Browsing by Author "Baral, Dipesh"
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Publication Dietary Diversity and its Associated Factors among Children Aged 6-59 Months in Madhyapur Thimi Municipality, Nepal(Central Department of Public Health, 2025) Thapa, Abhishek; Baral, Dipesh; Dahal, Pragati; Kharel, Jiban; Dangal, Archana; Baral, Swastika; Thapa, Rupa; Paudel, Pratiksha; Khadka, RenuBackground: Minimum dietary diversity for children (MDD-C) is a benchmark developed by the World Health Organization (WHO) to assess diet diversity in infants and young children worldwide. The lack of such diet diversity among growing children, which often leads to malnutrition, has been considered a significant public health concern in Nepal. This study is to assess the dietary diversity and associated factors among children aged 6-59 months in wards 2 and 3 of Madhyapur Thimi Municipality. Methods: A cross-sectional descriptive study was carried out by measuring the research variables in 2023 among the residents of wards number 2 (Jatigaal) and 3 (Kaushaltar) of Madhyapur Thimi Municipality. The survey was created and administered by the researchers themselves. The sample size of the study was 385. The survey includes a structured questionnaire to assess dietary diversity and associated factors among children aged 6-59 months. The association between the factors was measured by using Fisher’s Exact test. Results: 73.5% of the study population fulfilled the minimum requirement of dietary diversity. Factors such as the mother’s educational status (p=0.002), mother’s ethnicity (p=0.015), monthly expenditure on food (p=0.001), awareness of communicable diseases (p=0.001), feeding times a day (p=0.001), personal hygiene practices status (p=0.004), and awareness of junk foods (p=0.001) showed a significant association with MDD-C. Conclusion: Increasing mothers’ awareness about junk food, communicable diseases, and the importance of their hygiene practices via formal or informal education campaigns is necessary to increase the proportion of children meeting the MDD-C benchmark and prevent malnutrition.Publication Ranking Predictors of Child Dietary Diversity in Nepal Using a Decision Tree(Public Health Concern Trust-Nepal (phect-NEPAL), 2025) Baral, Dipesh; Lama, Dindu; Dangal, Archana; Baral, Dinesh; Kharel, Jiban; Thapa, Abhishek; Dahal, Pragati; Baral, SwastikaAbstract: Introduction: Minimum dietary diversity among children (MDD-C) remains low in Nepal, contributing to persistent malnutrition. This study aimed to rank and characterize the association of dietary, socioeconomic, and health-related predictors of MDD-C among children aged 6–59 months in Madhyapur Thimi Municipality of Nepal. Method: A secondary analysis of survey data from 375 children was conducted. Chi-squared tests were used to identify baseline associations of the predictors with MDD-C. A Chi-squared Automatic Interaction Detection (CHAID) decision tree was then fitted to identify key split variables and interaction structures. A CHAID-based sensitivity analysis was used to estimate food groups’ contributions to predicted dietary adequacy by toggling individual food groups from absent to present. Bootstrap resampling was used to quantify the internal variability of these estimates. Result: Overall, 73.6% of children were predicted to achieve MDD-C. The decision tree placed other fruits and vegetables (Group G) at the root level, followed by splits on eggs (Group E), legumes and nuts (Group B), and vitamin A–rich foods (Group F). Sensitivity analysis suggested that enabling consumption of Group G or Group E was associated with the largest expected improvements in predicted dietary adequacy, and bootstrap resampling indicated that this ranking was relatively stable across resamples. Conclusion: This model-based analysis indicates that Group G and Group E foods are strong positive predictors of adequate dietary diversity and offer the largest expected gains among diet-deficient children. Hence, access to Group G and Group E foods could be prioritized as dietary interventions to improve child nutrition.