Feeding Practices and Nutritional Status of Infants and Young Children Aged 6-23 Months in the South Kivu Region: A Cross-Sectional Study

Authors

  • Marie Amélie Nabuholo Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Sénégal and Center for Tropical Diseases and Global Health, Catholic University of Bukavu, South Kivu, Democratic Republic of Congo
  • Olouwafemi Mistourath Mama Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Sénégal
  • Adama Diouf Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Sénégal
  • Esto Bahizire Center for Tropical Diseases and Global Health, Catholic University of Bukavu, South Kivu, Democratic Republic of Congo and Center for Research in Natural Sciences of Lwiro, Bukavu, Democratic Republic of the Congo
  • Nicole Idohou-Dossou Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Sénégal

DOI:

https://doi.org/10.6000/1929-4247.2025.14.03.11

Keywords:

Infant and young feeding practices, dietary intakes, complementary food, nutritional status, South Kivu

Abstract

Background: The increasing prevalence of stunting in the Democratic Republic of the Congo (DRC) represents a major public health concern. Adequate complementary feeding is crucial for preventing and reducing chronic malnutrition in early childhood in the long term.

Objective: This study aimed to assess the baseline complementary feeding practices and nutritional status of children aged 6–23 months in South Kivu Province, with a focus on commonly consumed complementary foods.

Methods: A cross-sectional analytical study was conducted among 515 children in the Kadutu and Miti-Murhesa health zones of South Kivu. Participants were selected through a systematic random sampling method. Dietary intakes and infant feeding practices were assessed using dietary recall questionnaires and a 7-day food frequency questionnaire. The nutritional status was measured by anthropometry.

Results: The mean age of children was 13.3 ± 5 months. Results showed that 59% of the children had a low dietary diversity score. Only 23% received an appropriate complementary feeding according to the minimum acceptable diet. Most of the children (88.5%) consumed porridge made exclusively of cereals, roots, or tubers and water. Animal-source foods, fruits, and vegetables were rarely consumed. Acute malnutrition and stunting affected 4.9% and 36.6% of children, respectively.

Conclusion: Stunting remains prevalent in both rural and urban areas of South Kivu. Furthermore, infant diets are nutritionally inadequate, as evidenced by their lack of diversity. Enriching widely consumed staple foods (maize, sorghum, and soy) with locally available animal-source products could improve micronutrient intake and constitute a promising strategy for preventing child malnutrition.

References

UNICEF. Levels and trends in child malnutrition: UNICEF/WHO/World Bank Group joint child malnutrition estimates: key findings of the 2023 edition [Internet]. Available from: https://www.who.int/publications-detail-redirect/9789240073791

FAO. L’état de la sécurité alimentaire et de la nutrition dans le monde 2019: se prémunir contre les ralentissements et les fléchissements. Rome: FAO; 2019.

Global Nutrition Report. Country Nutrition Profiles: Democratic Republic of Congo [Internet]. Available from: https://globalnutritionreport.org/resources/nutrition-profiles/africa/middle-africa/democratic-republic-congo/

Rapport MICS RDC 2018. Kinshasa: Ecole de Santé Publique; 2020. Available from: https://espkinshasa.net/rapport-mics-2018/

Kandala N-B, Madungu TP, Emina JB, Nzita KP, Cappuccio FP. Malnutrition among children under the age of five in the Democratic Republic of Congo (DRC): does geographic location matter? BMC Public Health 2011; 11: 261. DOI: https://doi.org/10.1186/1471-2458-11-261

Burns J, Emerson JA, Amundson K, Doocy S, Caulfield LE, Klemm RDW. A qualitative analysis of barriers and facilitators to optimal breastfeeding and complementary feeding practices in South Kivu, Democratic Republic of Congo. Food Nutr Bull 2016; 37(1): 119-31. DOI: https://doi.org/10.1177/0379572116637947

Kambale RM, Ngaboyeka GA, Ntagazibwa JN, Bisimwa M-HI, Kasole LY, Habiyambere V, et al. Severe acute malnutrition in children admitted in an Intensive Therapeutic and Feeding Centre of South Kivu, Eastern Democratic Republic of Congo: why do our patients die? PLoS ONE 2020; 15: e0236022. DOI: https://doi.org/10.1371/journal.pone.0236022

Mukuzo WK, Wimba LK, Munyuli TM, Ombeni J. Assessment of feeding practices and nutritional status of infant and young child in rural health zones of South Kivu Province (Democratic Republic of the Congo). Innov Romanian Food Biotechnol 2021.

