Study links feeding frequency with caregiver beliefs in Ethiopian children
Among 514 caregiver-child pairs in Harar, 61.5% of children met the study’s minimum meal-frequency standard.
Low evidenceHuman studyInterpret with caution
Medical disclaimer: This article summarizes research findings and is for informational purposes only. It is not medical advice.
Editorial illustration — not from the study.
This human study used interviews and a 24-hour food recall to examine whether children met minimum meal-frequency standards and whether this was associated with caregivers’ knowledge, beliefs, and household or health-service factors. The researchers used a Health Belief Model to assess perceptions such as confidence in providing meals and perceived risk of nutrition problems.
The study found associations between meeting the meal-frequency standard and higher caregiver self-confidence, greater perceived susceptibility to nutrition problems, household food security, higher wealth, postnatal-care attendance, maternal education, and knowledge. Because the study measured these factors at one point in time, it cannot determine whether they caused differences in feeding frequency.
The question examined
Researchers conducted a facility-based analytical cross-sectional study from December 2023 to January 2024. It included 514 mothers or primary caregivers of children aged 6–23 months who attended three randomly selected public health centers in Harar City. Participants were selected using systematic sampling. Interviews assessed feeding during the previous 24 hours, maternal infant-feeding knowledge, household food security, and Health Belief Model domains including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Minimum meal frequency was defined using the study’s WHO-based thresholds: at least two meals for breastfed children aged 6–8 months, at least three meals for breastfed children aged 9–23 months, and at least four feeds for non-breastfed children aged 6–23 months.
What the analysis found
Overall, 61.5% of children met the study’s minimum meal-frequency definition, with a 95% confidence interval of 57.3% to 65.7%. Meeting the standard was associated with breastfeeding, being 6–8 months old, maternal primary education, higher maternal knowledge, household food security, postnatal-care attendance, and higher household wealth.
The reported adjusted odds of meeting the standard were higher among children whose mothers or caregivers had high self-efficacy, or confidence in providing meals, than among those with lower self-efficacy (adjusted odds ratio 2.05; 95% confidence interval 1.30–3.25). Higher perceived susceptibility to nutrition problems was also associated with meeting the standard (adjusted odds ratio 1.45; 95% confidence interval 1.05–2.20). Other reported associations included breastfeeding (3.20; 1.80–5.68), age 6–8 months (1.85; 1.10–3.12), maternal primary education (2.40; 1.05–5.45), high maternal knowledge (3.40; 1.40–8.10), household food security (3.10; 1.40–6.70), and postnatal-care attendance (3.10; 1.70–5.50). These figures describe associations, not causes. The breastfeeding association may partly reflect the different meal-frequency thresholds used for breastfed and non-breastfed children.
Where this may apply
These findings may be most relevant to caregivers of children aged 6–23 months who attend public health centers in settings similar to the three facilities studied in Harar City. They should not be assumed to apply to all families in Harar, other parts of Ethiopia, or other countries, particularly because families who do not use public health services were not included. The results also do not show that caregiver beliefs, postnatal-care attendance, food security, or other associated factors directly cause children to meet the meal-frequency standard.
The significance
The findings indicate that a substantial proportion of children in this facility-attending sample did not meet the study’s minimum meal-frequency standard. They also suggest that feeding frequency was associated not only with household resources and health-service contact, but also with caregivers’ knowledge and beliefs. However, the study does not establish that changing any of these factors would change feeding frequency, and the results may not represent children or caregivers who do not use public health facilities.
Limitations & evidence assessment
Because the study was cross-sectional, it could not establish which factors came first or support causal conclusions. Feeding was assessed with a single 24-hour recall, which may not represent a child’s usual pattern, and self-reported answers may have been affected by memory errors or the desire to give socially acceptable responses. The breastfeeding association may partly result from the indicator’s different thresholds, and using meal frequency and dietary diversity from the same recall may create measurement overlap. Participants were recruited only from public health facilities in Harar City, so the reported 61.5% may not represent the wider community, including families who do not use these services.
Why this evidence level: This was a human observational, cross-sectional study, so it can identify associations but cannot show that any factor caused children to meet or miss feeding targets. The participants came from selected public health centers in one Ethiopian city, which limits how broadly the findings can be applied.
Evidence levels are editorial estimates derived from study metadata — they are not clinical appraisals.
// Source
Discover Public Health · 2026 · DOI: 10.1186/s12982-026-03067-7
This systematic review examined randomized human trials of concurrent chemotherapy and radiation for locally advanced head and neck, cervical, esophageal, and non-small-cell lung cancers. Across the included trials, combined treatment was reported to provide better overall survival than radiation alone, but it also caused more severe short-term side effects. The review did not provide enough information in its abstract to show how many trials or patients were included.
Researchers pooled results from seven human studies comparing multiple-staged with single-stage removal and reconstruction of congenital melanocytic nevi, sometimes called congenital moles. Staged surgery was associated with fewer major wound complications and recurrences, as well as slightly shorter and narrower scars, but the studies did not find a clear difference in cosmetic or overall patient satisfaction.
A cluster-randomized human study in 210 adults with recently detected stage 1 hypertension in Uzbekistan compared salt-sensitivity testing followed by assigned medication choices with conventional management. After 12 weeks, more participants in the testing-guided group reached the study's blood pressure target, although the study was small, short, and conducted in only three primary care centers.
