Table 3.
Key determinants of maternal low dietary diversity among Syrian mothers
| Variables* | MDD-W | LDD | Maternal Low Dietary Diversity | |||
|---|---|---|---|---|---|---|
| n=159 | n=274 | OR** (95% CI) | P | aOR† (95% CI) | P | |
| Socio-economic characteristics | ||||||
| Mother’s education level | ||||||
| No schooling/Illiterate | 20 (12·7) | 50 (18·5) | 1·0 | 1·0 | ||
| Primary, Intermediate school | 84 (53·2) | 165 (60·9) | 0·78 (0·44–1·40) | 0·416 | 0·87 (0·39–1·94) | 0·727 |
| Secondary school and higher | 54 (34·2) | 56 (20·7) | 0·42 (0·22–0·79) | 0·007 | 0·97 (0·38–2·45) | 0·943 |
| Father’s employment status | ||||||
| Full-time job/Self-employed | 92 (58·6) | 122 (46·9) | 1·0 | 1·0 | ||
| No job/Part-time job | 65 (41·4) | 138 (53·1) | 1·60 (1·07–2·39) | 0·021 | 1·50 (0·89–2·55) | 0·132 |
| Monthly household income | ||||||
| ≤ 750,000 LBP | 79 (53·4) | 190 (72·2) | 2·27 (1·49–3·46) | 0·000 | 2·09 (1·19–3·67) | 0·010 |
| > 750,000 LBP | 69 (46·6) | 73 (27·8) | 1·0 | 1·0 | ||
| UNHCR refugee registration status | ||||||
| No | 39 (25·3) | 37 (13·7) | 1·0 | 1·0 | ||
| Yes | 115 (74·7) | 234 (86·3) | 2·14 (1·30–3·54) | 0·003 | 2·13 (1·07–4·24) | 0·031 |
| Receiving WFP food assistance (e-vouchers) | ||||||
| No | 148 (96·7) | 244 (90·4) | 1·0 | 1·0 | ||
| Yes | 5 (3·3) | 26 (9·6) | 3·15 (1·18–8·39) | 0·021 | 3·70 (1·09–12·53)‡ | 0·035 |
| Crowding index score (mean ± sd) | 3·27 (1·2) | 3·95 (1·8) | 1·34 (1·17–1·55) | 0·000 | 1·32 (1·07–1·64) | 0·031 |
| Healthcare service utilization | ||||||
| Mother’s use of micronutrients supplements | ||||||
| No | 99 (63·1) | 200 (73·8) | 1·0 | 1·0 | ||
| Yes | 58 (36·9) | 71 (26·2) | 0·61 (0·39–0·93) | 0·020 | 0·49 (0·27–0·88) | 0·018 |
| Number of antenatal care visits | ||||||
| 0 times | 26 (16·7) | 45 (16·6) | 1·21 (0·70–2·08) | 0·491 | 0·85 (0·42–1·73) | 0·666 |
| 1 to 3 times | 21 (13·5) | 70 (25·8) | 2·33 (1·35–4·02) | 0·002 | 2·01 (1·00–4·02) | 0·050 |
| ≥ 4 times | 109 (69·9) | 156 (57·6) | 1·0 | 1·0 | ||
| Sources of health and nutrition messages from healthcare professionals only | ||||||
| No healthcare professionals | 105 (66·0) | 203 (74·4) | 1·0 | 1·0 | ||
| One healthcare professional§ | 36 (22·6) | 57 (20·9) | 0·82 (0·51–1·32) | 0·414 | 0·72 (0·38–1·35) | 0·309 |
| Community healthcare worker | 9 (5·7) | 9 (3·3) | 0·52 (0·20–1·34) | 0·175 | 0·27 (0·08–0·84) | 0·024 |
| Multiple healthcare professionals | 9 (5·7) | 4 (1·5) | 0·23 (0·07–0·76) | 0·016 | 0·04 (0·00–0·43) | 0·008 |
| Maternal daily meal pattern | ||||||
| Have breakfast every day | ||||||
| No | 37 (23·9) | 91 (33·3) | 1·0 | 1·0 | ||
| Yes | 118 (76·1) | 182 (66·7) | 0·63 (0·40–0·98) | 0·041 | 0·55 (0·31–0·99) | 0·045 |
| Number of main meals per day (mean ± sd) | 2·19 (0·6) | 2·08 (0·6) | 0·73 (0·53–1·02) | 0·067 | 0·54 (0·35–0·85) | 0·008 |
| Number of snacks per day (mean ± sd) | 1·54 (1·0) | 1·19 (1·0) | 0·72 (0·59–0·88) | 0·001 | 0·76 (0·59–0·99) | 0·038 |
| Anemia and nutritional status of all mothers | ||||||
| Maternal anemia status | ||||||
| Not anemic | 122 (77·7) | 214 (78·7) | 1·0 | 1·0 | ||
| Anemic | 35 (22·3) | 58 (21·3) | 0·94 (0·59–1·52) | 0·814 | 1·17 (0·61–2·23) | 0·643 |
| Classification of malnutrition using MUAC | ||||||
| Normal weight (23·0–27·9 cm) | 47 (29·6) | 99 (36·4) | 1·0 | 1·0 | ||
| Undernourished (< 23·0 cm) | 9 (5·7) | 11 (4·0) | 0·58 (0·22–1·50) | 0·260 | 0·32 (0·10–1·03) | 0·056 |
| Overweight/Obese (≥ 28·0 cm) | 103 (64·8) | 162 (59·6) | 0·75 (0·49–1·14) | 0·179 | 0·82 (0·46–1·46) | 0·503 |
| Nutritional status of non-pregnant mothers‖ | n=130 | n=226 | OR** (95% CI) | aOR¶ (95% CI) | ||
| BMI for the mother (kg/m2) | ||||||
| Normal weight (18·5–24·9) | 39 (30·0) | 92 (40·7) | 1·0 | 1·0 | ||
| Underweight (< 18·5) | 4 (3·1) | 5 (2·2) | 0·53 (0·14–2·08) | 0·363 | 0·58 (0·12–2·76) | 0·492 |
| Overweight/Obese (≥ 25·0) | 87 (66·9) | 129 (57·1) | 0·63 (0·40–0·99) | 0·049 | 0·69 (0·37–1·26) | 0·226 |
LDD, low dietary diversity (< 5 out of 10 food groups); MDD-W, Minimum Dietary Diversity for Women (≥ 5 out of 10 food groups); WFP, World Food Programme; aOR, adjusted OR; PM, pregnant mothers.
* Categorical variables are expressed as n (%) and continuous variables are expressed as mean ± sd. Lack of corresponding sum of frequencies with total sample size is due to missing data.
** OR of the dependent variable (MDD-W vs. LDD) are presented with 95% CI using simple logistic regression.
† aOR are presented with 95% CI using multiple logistic regression analysis. Model 2: adjusted for age of the mother and child, sex of the child, reproductive status of the mother, marital status, education and employment status of the parents, household monthly income, crowding index, UNHCR registration status, perception of safety, receiving cash or food assistance, reliance on savings, household type, head of household, total number of under-five children, health insurance coverage, healthcare type, sources of health messages, the probability of being moderately and severely food insecure, and maternal anemia.
‡ Model 3: Model 2 without receiving cash or food assistance.
§ Healthcare professionals included physicians, nurses, dietitians, and pharmacists.
‖ Non-PM include lactating mothers and non-pregnant non-lactating mothers.
¶ Model 4: Model 2 without the age/marital status/physiological status of the mother.
Statistical significance was defined as P-value < 0·05.