Determinants of Infant and Young Child Feeding (IYCF) Practices among Rohingya Refugees: A Mixed-methods Survey in Cox’s Bazar Camps, Bangladesh

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dc.contributor.authorTaslima, Arzuen_US
dc.contributor.authorSujan, MAKen_US
dc.contributor.authorBappy, SSen_US
dc.contributor.authorProsad, Ven_US
dc.contributor.authorToma, SD.en_US
dc.date.accessioned2025-08-13T10:17:47Z
dc.date.available2025-08-13T10:17:47Z
dc.date.issued2025-06
dc.description.abstractAim: The objective of the exercise was to determine the factors influencing infant and young child feeding practices among Rohingya communities and come up with ways to address them in areas where the nutrition-sensitive program is implemented. The findings would be used by the implementing partners to develop more effective, longer-term strategies for improvement and scale-up of IYCF–E program in the camps. Study Design: This study adopted a mixed-methods design to assess Infant and Young Child Feeding (IYCF) practices among Rohingya refugee communities. The study incorporated both quantitative data from cross-sectional household surveys (541 children surveyed from 531 households) to generate measurable indicator data and qualitative data from focus group discussions (FGDs) and Key Informants Interview (KII) to gain contextual insights into socio-cultural factors influencing feeding practices. Place and Duration of Study: The assessment was conducted in ten Rohingya camps (Camps 4, 5, 6, 8W, 10, 13, 14, 15, 16, and 22) within the Ukhiya and Teknaf sub-districts of Cox’s Bazar, where ongoing nutrition-specific and nutrition-sensitive programs are being implemented from July 26, 2023, to August 16, 2023 Methodology: A detailed monitoring exercise involved quantitative and qualitative methods of data collection. A formative questionnaire was developed targeting children aged 0-23 months, and as with all the questions on IYCF, the questionnaire was administered to primary caregivers, mainly the mothers of the children aged 0-23 months. Children aged 0 – 23 months were targeted specifically to find-out the proportion of children ever breastfed and timely initiation of breastfeeding in 0 – 23 months, exclusive breastfeeding (EBF) in 0 – 5 months, continuation of breastfeeding at one year and introduction of semi-solid, solid or soft food in 6 – 8 months. Other indicators were minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD) in 6 – 23 months. Result and Discussion: The findings from the assessment of breastfeeding and complementary feeding practices among the Rohingya communities in the refugee camps provide valuable insights and highlight both positive aspects and areas of concern. Quantitative results showed that children aged 0-23 months, 97.23% from Rohingya camps, were ever breastfed, which was a good indication of breastfeeding practices. It was also found that 84.1% of infants were introduced to breastmilk immediately after their birth (within 1 hour). Though the exclusive breastfeeding rate was 66.1% in the survey, it has improved from last year’s UNICEF-ACF IYCF survey (62.3%), and the continuation of breastfeeding up to 23 months was also high at 81.5% According to the survey findings, 78.05% of the camps surveyed children aged 6-8 months were timely introduced to complementary feeding in addition to breastmilk. 55.3% of the children from Rohingya camps aged 6-23 months were reported to have eaten at least five or more of the eight food groups within 24 hours, and 68.5% of caregivers of children maintained a minimum meal frequency. Finally, we found that 30.3 % of children 6-23 months fed with age-appropriate complementary feeding with minimum diversity and frequency of meals. However, caregivers during the focus group discussions reported that mothers who get pregnant while still breastfeeding usually stop breastfeeding the current child, even if this child is still at a recommended breastfeeding age. This practice is related to religious beliefs where breastfeeding while being pregnant is considered a sin among the religious communities, hence directly affecting the continued breastfeeding practices in communities where child spacing is not fully practiced. The qualitative results from the focus group discussions also indicate that caregivers have good knowledge of the timely introduction of complementary feeding. Nevertheless, the practices on the timely introduction of solid/semi-solid foods continue to be negatively affected by some social influence from family members like in-laws, grandmothers, and neighbors, hence resulting in either too early or too late introduction of solid/semi-solids before the 6th month after birth. The qualitative results from the conducted focus group discussions reveal that mothers have good knowledge of how often a child above 6 months should eat, but the actual practices do not always reflect this knowledge. Conclusion & Recommendation: This survey revealed strong cultural and religious influences on IYCF practices. Introducing pre-lacteal feeds was a common practice due to a strong cultural belief that giving honey, mustard seeds, and sugar/glucose water enhances the child’s lip movement and improves suckling. This has negatively affected exclusive breastfeeding for infants under six months. Mothers who reported giving birth at home due to cultural barriers were also deprived of the initial assistance and guidance provided by medical personnel regarding appropriate breastfeeding practices immediately after delivery at the health facility, or later during the 1000-day window of opportunity. Consequently, this negatively impacted the child's breastfeeding practices during the first two years of life. From both the quantitative and qualitative surveys, some short-term, medium-term term and long-term recommendations came out for nutrition-sensitive programming. Strengthening the community awareness interventions through training and engaging peer counsellors, mother-to-mother support groups, and community support groups to provide counselling and guidance to mothers in their communities on Infant and Young Child Feeding, including hygiene practices Scale up outreach activities through quality home visits, group meetings, growth monitoring sessions, and cooking sessions (i.e., Mukhe vat) for nutrition education and interpersonal communication to facilitate knowledge into optimal practices Ensure that monitoring, evaluation, and research are conducted regularly and are used to revise strategies and interventions for improving infant and young child feeding Pay special focus on nutrition-sensitive activities for minimizing economic barriers and ensuring the availability of a nutritious diet year-round, like income-generating activities, homestead gardening/ kitchen gardening, livestock rearing, etc., to meet the nutritional needs Promote gender equality and empower women in multi multi-sectoral approach to fight against malnutrition and improve IYCF-related decision-makingen_US
dc.identifier.affiliationsRohingya Response, Cox’s Bazar, Bangladeshen_US
dc.identifier.affiliationsGonoshasthaya Kendra, Cox’s Bazar, Bangladeshen_US
dc.identifier.affiliationsGonoshasthaya Kendra, Cox’s Bazar, Bangladeshen_US
dc.identifier.affiliationsGonoshasthaya Kendra, Cox’s Bazar, Bangladeshen_US
dc.identifier.affiliationsNutrition Sector, Cox’s Bazar, Bangladesh.en_US
dc.identifier.citationTaslima Arzu, Sujan MAK, Bappy SS, Prosad V, Toma SD.. Determinants of Infant and Young Child Feeding (IYCF) Practices among Rohingya Refugees: A Mixed-methods Survey in Cox’s Bazar Camps, Bangladesh . European Journal of Nutrition and Food Safety. 2025 Jun; 17(6): 338-351en_US
dc.identifier.issn2347-5641
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/253244
dc.languageenen_US
dc.publisherMs. M. B. Mondalen_US
dc.relation.issuenumber6en_US
dc.relation.volume17en_US
dc.source.urihttps://doi.org/10.9734/ejnfs/2025/v17i61761en_US
dc.subjectInfanten_US
dc.subjectyoung child feedingen_US
dc.subjectRohingya refugeesen_US
dc.subjectbreast-feedingen_US
dc.titleDeterminants of Infant and Young Child Feeding (IYCF) Practices among Rohingya Refugees: A Mixed-methods Survey in Cox’s Bazar Camps, Bangladeshen_US
dc.typeJournal Articleen_US
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