The Association Between Dietary Diversity And Development Among Children Under 24 Months In Rural Uganda: Analysis Of A Cluster-Randomised Maternal Education Trial

Objective: To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children. Design: A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6-8 months with child development domains (communication, fine motor, gross motor, personal-social and problem solving) at 20-24 months of age. Setting: Rural areas in Kabale and Kisoro districts of south-western Uganda. Participants: Children under 24 months. Results: After multivariable analysis, DDS at 6-8 months were positively associated with normal fine motor skills development at 20-24 months (AOR = 1 center dot 18; 95 % CI 1 center dot 01, 1 center dot 37; P = 0 center dot 02). No significant association was found between DDS and other development domains. Children who were not ill at 6-8 months had higher odds of developing normal communication (AOR = 1 center dot 73; 95 % CI 1 center dot 08, 2 center dot 77) and gross motor (AOR = 1 center dot 91; 95 % CI 1 center dot 09, 3 center dot 36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0 center dot 58; 95 % CI 0 center dot 33, 0 center dot 98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0 center dot 05). Conclusions: We found an association between child DDS at 6-8 months and improvement in fine motor skills development at 20-24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20-24 months.