Wealth-related inequalities in WHO/UNICEF unhealthy complementary feeding indicators among children aged 6 to 23 months in Ghana

Abstract Background Complementary feeding from 6 to 23 months is important for growth and nutrient adequacy. Sweet beverage consumption, unhealthy food consumption, and zero vegetable or fruit consumption capture different aspects of young children’s diets. This study assessed wealth-related inequalities and factors associated with these indicators in Ghana. Methods This cross-sectional analysis used the 2022 Ghana Demographic and Health Survey and included 2,786 youngest living children aged 6 to 23 months living with their mothers. Weighted prevalence and the Erreygers Concentration Index (ECI) were estimated. Separate survey-weighted Poisson models with robust, design-based variance yielded adjusted prevalence ratios (aPRs). Models included eleven explanatory variables, including region and current breastfeeding status. Average adjusted prevalence and percentage-point contrasts were estimated for wealth and maternal education. Results Sweet beverage consumption was 31.6%, unhealthy food consumption was 32.9%, and zero vegetable or fruit consumption was 31.2%. The corresponding ECI estimates were 0.299 (95% CI 0.247–0.350), 0.278 (0.218–0.338), and − 0.084 (− 0.142,−0.026). Children in the richest households had higher sweet beverage prevalence than those in the poorest households (aPR 2.82, 95% CI 2.06–3.86). The richest–poorest estimate for unhealthy food consumption was less precise (aPR 1.49, 95% CI 0.98–2.28). Current breastfeeding was associated with lower sweet beverage and unhealthy food prevalence and higher zero vegetable or fruit prevalence. Conclusions The socioeconomic pattern differed across the three feeding indicators. Sweet beverage and unhealthy food consumption were concentrated among children from wealthier households, whereas zero vegetable or fruit consumption was concentrated among poorer households. Monitoring complementary feeding in Ghana may need to consider both exposure to unhealthy foods and beverages and the absence of vegetable or fruit consumption across household wealth groups.