Infant and Young Child Feeding (IYCF) Practices, Household Food Security and Nutritional Status of Under-five Children in Cox's Bazar, Bangladesh

This study was conducted among people in the two southern most sub-districts or Upazilas (Teknaf and Ukhiya) of Bangladesh. This area is known nationally and internationally for a number of reasons including the presence of Rohingya refugees, the longest sea beach in the world, the location of a crucial international border between Bangladesh and Myanmar, and its Rakhaine ethnic population. This study focuses on the host community people of these two Upazilas from a nutritional lens. Objectives of this study were to assess the socio-economic status, infant and young child feeding (IYCF) practices, household food security levels, hygiene, sanitation and healthcare seeking behavior, and also the nutritional status of children under-five among the population of Teknaf and Ukhiya Upazilas of Cox's Bazar, Bangladesh. The study employed a cross sectional approach. A total of 300 households with at least one 6-59 month old child were randomly selected by two stage cluster sampling in 2014. Data was collected through direct interviews with the participants using a semi-structured questionnaire. Analysis of the data was carried out using the Statistical Package for Social Sciences (version 16.0 SPSS Inc, Chicago, IL, USA) and Emergency Nutrition Assessment (ENA) software. Food security was measured by Household Food Insecurity Access Scale (HFIAS). The study found that 43.6% of the children were breastfed within 1 hour of birth, 41.9% of the children were exclusively breastfed up to six months, and the average duration of exclusive breastfeeding was 5.2 months. Age appropriate meal frequency was found inaccurate for 60.3% of the children aged 9-11 month. The rates of severe stunting, wasting, and underweight among the children were 16.0%, 3.0% and 14.6% respectively. Among the households, 46.9% were severely food insecure. It was found that household food insecurity was significantly associated with household income (p=0.000), maternal education (p=0.000), and stunting (p=0.005) and wasting (p=0.044) for children under-five. Overall IYCF practices, nutritional status of under-five children and household food security among the studied population were not at a satisfactory level and the status was lower than reference data for the same region.