Nutrition Intervention Coverage and Inequities Along the Continuum of Care: Results from the Eighth Demographic and Health Survey in Six Sub-Saharan African Countries

Abstract

Many countries rely on national household surveys to monitor coverage of nutrition interventions. Following a multi-year consultative effort, 14 new and revised nutrition coverage indicators were included in the Round 8 Demographic and Health Survey (DHS-8) core questionnaire. These indicators were better aligned with international recommendations and generate actionable data for policy and programmatic decision making at national, subnational, and global levels. This analysis highlights their potential applications. We included six sub-Saharan African countries who collected and released DHS-8 datasets between January 2021 and June 2024 (Burkina Faso, Cote d'Ivoire, Ghana, Kenya, Mozambique, and Tanzania). We present weighted averages for all nutrition coverage indicators from pregnancy through young childhood by country and estimate inequities in coverage. Coverage of nutrition interventions provided during pregnancy, birth, and postnatal care was higher than during infancy and young childhood, with wide variation between and within countries. For the new indicators on prenatal counseling about breastfeeding and maternal diet, Ghana had the highest coverage (88% and 92%, respectively) and Mozambique the lowest (48% and 51%). Postnatal counseling about infant and young child feeding practices was universally lower, ranging from 12% in Mozambique to 50% in Ghana. Subnational region, wealth quartile, and maternal education were consistent drivers of inequity. The greatest differences in coverage were by subnational region, as high as 71 percentage points for coverage of height and weight measurement of young children in Kenya. The expanded DHS-8 nutrition indicators fill critical information gaps about coverage and inequalities in care.