Percentage of youngest children age 6-23 months who are living with the mother who were fed:
1) A minimum dietary diversity of 5 out of 8 food groups during the previous day or night:
a) Breastmilk
b) Grains, white/pale starchy roots, tubers, and plantains
c) Legumes and nuts
d) Dairy products (infant formula, milk, yogurt, cheese)
e) Flesh foods (meat, fish, poultry and liver/organ meats)
f) Eggs
g) Vitamin A rich fruits and vegetables
h) Other fruits and vegetables
2) A minimum meal frequency during the previous day or night of:
a) 2 or more solid, semi-solid or soft feeds for breastfeeding children age 6-8 months, or
b) 3 or more solid, semi-solid or soft feeds for breastfeeding children age 9-23 months; or
c) 4 or more solid, semi-solid or soft food or milk feeds for non-breastfeeding children age 6-23 months where at least one of the feeds must be a solid, semi-solid, or soft feed.
3) A minimum milk feeding frequency of at least two milk feeds during the previous day or night (for children not breastfed).
4) A minimum acceptable diet during the previous day or night:
a) Breastfed children – minimum dietary diversity and minimum meal frequency as above.
b) Non-breastfed children – minimum dietary diversity but excluding the dairy products category (4 out of 6 groups) and minimum meal frequency and 2 or more milk feeds.
Coverage:
Population base: Youngest child age 6-23 months living with the mother (KR file)
Time period: Previous day or night before the survey
Numerators:
Number of youngest children age 6-23 months living with the mother who were fed:
1) At least 5 of the following 8 food groups during the previous day or night before the survey:
a) Breastmilk (m4 = 95)
b) Grains, white/pale starchy roots, tubers, and plantains (v412a = 1 or v414e = 1 or v414f = 1)
c) Legumes and nuts (v414o = 1 or v414c = 1)
d) Dairy products (infant formula, milk, yogurt, cheese) (v411 = 1 or v411a = 1 or v414v = 1 or v414p = 1)
e) Flesh foods (meat, fish, poultry and liver/organ meats) (v414h = 1 or v414m = 1 or v414n = 1 or v414b = 1)
f) Eggs (v414g = 1)
g) Vitamin A rich fruits and vegetables (v414i = 1 or v414j = 1 or v414k = 1)
h) Other fruits and vegetables (v414a = 1 or v414l = 1)
2) A minimum meal frequency:
a) Defined for breastfed children as receiving solid or semi-solid foods
b) at least twice a day for infants 6-8 months (m4 = 95 & b19 in 6:8 & m39 in 2:7) or
c) at least three times a day for children 9-23 months (m4 = 95 & b19 in 9:23 & m39 in 3:7)
d) Defined for non-breastfed children age 6-23 months as receiving solid, semi-solid, or soft foods or milk feeds at least four times a day (m4 ≠ 95 & total milk feeds (sum of v469e (if in 1:7) plus v469f (if in 1:7) plus v469x (if in 1:7 and v413a = 1) >= 2) plus solid feeds (m39 – if in 1:7) >= 4) where at least one of the feeds must be a solid, semi-solid, or soft food (m39 in 1:7)
3) A minimum milk feeding frequency of at least two milk feeds during the day or night preceding the survey (sum of v469e (if in 1:7) among non-breastfeeding children (m4 ≠ 95))
4) A minimum acceptable diet:
a) Defined for breastfed children (m4 = 95) as minimum dietary diversity and minimum meal frequency as above during the previous day or night preceding the survey.
b) Defined for non-breastfed children (m4 ≠ 95) as minimum dietary diversity and minimum meal frequency and 2 or more milk feeds during the previous day or night preceding the survey.
Disaggregated by whether breastfeeding or not (m4 = 95)
Denominators: Number of youngest children age 6-23 months living with the mother, disaggregated by whether breastfeeding or not (m4 = 95). See Calculation for the selection for the denominator.
Variables: KR file.
|
caseid |
Case Identification |
|
b5 |
Child is alive |
|
b9 |
Child lives with whom |
|
b19 |
Current age of child in months (months since birth for dead children) |
|
m4 |
Duration of breastfeeding |
|
v411 |
Gave child tinned, powdered or fresh milk |
|
v411a |
Gave child baby formula |
|
v412a |
Gave child fortified baby food (cerelac, etc) |
|
v413 |
Gave child other liquid |
|
v414a |
Gave child any other vegetables |
|
v414b |
Gave child sausages, hot dogs, frankfurters, ham, bacon, salami, canned food |
|
v414c |
Gave child nuts, seeds |
|
v414d |
Gave child any insects |
|
v414e |
Gave child bread, noodles, other made from grains |
|
v414f |
Gave child potatoes, cassava, or other tubers |
|
v414g |
Gave child eggs |
|
v414h |
Gave child meat (beef, pork, lamb, chicken, etc) |
|
v414i |
Gave child pumpkin, carrots, squash (yellow or orange inside) |
|
v414j |
Gave child any dark green leafy vegetables |
|
v414k |
Gave child mangoes, papayas, other vitamin A fruits |
|
v414l |
Gave child any other fruits |
|
v414m |
Gave child liver, heart, other organs |
|
v414n |
Gave child fish or shellfish |
|
v414o |
Gave child food made from beans, peas, lentils, nuts |
|
v414p |
Gave child cheese, yogurt, other milk products |
|
v414v |
Gave child yogurt |
|
v469e |
Times gave child powdered/tinned/fresh milk |
|
v469f |
Times gave child infant formula |
|
v469x |
Times gave child yogurt |
|
m39 |
Number of times ate solid, semi-solid or soft food yesterday |
Based on DHS-8 standard questionnaires. Other variables may be needed if additional survey-specific foods are included.