Prado EL, Dewey KG. Nutrition and brain development in early life. Nutr Rev 2014; 72(4): 267-84. DOI: https://doi.org/10.1111/nure.12102

Berkman DS, Lescano AG, Gilman RH, Lopez SL, Black MM. Effects of stunting, diarrhoeal disease, and parasitic infection during infancy on cognition in late childhood: a follow-up study. Lancet 2002; 359(9306): 564-71. DOI: https://doi.org/10.1016/S0140-6736(02)07744-9

Walker SP, Chang SM, Powell CA, Simonoff E, Grantham-McGregor SM. Early childhood stunting is associated with poor psychological functioning in late adolescence and effects are re-duced by psychosocial stimulation. J Nutr 2007; 137(11): 2464-9. DOI: https://doi.org/10.1093/jn/137.11.2464

Marinda PA, Genschick S, Khayeka-Wandabwa C, Kiwanuka-Lubinda R, Thilsted SH. Dietary diversity determinants and contribution of fish to maternal and under-five nutritional status in Zambia. PLoS ONE 2018; 13: e0204009. DOI: https://doi.org/10.1371/journal.pone.0204009

Olack B, Burke H, Cosmas L, Bamrah S, Dooling K, Feikin DR, et al. Nutritional status of under-five children living in an informal urban settlement in Nairobi, Kenya. J Health Popul Nutr 2011; 29(4): 357-63. DOI: https://doi.org/10.3329/jhpn.v29i4.8451

Thiam M, Diouf A, Coly OB, Kébé SD, Diongue O, Badiane A, et al. Dietary intakes and nutritional status of mother-child (6-23 months old) pair targeted through the “Organic Residual Products for Biofortified Foods for Africa Project” in rural area in Senegal. Int J Child Health Nutr 2022; 11(3): 119-30. DOI: https://doi.org/10.6000/1929-4247.2022.11.03.1

Hoffman D, Cacciola T, Barrios P, Simon J. Temporal changes and determinants of childhood nutritional status in Kenya and Zambia. J Health Popul Nutr 2017; 36: 27. DOI: https://doi.org/10.1186/s41043-017-0095-z

George CM, Coglianese N, Bauler S, Perin J, Kuhl J, Williams C, et al. Low dietary diversity is associated with linear growth faltering and subsequent adverse child developmental outcomes in rural Democratic Republic of the Congo (REDUCE program). Matern Child Nutr 2022; 18: e13340. DOI: https://doi.org/10.1111/mcn.13340

Żukiewicz-Sobczak W, Wróblewska P, Zwoliński J, Chmielewska-Badora J, Adamczuk P, Krasowska E, et al. Obesity and poverty paradox in developed countries. Ann Agric Environ Med 2014; 21(3): 590-4. DOI: https://doi.org/10.5604/12321966.1120608

Matanda DJ, Urke HB, Mittelmark MB. Changes in optimal childcare practices in Kenya: insights from the 2003, 2008-9 and 2014 Demographic and Health Surveys. PLoS ONE 2016; 11(6): e0161221. DOI: https://doi.org/10.1371/journal.pone.0161221

Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013; 35(2): 121-6. DOI: https://doi.org/10.4103/0253-7176.116232

Gibson RS. An interactive 24-hour recall for assessing the adequacy of iron and zinc intakes in developing countries. n.d.: 160.

UNICEF. Indicators for assessing infant and young child feeding practices: definitions and measurement methods [Internet]. Available from: https://www.who.int/publications-detail-redirect/9789240018389

WHO. WHO child growth standards: length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: WHO; 2006.

WHO, PAHO, Dewey K. Guiding principles for complementary feeding of the breastfed child. Washington, D.C.: PAHO; 2003.

Grummer-Strawn LM, Scanlon KS, Fein SB. Infant feeding and feeding transitions during the first year of life. Pediatrics 2008; 122(Suppl 2): S36-42. DOI: https://doi.org/10.1542/peds.2008-1315D

Gartner LM, Morton J, Lawrence RA, Naylor AJ, O’Hare D, Schanler RJ, et al. Breastfeeding and the use of human milk. Pediatrics 2005; 115(2): 496-506. DOI: https://doi.org/10.1542/peds.2004-2491

Shrimpton R, Victora CG, de Onis M, Lima RC, Blössner M, Clugston G. Worldwide timing of growth faltering: implications for nutritional interventions. Pediatrics 2001; 107(5): e75. DOI: https://doi.org/10.1542/peds.107.5.e75

Kambale RM, Ngaboyeka GA, Kasengi JB, Niyitegeka S, Cinkenye BR, Baruti A, et al. Minimum acceptable diet among children aged 6-23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study. BMC Pediatr 2021; 21: 239. DOI: https://doi.org/10.1186/s12887-021-02713-0

Geng S, Ma J, Liu S, Zhang J, Sheng X. Lack of dietary diversity contributes to the gaps in micronutrient status and physical development between urban and rural infants. Iran J Public Health 2018; 47(7): 958-66.

