A meta-analysis of compliance with revised WHO-infant and young child feeding indicators in data generation

Background & aims: A comprehensive set of validated core infant and young child feeding (IYCF) indicators replaced the previous guideline and created a consensus on breastfeeding and complementary feeding indicators. It remains unknown how local studies have adopted these originally absent complementary feeding indicators in their data generation. The study is aimed to evaluate the level/rate of adoption of core complementary feeding (CF) indicators in Nigeria. Methods: Meta-analysis of literature on complementary feeding indicators utilized in Nigeria by peer-reviewed articles published from 2009-2019 was conducted. A bibliographic survey was carried out in several databases, review of abstracts and full texts followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Eligible peer-reviewed published studies were compared to the core CF indicators proposed by WHO in 2008. Data were analysed using SPSS version 25. Results: A total of 33 articles met the inclusion criteria. Majority (72.7%) of the peer-reviewed published studies failed to adopt a single core CF. Trends in the mean utilization of CF indicators revealed that recent studies published in 2015, 2016, 2017 and 2019 reported a mean utilization score of 0.4, 0.75, 1.33 and 1.50 out of an available 5 indicators respectively. A significant positive correlation between publication year and the number of indicators adopted (r = 0.48; p = 0.004) was observed. In comparison with standards, CF indicators such as the introduction of semi-solid foods and minimum meal frequency indicators though mentioned were inappropriately utilized by 75.8% and 36.4% of the reviewed studies as the required age and/or breastfeeding status were not considered. Conclusion: Slow but significant adoption of CF indicators overtime was reported in this study. Hence, there is need to ensure quick adoption of standard indicators/guidelines by local studies as this will promote the generation of pooled evidence.