 95% CI (1.40, 1.76)], child\'s age [AOR = 0.70; 95% CI (0.53, 0.93)], and residence [AOR = 2.15; 95% CI (1.87, 2.46)] were significantly associated with minimum milk feeding frequency.
CONCLUSIONS: In sub-Saharan Africa, the proportion of minimum milk feeding frequency among non-breastfed children aged between 6 and 23 months was low. The likelihood of minimum milk feeding frequency increases with high levels of education, unemployment, media exposure, rich wealth status, being unmarried, having a child born in a health facility, getting PNC checks, being between 6 and 8 months old, and living in an urban area. Hence, promoting women\'s education, increasing the economic status of the household, disseminating nutrition information through media, strengthening maternal health service utilization like health facility delivery and PNC services, and giving prior attention to mothers with older children and from rural areas are strongly recommended.
METHODS: Data from the most recent health and demographic surveys, which were carried out between 2015 and 2022 in 20 sub-Saharan African countries, were used. The study comprised a weighted sample consisting of 13,315 non-breastfed children between the ages of 6 and 23 months. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio test, median odds ratio, and intra-class correlation coefficient. Finally, variables with a p-value < 0.05 and an adjusted odds ratio with a 95% confidence interval were declared statistically significant.
RESULTS: The pooled magnitude of minimum milk feeding frequency among non-breastfed children aged 6-23 months in sub-Saharan African countries was 12.39% (95% CI: 11.85%, 12.97%). Factors like maternal educational level [AOR = 1.61; 95% CI (1.35, 1.91)], marital status of the mother [AOR = 0.77; 95% CI (0.67, 0.89)], maternal working status [AOR = 0.80; 95% CI (0.71, 0.91)], media exposure [AOR = 1.50; 95% CI (1.27, 1.77)], wealth index [AOR = 1.21; 95% CI (1.03, 1.42)], place of delivery [AOR = 1.45; 95% CI (1.22, 1.72)], ANC visit attended during pregnancy [AOR = 0.49; 95% CI (0.39, 0.62)], PNC checkup [AOR = 1.57; 95% CI (1.40, 1.76)], child\'s age [AOR = 0.70; 95% CI (0.53, 0.93)], and residence [AOR = 2.15; 95% CI (1.87, 2.46)] were significantly associated with minimum milk feeding frequency.
CONCLUSIONS: In sub-Saharan Africa, the proportion of minimum milk feeding frequency among non-breastfed children aged between 6 and 23 months was low. The likelihood of minimum milk feeding frequency increases with high levels of education, unemployment, media exposure, rich wealth status, being unmarried, having a child born in a health facility, getting PNC checks, being between 6 and 8 months old, and living in an urban area. Hence, promoting women\'s education, increasing the economic status of the household, disseminating nutrition information through media, strengthening maternal health service utilization like health facility delivery and PNC services, and giving prior attention to mothers with older children and from rural areas are strongly recommended.
摘要：
背景：不良的婴儿和儿童喂养习惯，加上传染病发病率的增加，是生命头两年营养不良的主要直接原因。非母乳喂养的儿童需要牛奶和其他乳制品，因为它们是钙和其他营养素的丰富来源。就我们的搜索而言，使用2021年公布的最新婴幼儿喂养方式评估指标,没有证据显示撒哈拉以南非洲地区非母乳喂养儿童最低喂养频率的汇总幅度和决定因素.因此,本研究旨在使用最新的指南和人口统计学和健康调查数据集,确定撒哈拉以南非洲地区6~23个月非母乳喂养儿童最低牛奶喂养频率的大小和相关因素.
方法：来自最新健康和人口调查的数据，这是在2015年至2022年期间在20个撒哈拉以南非洲国家进行的，被使用。该研究包括一个加权样本，由13,315名6至23个月的非母乳喂养儿童组成。使用STATA/SE14.0版统计软件进行清理,重新编码,并分析来自DHS数据集的数据。利用多级混合效应逻辑回归，确定了与结果变量相关的因素.使用偏差(-2LLR)评估模型比较和适合度，似然比检验,中位数赔率比，和类内相关系数。最后,p值<0.05的变量和95%置信区间的调整后比值比被宣布为有统计学意义.