Shively GE, Hao J, editors. A review of agriculture, food security and human nutrition issues in Uganda 2012.

Agize A, Jara D, Dejenu G. Level of knowledge and practice of mothers on minimum dietary diversity practices and associated factors for 6-23-month-old children in Adea Woreda, Oromia, Ethiopia. Biomed Res Int 2017; 2017: 7204562. DOI: https://doi.org/10.1155/2017/7204562

Dangura D, Gebremedhin S. Dietary diversity and associated factors among children 6-23 months of age in Gorche district, Southern Ethiopia: cross-sectional study. BMC Pediatr 2017; 17: 6. DOI: https://doi.org/10.1186/s12887-016-0764-x

Rathnayake KM, Madushani P, Silva K. Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka. BMC Res Notes 2012; 5: 469. DOI: https://doi.org/10.1186/1756-0500-5-469

Kawarazuka N, Béné C. The potential role of small fish species in improving micronutrient deficiencies in developing countries: building evidence. Public Health Nutr 2011; 14(11): 1927-35. DOI: https://doi.org/10.1017/S1368980011000814

Thilsted SH, Thorne-Lyman A, Webb P, Bogard JR, Subasinghe R, Phillips MJ, et al. Sustaining healthy diets: the role of capture fisheries and aquaculture for improving nutrition in the post-2015 era. Food Policy 2016; 61: 126-31. DOI: https://doi.org/10.1016/j.foodpol.2016.02.005

Popova A, Mihaylova D. Antinutrients in plant-based foods: a review. Open Biotechnol J 2019; 13: 68-76. DOI: https://doi.org/10.2174/1874070701913010068

Ahmed KY, Dadi AF, Ogbo FA, Page A, Agho KE, Akalu TY, et al. Population-modifiable risk factors associated with childhood stunting in sub-Saharan Africa. JAMA Netw Open 2023; 6(5): e2338321. DOI: https://doi.org/10.1001/jamanetworkopen.2023.38321

Yaya S, Oladimeji O, Odusina EK, Bishwajit G. Household structure, maternal characteristics and children’s stunting in sub-Saharan Africa: evidence from 35 countries. Int Health 2020; 14(4): 381-9. DOI: https://doi.org/10.1093/inthealth/ihz105

Addo IY, Boadu EF, Osei Bonsu E, Boadi C, Dadzie FA. Prevalence and factors associated with undernutrition among children under the age of five years in Benin. PLoS ONE 2023; 18: e0289933. DOI: https://doi.org/10.1371/journal.pone.0289933

Ndiku M, Jaceldo-Siegl K, Singh P, Sabaté J. Gender inequality in food intake and nutritional status of children under 5 years old in rural Eastern Kenya. Eur J Clin Nutr 2011; 65(1): 26-31. DOI: https://doi.org/10.1038/ejcn.2010.197

Moshi CC, Sebastian PJ, Mushumbusi DG, Azizi KA, Meghji WP, Kitunda ME, et al. Determinants of underweight among children aged 0-23 months in Tanzania. Food Sci Nutr 2022; 10(4): 1167-74. DOI: https://doi.org/10.1002/fsn3.2748

Beckerman JP, Slade E, Ventura AK. Maternal diet during lactation and breastfeeding practices have synergistic association with child diet at 6 years. Public Health Nutr 2020; 23(2): 286-94. DOI: https://doi.org/10.1017/S1368980019001782

Downloads

Published

2025-08-01

How to Cite

Nabuholo, M. A. ., Mama, O. M. ., Diouf, A. ., Bahizire, E. ., & Idohou-Dossou, N. . (2025). Feeding Practices and Nutritional Status of Infants and Young Children Aged 6-23 Months in the South Kivu Region: A Cross-Sectional Study. International Journal of Child Health and Nutrition, 14(3), 307–320. https://doi.org/10.6000/1929-4247.2025.14.03.11

Issue

Section

General Articles

Most read articles by the same author(s)