Trend and factors associated with consumption of iron-rich foods among children aged 6–23 months in Ethiopia, Evidenced from 2005–2019 Ethiopia demographic and health survey: A multivariate decomposition analysis

INTRODUCTION: Micro-nutrient deficiencies remain the major public health concern in sub-Saharan African countries including Ethiopia. In particular, adequate consumption of iron-rich foods among children aged 6-23 months in Ethiopia is very low, and is one of the reasons for the high prevalence of micronutrient deficiencies. Consumption of iron-rich food among children aged 6-23 months has changed over time in Ethiopia. However, there is scant evidence on the factors contributed for the change in the consumption of iron-rich foods. OBJECTIVE: To assess the trend and factors associated with consumption of iron-rich foods among children aged 6-23 months in Ethiopia based on the 2005-2019 Ethiopian Demographic Health Surveys. METHODS AND MATERIALS: A repeated cross sectional study design was employed based on the 2005, 2011, 2016 and 2019 Ethiopian Demographic Health Surveys data. A total weighted samples of 10,796 children aged 6-23 months were included. Stata version 17 statistical software was used for data management and analysis. A logit-based decomposition analysis was employed to identify factors contributing for the change in consumption of iron-rich food over time. Coefficients with the 95% Confidence Interval (CI) and P-value were reported to declare the statistical significance and strength of the contribution. RESULT: The consumption of iron-rich foods among children aged 6-23 months increased significantly from 10.8% (95%CI: 9.7, 11.9) in 2005 to 23.5% (95%CI:21.3, 25.6) in 2019. About 46.4% of the overall increment in the consumption of iron-rich foods among children was due to the difference in composition of women (change in endowment) across the surveys, while the difference due to the change in the effect of coefficients (change in characteristics) was insignificant. In the endowment component, the difference in composition of women with primary (23%) and secondary (10%) education, and difference in composition of women having four and above antenatal care visits (18%) were found to be significant contributing factors for the increase in the intake of iron-rich foods among young children. The increase in number of households with rich wealth status showed a 67.4% contribution for the increment of consumption of iron-rich foods during the third phase (2016-2019). CONCLUSION AND RECOMMENDATION: Consumption of iron-rich foods among children aged 6-23 months has shown a remarkable increase over time in Ethiopia. Improvement in maternal education status, increase in number of antenatal care visits and improvement in household wealth status were the main drivers for the observed change. Strengthening policies that expand women's educational opportunities and integrate nutrition counseling into antenatal care services, and promoting household economic empowerment could further enhance iron-rich food intake. iron-rich.