A total of 339 study participants have taken part in the study. Of the total study participants, about (41.6% males) and (58.4%) were females. Regarding to the study participants educational background, (uneducated 33.0%), (can read and write 33.6%), (completed primary school 25.1%) and about 8.3% were secondary school and above). The majority (58.1%) were Protestant and (41.9%) were Orthodox followers. The majority 66.7% of study mothers were housewife, (farmer 16.8%), government employee 8.3% and daily laborer 8.3%. about 58.5% of the study fathers were farmers while 17% of were merchants. Of the study participants about 58.7%, 33% and 8.3% had 6-10, 1-5 and 11-15 family size, respectively. About half 50% of the study mothers hadn’t autonomous decision-making and power to control their assets. The majority (41.6%) of the study participants’ child age (in moths) was 12-24 while 6-12 months 33.3% and 1-6 was 25% (table 1)
Table: 1. Socio-demographic characteristics of the study participants in Jima Rare district of Ethiopia, 2020
The status of maternal healthcare service delivery and child Anthropometric measurements. The majority (91.7%) of the study mothers’ child were immunized and following the rest of vaccine that delivered in their age rages. About (74.6%) children were had no illness diarrhea, cough, and fever in the past six months while (33%) had these symptoms at least once in the last six months. Most (57.6%) of the respondents seek advice about IYCF practice from HEW or other Health professionals in the last past three months, but 42.2% did not. The majority (68.7%) of child’s MUAC measures was >12, while 0.6% and 5.6% of MUAC measurement were <11 and between 11-12 centimeters, respectively. About 58.7% of study respondents were visited by HEW/other health professionals at their home, but their counterparts (41.3% did not) in the last 3 months of this study.
The study mothers maternal ANC healthcare utilization practice (table 3) shows that the majority (38.3%) of mothers visited health institutions 2-3 times for ANC, while others (none 26%), at least once (32%) and more than four times 3.5%). About 30.7% of mothers gave their last childbirth at health center, while (health post 27.4), (home 25%0, (hospital 16.8%) their last child place of delivery. The majority (76.7) of study participants didn’t received IYCF Counseling from healthcare professionals during ANC and/or PNC visit of health institutions. Of the study participants about 56.9% received the postnatal care service visit for 1-2 times, whereas 11.8% received ≥ 3 times and 31.3 didn’t for postnatal care service visit. The majority (31.6%) of study participants hadn’t received IYCF practical support from anyone. However, others received the IYCF practical support from (Family members 12.4%), (WDA 18.6%), HEWs 30% and (other healthcare professionals 7.4%). About 38% of study mothers hadn’t got the opportunity to discuss IYCF practices. However, about 12.7%, 16.8% and 25% had got the opportunity to discuss about it from family members, WDA, and HEWs, respectively (table 2).
Table 2: The status of maternal healthcare service delivery and child Anthropometric measurements of the study participants in Jima Rare district of Ethiopia, 2020
Women’s empowerment, household food security and agriculture practices
Out of the total study respondents the autonomy to make a decision on their monthly or yearly earned money the majority (58.4%) was by their husbands, while 16.5% of them had an autonomy to decide on their monthly/yearly income jointly. The majority (58.1%) of mother participants hadn’t control and power in decision-making, but (41.9%) had some power in decision-making and control over assets. About (58.7%) study participants reported any of their household members hadn’t eat a smaller meal than they felt they need in the last four weeks of the study, but their counterpart (41.3%) they did they felt they had smaller meal than the usual. Furthermore, the majority (51%) of the respondent didn’t eat a limited variety of foods in the last four weeks, but about half (49%) had limited variety of foods due to a lack of resources.
The majority (83.5%) of the study participants reported they have their own agricultural land, of this the majority (75.2%) have 1-3 hectares,8.3% have 4-6 hectares, however (16.5%) households hadn’t the agricultural land. More than half (75.2%) of households had their own any livestock, herds, other farm animals and 84(24.8%) hadn’t any of these livestock or other farm animals (table 3).
