Exploration of dietary diversity and its associated factors among infant and young children in Rural Tamil Nadu - A mixed-method study.

Background: A child receiving an acceptable diet is expected to reach the optimal anthropometric measures. More than 60% of dietary requirement has to be met through complimentary diet. Objectives: This aimed to estimate the prevalence of dietary diversity and to assess factors associated with it from caregivers' perceptions by quantitative and qualitative participatory techniques. Methods: A mixed-method study comprising community-based cross-sectional quantitative and participatory rural appraisal qualitative components was conducted in 25 villages from the field practice area of medical institute in South India during 2017. Caregivers of eligible children 6–23 months from villages were interviewed regarding various food groups consumed in the last 24 h using a validated checklist. Association of demographic-, child, and mother-related characteristics with inappropriate dietary diversity was identified using multivariate negative log-binomial model. Results: Of the 603 eligible children, 75.1% had inappropriate dietary diversity. Although inappropriate dietary diversity prevailed across all categories, mothers with less than primary education (adjusted prevalence ratio [PR]: 1.26) children <1 year (adjusted PR: 1.29) and not on current breastfeeding (adjusted PR: 1.15) had significantly more inappropriate diversity. Restraining and motivating forces for dietary diversity were initially recorded from free listing and subjected to force-field analysis. Ignorance, lack of literacy, affordability issues, nuclear family pattern, and influence of junk foods are restraining forces. Conclusion: Inappropriate dietary diversity among 6–23 months children in the rural block of Tamil Nadu, South India, is extensive (75%). Current Child development programs should focus to address these issues based on these identified contextual factors.