结果：撒哈拉以南非洲国家6-23个月非母乳喂养儿童的最低牛奶喂养频率的汇总幅度为12.39％（95％CI：11.85％，12.97%）。母亲教育水平等因素[AOR=1.61；95%CI(1.35,1.91)]，母亲的婚姻状况[AOR=0.77；95%CI(0.67,0.89)]，产妇工作状态[AOR=0.80；95%CI（0.71，0.91）]，媒体暴露[AOR=1.50；95%CI（1.27，1.77）]，财富指数[AOR=1.21；95%CI（1.03，1.42）]，交货地点[AOR=1.45；95%CI（1.22，1.72）]，怀孕期间参加的ANC访问[AOR=0.49;95％CI（0.39，0.62）]，PNC检查[AOR=1.57；95%CI（1.40，1.76）]，儿童年龄[AOR=0.70；95%CI（0.53，0.93）]，和居住地[AOR=2.15；95％CI（1.87，2.46）]与最低牛奶喂养频率显着相关。
结论：在撒哈拉以南非洲，在6至23个月的非母乳喂养儿童中,最低喂养次数的比例较低.最低牛奶喂养频率的可能性随着教育水平的提高而增加，失业,媒体曝光,富有的财富地位，未婚,在医疗机构出生的孩子，获取PNC检查，在6到8个月大之间，生活在城市地区。因此，促进妇女的教育，提高家庭的经济地位，通过媒体传播营养信息，加强孕产妇保健服务的利用，如保健设施的提供和PNC服务，并给予优先注意母亲与年龄较大的孩子和来自农村地区的强烈建议。
方法：来自最新健康和人口调查的数据，这是在2015年至2022年期间在20个撒哈拉以南非洲国家进行的，被使用。该研究包括一个加权样本，由13,315名6至23个月的非母乳喂养儿童组成。使用STATA/SE14.0版统计软件进行清理,重新编码,并分析来自DHS数据集的数据。利用多级混合效应逻辑回归，确定了与结果变量相关的因素.使用偏差(-2LLR)评估模型比较和适合度，似然比检验,中位数赔率比，和类内相关系数。最后,p值<0.05的变量和95%置信区间的调整后比值比被宣布为有统计学意义.
结果：撒哈拉以南非洲国家6-23个月非母乳喂养儿童的最低牛奶喂养频率的汇总幅度为12.39％（95％CI：11.85％，12.97%）。母亲教育水平等因素[AOR=1.61；95%CI(1.35,1.91)]，母亲的婚姻状况[AOR=0.77；95%CI(0.67,0.89)]，产妇工作状态[AOR=0.80；95%CI（0.71，0.91）]，媒体暴露[AOR=1.50；95%CI（1.27，1.77）]，财富指数[AOR=1.21；95%CI（1.03，1.42）]，交货地点[AOR=1.45；95%CI（1.22，1.72）]，怀孕期间参加的ANC访问[AOR=0.49;95％CI（0.39，0.62）]，PNC检查[AOR=1.57；95%CI（1.40，1.76）]，儿童年龄[AOR=0.70；95%CI（0.53，0.93）]，和居住地[AOR=2.15；95％CI（1.87，2.46）]与最低牛奶喂养频率显着相关。
结论：在撒哈拉以南非洲，在6至23个月的非母乳喂养儿童中,最低喂养次数的比例较低.最低牛奶喂养频率的可能性随着教育水平的提高而增加，失业,媒体曝光,富有的财富地位，未婚,在医疗机构出生的孩子，获取PNC检查，在6到8个月大之间，生活在城市地区。因此，促进妇女的教育，提高家庭的经济地位，通过媒体传播营养信息，加强孕产妇保健服务的利用，如保健设施的提供和PNC服务，并给予优先注意母亲与年龄较大的孩子和来自农村地区的强烈建议。
