Practice of Essential Nutrition Action Messages and Associated Factors Among Mothers of Children Aged 0-24 Months in Rural and Urban Kebeles of the Southern Zone, Sidama Region, Ethiopia

Background: Essential Nutrition Actions (ENA) is a comprehensive nutrition program during the first 1,000 days of life, from conception to age two. One-fourth of nutrition-related morbidity and mortality rates are caused by inadequate implementation practice of essential nutrition actions. However, some studies conducted predominantly emphasized only rural settings or only urban settings but no studies show the prevalence of ENA practices by comparing urban and rural setting for prioritization of intervention purpose. Therefore, this study sought to close this gap by assessing adherence to essential nutrition action messages and factors associated among mothers of children aged 0-24 months in rural and urban kebeles of the Southern zone. Methods: A community based comparative cross-sectional study was conducted among 466 participants 233 from urban and 233 from rural. A structured interviewer administrated questionnaire was used to collect data. Data was entered into Epi Info and then transported to SPSS for analysis. Descriptive analysis was used to describe the percentages and frequency. During bivariable logistic regression analysis at P value less than 0.25 was candidate variable included in multivariable logistic regression analysis. Statistical significance was declared at P value <0.05 in the multivariable logistic regression model. Result: The study results were found to be 50.2% of urban mothers and 57.1% of rural mother’s demonstrated poor ENA practice. Among urban kebeles prim-parous mothers [AOR=2.580, 95% CI: 1.269-5.245] were associated with poor ENA practices. Among rural kebeles mothers having nutritional counseling during ANC [AOR=0.342, 95% CI: 0.110-1.063] and mothers who are adequate in dietary diversity [AOR=0.267, 95% CI: 0.093- 0.769] was identified as a predictor. Conclusion and recommendation: The study shows that the prevalence of poor ENA practices higher among rural than urban kebeles. All concerned bodies should give community based education about ENA messages (maternal nutrition, breastfeeding, complementary feeding) and counseling to mothers to increase awareness about the importance of nutrition during pregnancy and increase practice of key ENA messages.