Patterns and predictors of infant and young child feeding practices among mothers of children aged 6-23 months in Plateau State, Nigeria: a mixed-methods comparison of nutrition intervention beneficiaries and non-beneficiaries.

BACKGROUND

Nigeria ranks second globally in the burden of stunted children, with 40% of children under five affected and poor infant and young child feeding (IYCF) practices as a primary contributor. This study assessed mothers' knowledge, attitudes, and feeding practices related to IYCF in Plateau State, Nigeria, comparing beneficiaries and non-beneficiaries of the Accelerating Nutrition Results in Nigeria (ANRiN) project, and identifying sociodemographic predictors associated with these outcomes.

METHODS

A mixed-methods cross-sectional design was employed. A total of 503 mothers of children aged 6-23 months completed structured questionnaires for quantitative analysis, while 8 focus group discussions and 12 key informant interviews provided qualitative data. Knowledge, attitude, and practice scores were computed with categorization (adequate/inadequate, positive/negative, good/poor). Data were analyzed using chi-square tests, independent t-tests, and multivariable logistic regression stratified by beneficiary status.

RESULTS

The overall prevalence of adequate knowledge was 21.1%, positive attitudes 91.4%, and good feeding practices 55.7%. Beneficiaries demonstrated significantly better practice scores than non-beneficiaries (mean 6.95 ± 1.42 vs. 6.34 ± 1.57, p < 0.001), while non-beneficiaries showed slightly higher attitude scores (3.68 ± 0.64 vs. 3.52 ± 0.77, p = 0.012). No significant difference in knowledge scores was observed. Maternal tertiary education was significantly associated with adequate knowledge in both groups (p < 0.01), while healthcare provider information was the strongest predictor of knowledge and attitudes among beneficiaries (p < 0.001 and p = 0.019, respectively). Qualitative findings identified poverty, food insecurity, and cultural norms as barriers to applying knowledge, while hands-on food demonstrations improved practical skills.

CONCLUSION

The study highlights a persistent knowledge-practice gap and demonstrates that ANRiN participation is associated with improved feeding practices. The distinct predictors between beneficiaries and non-beneficiaries suggest that tailored interventions accounting for these differential factors could strengthen IYCF program effectiveness in Nigeria.