Magnitude and determinants of complementary feeding practices in Ethiopia: A systematic review and meta-analysis

Background & aim: Concurrent estimates on the magnitude and evidence on the determinants of complementary feeding (CF) practices in Ethiopia are currently disparate. Hence, this systematic review and meta-analysis assessed the magnitude and determinants of CF among children age 6-23 months in Ethiopia. Methods: Studies from various databases published until July 2018 were identified, selected, extracted and assessed for risk of bias by two authors independently. A random-effects model was used to pool the prevalence and odds ratios (ORs). Results: 26 studies with 17, 383 children were included. The pooled prevalence estimate of timely initiated CF, minimum dietary diversity (DD), minimum meal frequency and minimum acceptable diet were 61.0%, 18.0%, 56.0%, and 10.0% respectively. The pooled prevalence of timely initiation and minimum DD were higher in Northern Ethiopia. On the other hand, except for the minimum meal frequency, all the three core indicators of CF were better in urban than rural settings. Child age, maternal and/or paternal education, paternal involvement, maternal DD, antenatal and postnatal care, and place of delivery were the main determinants that can increase appropriate CF practices. Conclusion: The reported estimates of the prevalence of core CF indicators in Ethiopia remained poor. Therefore, the authors would like to acknowledge the effort that has been done by the minister of health and its partners including Alive & Thrive to improving CF practices in the country, however, these programs should be done more thoroughly, and scaled up by applying and adapting tested, proven approaches and tools in contexts.