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Several indicators have been created by the WHO to assess feeding practices for young children in regions at risk for inadequacies [8, 9]. A minimum dietary diversity score is calculated as a proxy measure for micronutrient adequacy of the diet. Minimum meal frequency is used to assess the likelihood of adequate energy intakes. These scores together are used to calculate a minimum acceptable diet score [10]. These indicators are collected as part of Demographic and Health Surveys (DHS), funded by the US Agency for International Development (USAID) and the Multiple Indicator Cluster Surveys (MICS) from UNICEF. Table 1 shows the scores for these indicators for children 12–23 months old across 7 UNICEF-defined regions [10].

Diet quality indicators show wide variability by geographic region and by country (Table 1). Overall, in the region of West and Central Africa, only 21.1% of children 12–23 months old reach minimum dietary diversity, and more than half of the countries in that region had less than 10% that met the minimum diversity score. In contrast, an average of 64.4% of children 12–23 months old in countries in Latin America and the Caribbean achieved the minimum diet diversity score. The average would have been >68% without Haiti, which suffered the aftermath from Hurricane Matthew during their most recent survey (2016–2017), resulting in only 19.8% achieving the minimum diet diversity score. The percentage of children 12–23 months of age achieving the minimum feeding frequency ranged from 41.3% in Eastern and Southern Africa to 74.8% in Eastern Europe and Central Asia. However, the overall scores for minimum acceptable diet were much lower, ranging from 11.2 in West and Central Africa to 50.1% in Latin America and the Caribbean. These assessments are qualitative, not quantitative, so specific estimates of energy and nutrient intakes are not possible with these instruments.

Table 1. Percentage of children 12–23 months of age achieving minimum dietary diversity, minimum feeding frequency, and minimum acceptable diet scores by UNICEF region