Exploring Spatial variation and determinants of the Minimum Dietary Diversity among Children in Cambodia: A Multilevel Analysis Using Four Rounds of Demographic Health Survey (2005-2022)

Abstract

Abstract Nutritional security is fundamental for fostering the human capital development of nations and, hence, future prosperity and economic growth. The dietary diversity among children is a crucial factor influencing the nutritional status of the children; therefore, this paper uses data from five rounds of the Cambodia Demographic Health Survey spanning from 2005 to 2022 to examine the minimum dietary diversity among children aged 6–23 months. Multilevel binary regression model is used to evaluate the demographic variation such as age, sex, access to ante natal care and health services, wealth, mother education etc impact minimum dietary diversity and account for variations at the cluster and province levels. The result shows that nearly half of Cambodian children consistently lacked access to vitamin A-rich fruits and vegetables. Though the prevalence of inadequate minimum dietary diversity among children has significantly dropped from 76 percent in 2005 to 51 percent in 2021-22, it is still high and needs attention. A decomposition analysis were further used to understand the drivers of this temoparal change in diet diversity. The empirical result shows that clusters represented the most significant source of geographic variation regarding children’s dietary patterns, particularly with respect to all eight food groups and MDD. Nutritional policy should improve education and awareness, reduce socio-economic disparities, leverage media, and promote full antenatal care to improve diet diversity in Cambodia. Initiatives targeting the enhancement of insufficient minimum dietary diversity intake should encompass individual aspects and be customized to suit geographic and community settings.