Numerator divided by denominator, multiplied by 100.
Denominator:
To select the cases for the denominator, first filter or keep only living children living with the mother born in the preceding 24 months (keep/select if b19 < 24 & b9 = 0), then keep only the youngest child (keep/select if the first entry in the dataset (_n = 1) or the first for this respondent (caseid ≠ caseid[_n-1]) as the youngest child is the first listed for the respondent in the data file), then finally restrict to children age 6-23 (note that you cannot select for children age 6-23 in the first step as this would include some cases that were not asked the questions. The commands in Stata and SPSS are given below:
Stata |
|
* keep if under 24 months and living with mother keep if b19 < 24 & b9 == 0 * and keep the last born of those. * if caseid is the same as the prior case, then not the last born keep if _n == 1 | caseid != caseid[_n-1] * now restrict to age 6-23 keep if b19 >= 6 |
SPSS |
|
* keep if under 24 months and living with mother. Select if (b19 < 24 & b9 = 0). * and keep the last born of those. * if caseid is the same as the prior case, then not the last born. Select if (caseid <> lag(caseid)). * now restrict to age 6-23. Select if (b19 >= 6). |
Breastfeeding: Missing values and “don’t know” assumed not breastfeeding.
Specific liquids and foods: Missing values and “don’t know” excluded from numerators in all percentages but included in denominators.
Solid, semi-solid or soft foods: Missing values and “don’t know” excluded from numerator but included in denominator.
Country-specific liquids and foods may be added to each category. Percentages are based only on children living with their mother. Children living elsewhere are excluded from both the numerators and the denominators.
If the last-born child is deceased or not living with the mother, questions on foods and liquids are asked of the prior child born in the two years preceding the interview and living with the mother. In earlier surveys prior to DHS-8, however, the question on breastfeeding was not asked of this child. In this situation the child will be treated as not currently breastfeeding in the numerator and included in the denominator.
In DHS-8 surveys, as per the 2021 update to the “Indicators for assessing infant and young child feeding practices” several indicators have been updated (WHO and UNICEF 2021).
The minimum dietary diversity indicator was previously defined as receiving 4 out of 7 food groups but is now defined as receiving 5 out of 8 food groups with a group for breastmilk being added (WHO 2017). The change in the definition of the indicator was made to eliminate disparities in the indicator for breastfeeding compared with non-breastfeeding children. DHS-7 surveys from February 2019, also use the updated indicator definition.
The definition for minimum meal frequency for non-breastfed children has changed to require that at least one of the feedings is solid, semi-solid or soft foods. Both the minimum dietary diversity and the minimum meal frequency updated definitions affect the minimum acceptable diet. DHS-7 surveys from February 2019, also use the updated indicator definitions.
Caution should be observed when comparing DHS-8 and late DHS-7 surveys to earlier rounds of DHS as the definitions of minimum dietary diversity, minimum meal frequency and minimum acceptable diet have changed.
Additional variables related to fresh milk, tea and coffee, porridge gruel, and other foods or drinks have been used in older surveys (see v412, v412b, v413a – d, v414a – d, t, u, w), and should be taken into consideration when comparing results with the surveys reports.
WHO and UNICEF 2021. Indicators for assessing infant and young child feeding practices: definitions and measurement methods. https://www.who.int/publications/i/item/9789240018389
WHO. 2017. Global Nutrition Monitoring Framework: Operational Guidance for Tracking Progress in Meeting Targets for 2025. http://www.who.int/nutrition/publications/operational-guidance-GNMF-indicators/en/
DHS-8 Tabulation plan: Tables 11.8 and 11.10
API Indicator IDs:
Breastfeeding children:
CN_IYCF_C_4FB, CN_IYCF_C_MNB, CN_IYCF_C_BTB
Non-breastfeeding children:
CN_IYCF_C_MKN, CN_IYCF_C_4FN, CN_IYCF_C_MNN, CN_IYCF_C_3PN
All children:
CN_IYCF_C_MKA, CN_IYCF_C_4FA, CN_IYCF_C_MNA, CN_IYCF_C_3PA
GNMF Indicator 12: Proportion of children aged 6-23 months who receive a minimum acceptable diet
WHO/UNICEF IYCF Indicator 8: Minimum dietary diversity 6-23 months
WHO/UNICEF IYCF Indicator 9: Minimum meal frequency 6-23 months
WHO/UNICEF IYCF Indicator 10: Minimum milk feeding frequency for non-breastfed children 6-23 months
WHO/UNICEF IYCF Indicator 11: Minimum acceptable diet 6-23 months
MICS6 Indicator TC.39a: Minimum acceptable diet (breastfed children)
MICS6 Indicator TC.39b: Minimum acceptable diet (non-breastfed children)
MICS6 Indicator TC.40: Milk feeding frequency for non-breastfed children
MICS6 Indicator TC.41: Minimum dietary diversity
MICS6 Indicator TC.42: Minimum meal frequency