Table 3: The Women’s empowerment, household Food security and agriculture practices
of the study participants in Jima Rare district of Ethiopia, 2020
Water, Sanitation and Hygiene (WASH) practice of the study participants
The majority (65.5%) of their households’ main source of drinking water was protected spring, while (unprotected springs 24.5%), (public stand pipes 8.6%) and 1.5% of them of participants’ households use a pipe connected into their home. Of the total respondents (had latrine without slab 66.7%), no latrine 24.8% and (latrine with slab 8.6%) for defecation. The majority 75% of households primarily buried their households waste, while their counterparts (25%) dumped in street/open space. About (66.7%) of respondents practice hand washing with a soap after and before preparing food, but 33.3% did not practice handwashing before and after food preparation. Out of the total children who had diarrhea, cough, and fever in the last 3 months (n= 112), about 70.5% and 19.6 % their households were using unprotected springs and protected source of drinking water, respectively. Of the total children who had diarrhea, cough, and fever in the last 3 months (n= 112), majority 64.3% and 22.3 % of children’s family haven’t toilet facility and used shared toilet shared with other households (table 4).
Table4: Water, sanitation and hygiene (WASH) practice of the study participants in Jima Rare district of Ethiopia, 2020
The IYCF breastfeeding and complementary feeding practices by using the eight core indicators of WHO) of study participants
The actual feeding practice style among the respondents had been assessed by using eight core indicators of infant and child feeding practice of the WHO. About (78%) of mothers initiated breastfeeding within one-hour after birth, but (25%) of mothers did it after birth within twenty-four hours. More than (half 66.7%) and 33.4% of the respondents practiced exclusive breastfeeding at 4-5 months and for the first six months without giving any additional food except for necessary medications, respectively. Less than half (33.3%) of mothers continued breastfeeding at 1 year of child age. But about 16.7% and 11.8% of mothers continued breastfeeding at 18 months and at 2 years of the child age. Moreover, about 21.6% of participants reported they were practicing bottle feeding.
Regarding to complementary feeding practices (fig 1), about 33.4% and 66.7% of mothers started introducing solid, semi-solid or soft foods at (for all children at 4 to 5 months) and (all children at 6 months and above), respectively. Overall, of the total participants’ proportion of children age 6- 23 months who met minimum meal frequency, composite of minimum dietary diversity and, consumption of iron-rich or iron-fortified foods accounts for 51.2%, 49.9% and 25.4%, respectively. About half proportion (49.9%) of children age 6- 23 months fit for the minimum acceptable diet (fig 1).
Predictors of IYCF practice of the study participants in Jima Rare district of Ethiopia, 2020
The multivariate analysis revealed that being illiterate (AOR = 0.231; 95% CI (0.625-0.942)), less power to decide on the earned money ((AOR = 0.231; 95% CI (0.625-0.942)), hadn’t get the opportunity to discuss IYCF practices ((AOR = 0.231; 95% CI (0.625-0.942)), and less autonomy of decision-making and control power over assets ((AOR = 0.231; 95% CI (0.625-0.942)) were identified as factors that contribute in less likely IYCF appropriate practices than their counterparts. Moreover, the households who have 11-15 total family size were less likely practice IYCF than those household who have less family size AOR=0.431; 95% CI (0.715-0.802)). However, mothers who gave birth at health institutions, get help from their husband, had received practical support of IYCF practices, counseling during ANC and/or PNC visit and the households who have agricultural land and radio were more likely to carryout appropriate IYCF practices than their comparable groups.
Mothers who gave birth at health institutions were 1.734 times more likely to have appropriate IYCF practice than mothers who gave birth at home (AOR =1.734; 95% CI: (1.130, 2.661)). Mothers who have been counseled during ANC and/or PNC visit and having practical support on IYCF practices were 3.41 and 2.15 times more likely to practice IYCF appropriately than their comparable group (AOR=3.41; 95% CI: (2.641-4.012), (AOR=2.15; 95% CI: (3.312-5.013), respectively. Furthermore, mothers who got their husband help to feed child and those who have agricultural land were about two-times more likely to practice IYCF appropriately than their comparable group (AOR=1.982 and 1.473 (AOR=1.893 3.41; 95% CI: (2.641-4.012), (AOR=2.15; 95% CI: (3.312-5.013), respectively. Mothers who gave birth at health institutions were 1.734 times more likely to have appropriate IYCF practice than mothers who gave birth at home (AOR =1.734; 95% CI: (1.130, 2.661)). This also extends to households those who have radio were 1.2 times more likely to have appropriate IYCF practice than their comparable group (table 5).
Table 5. Predictors of IYCF practice of the study participants in Jima Rare district of Ethiopia, 2020