In this secondary analysis of the 2016 EDHS, which included a total of 2861 children aged 6–23 months, 46.5% reported consuming any type of ASF in the day prior to the survey. This is similar to a recent survey in Ethiopia that found a slightly higher magnitude (51%) of ASF consumption [18]. A survey in Kenya reported that less than 30 and 10% of children consumed flesh foods and eggs, respectively [21]. The lower magnitude in the latter study could be due to the absence of information on dairy consumption.
Religion, number of household assets, number of livestock owned by a household, ownership of land usable for agriculture, and child age are the five variables that were significantly associated with the outcome variable.
Children from orthodox family had lower odds of ASF consumption compared to children from other religions. Not differently, a study that assessed ASF consumption by children from four regions of Ethiopia found a 30% lower consumption in children from Orthodox households than children from Muslim households [18]. Throughout the year, Ethiopian Orthodox Christians have seven official fasting periods; All Wednesday and Fridays, except for the 50 days after Easter, the Lenten fast of 55 days, the Nineveh fast of 3 days, the vigils, or gahad of Christmas and epiphany, the 14–44 days fast of the apostles, the 43 days of the fast of the prophets, and the 15 days fast of the assumption in august. The average person may fast about 180 days, refraining from consuming ASF including meat, eggs, and milk [22]. During these extended time periods, a person is expected not to consume any food of animal origin. Although children are not supposed to fast, the limited availability of ASFs in the households they live during such periods may affect their consumption of those foods. The other reason that could affect ASF consumption by children is fear of contamination of cooking utensils and violation of religious rules and procedures by caregivers [23]. Notwithstanding the above explanations, a recent report by Alive and Thrive on IYCF practices, beliefs, and influences in Tigray region discussed that some mothers reported unaffordability and unavailability of meat and chicken in the market in fasting periods [24]. This could be due to the fact that ASFs especially meat are scarce and more expensive particularly during long periods of fasting like Lent in Orthodox communities because fasting adults are unwilling to slaughter animals [25].
Besides, children from households with higher numbers of livestock showed higher ASF consumption. Other studies found similar findings. Compared to households that did not own a particular livestock group, consumption of ASF during the 30 days before the survey was found to be significantly higher in households that owned the livestock group from which the food was derived [26]. Besides, according to a study in rural Uganda, promoting (small) livestock ownership significantly increased dairy consumption [27]. Moreover, in a study in rural Nepal, even low levels of poultry and cattle ownership were respectively associated with higher consumption of eggs and dairy among young children [28]. Ownership of livestock is also a positive facilitator of child dietary diversity [29]. These findings support the argument that households are utilizing livestock for own consumption. Therefore, such a positive association between livestock ownership and ASF consumption should be maintained by addressing socio-cultural norms and practices towards motives of livestock keeping, promoting good livestock rearing practices, improving market access, and filling gaps on nutrition importance of ASFs [30]. This is especially important in Ethiopia, a country known as one of the owners of huge number of livestock in the world [31].
In contrast to the findings in our study, a study by Kobina et al. noted that household ownership of any livestock, but not poultry, was associated with decreased consumption of ASFs [32]. The reason for this difference could be the higher ownership of free-range poultry compared to other livestock and the relatively very low sample size in the Kobina et al. study. Similarly, a study in Luangwa Valley, Zambia, found no significant association between livestock ownership and ASF consumption [33].
In this presented study, ASF consumption increased by nearly 20% with a unit increase in the number of household assets. This is similar to a study done in Indonesia in which increased value of household assets was significantly associated with ASF consumption [34]. Economic capability of households possesses a great role in determining the likelihood of ASF consumption [35]. Households with a higher number of assets (electricity, a television, a radio, mobile/non-mobile telephone, a refrigerator, a table, a chair, a bed with a mattress (cotton/sponge/spring), an electric mitad (a grill or cooktop used for preparing injera or bread), and a kerosene lamp/pressure lamp) may have a better opportunity to prepare and present ASFs on their table for consumption.
This study showed higher odds of ASF consumption among children in higher age categories. Similarly, in their study about ASF and child stunting, Headey et al. witnessed that consumption of any ASF and only dairy (consumption of meat, eggs, and fish were similar across age groups) increased with age [36]. The reason could be that as age is increasing, it is more likely feeding skills are improved and caloric needs are increased.
Nevertheless, children from households that own land usable for agriculture showed lower ASF consumption. This is challenged by a recent report by food and agriculture organization which states that the ownership, including its quality, of agricultural land is a major positive determinant of the relationship between crop and livestock production [37]. The reason for this negative association could be the fact that more than 72% of households that own land usable for agriculture in this study lie within the three lowest wealth quintles (middle, poorer, and poorest). These households are more likely to sell and/or exchange any of their livestock for other necessary goods than using for own consumption. In such households, ASFs are considered as luxury foods and usually are only consumed during holidays and special events.
Strengths and limitations of the study
The main strength of this study is that it utilized a large sample size and that the sampling technique (especially the use of sampling weights) allowed every household to have equal probability of inclusion. The larger sample size proved important in maintaining the internal validity of the study by helping provide precise descriptive and analytic findings. The other strength is that the data in this study were collected from all the regions in Ethiopia, which makes generalizability of the findings forward.
The crosssectional design of this study means it doesn’t show any cause and effect relationship between the outcome variable and the explanatory variables. Additionally, lack of information on possible explanatory variables like food insecurity status of the households may have changed the picture of the current associations between the variables. Therefore, incorporating a household food insecurity access score in future studies can be crucial in identifying other unseen associations. Another possible limitation is that this study did not provide information on the amount and frequency of ASF consumption. The use of 24-h dietary recalls may not perefectly tell about the usual diets (i.e., by creating within-person error) leading to an attenuation bias [38]. Therefore, future similar studies should consider and try to address the points raised.