Spatial Pattern and Determinants of Inadequate Complementary Feeding Indicators Among Children Aged 6–23 Months in Bangladesh: A Cross‐Sectional Study

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Abstract
Background and Aims: Inadequate complementary feeding practices (CFPs) can lead to malnutrition among children and result in poor health outcomes throughout life. This study aimed to explore the spatial patterns and determinants of inadequate complementary feeding indicators (CFIs) among children aged 6–23 months in Bangladesh. Methods: We used data from the latest Bangladesh Demographic and Health Survey (BDHS) 2022. Three CFIs: minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) were the outcome variables. Data from a weighted sample of 2578 children aged 6–23 months were included in this study. Hot spot analysis, ordinary Kriging interpolation, and multilevel binary logistic regression analyses were employed. Results: The overall prevalence of inadequate MDD, MMF, and MAD among children was 62.8%, 34.4%, and 70.4%, respectively. Spatial autocorrelation analysis showed that the distributions of inadequate MDD, MMF, and MAD across Bangladesh were highly clustered. For all three outcomes, a significant hot spot of inadequate feeding practice was noticed in the northeast region (Sylhet) of Bangladesh, while the cold spot was in the Southwest Khulna division. Young children (6–11 months), children of parents having no formal education, mothers with no employment, no media exposure, and belonging to households with low wealth status had higher odds of having inadequate MDD, MMF, and MAD. In contrast, children of mothers who had more frequent antenatal care (ANC) visits were less likely to have inadequate MMF and MAD. Conclusion: Socioeconomic and maternal factors, such as low parental education, lack of maternal employment, limited media exposure, and lower household wealth, were significantly associated with suboptimal CFPs. Monitoring appropriate CFIs nationwide and implementing policies and programs to address geographical and socioeconomic disparities are crucial for ensuring optimal child nutrition.

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