Minimum Acceptable Diet

Outcome

% of children 6–23 months of age who consumed a minimum acceptable diet during the previous day

This composite indicator assesses, at population level, the proportion of children aged 6–23 months whose feeding during the previous day met the minimum criteria for dietary diversity and meal frequency, with an additional milk-feeding criterion for non-breastfed children.

According to the WHO/UNICEF 2021 guidance (see below), the calculation of this indicator is different for breastfed and non-breastfed children:

Breastfed children: A breastfed child is considered to have consumed a minimum acceptable diet if, during the previous day, the child met both:

• the minimum dietary diversity criterion; and

• the minimum meal frequency criterion for their age.

Non-breastfed children: A non-breastfed child is considered to have consumed a minimum acceptable diet if, during the previous day, the child met all three:

• the minimum dietary diversity criterion;

• the minimum meal frequency criterion for their age; and

• the minimum milk feeding frequency criterion of at least two milk feeds.

Use the respective IndiKit guidance for Minimum Dietary Diversity, Minimum Meal Frequency and Minimum Milk Feeding Frequency to collect and calculate these component indicators.

To calculate the indicator's value:

• Add up the number of children aged 6–23 months who met the relevant minimum acceptable diet criteria according to their breastfeeding status.

• Divide this number by the total number of surveyed children aged 6–23 months.

• Multiply the result by 100 to convert it to a percentage.

For WHO/UNICEF-standard calculation, children with missing information required to meet a numerator criterion remain in the denominator but are not counted in the numerator. If information on current breastfeeding status is missing, classify the child as non-breastfed for the calculation. Follow the WHO/UNICEF 2021 guidance for the detailed coding of missing responses.

This data can be disaggregated by child sex and age group, and, if relevant and feasible, also by breastfeeding status, geographical area and household wealth. Consider age groups 6–11, 12–17 and 18–23 months where sample size is adequate; as a general rule, do not present subgroup estimates based on fewer than 25 unweighted children.

1) If the caregiver is taking care of two children aged 6 - 23 months (from the same household) and household sampling has been used, then data should be collected for both children. If a list method has been used and children have been identified as the primary sampling unit, then data should only be collected for the sampled child.

 

2) Feeding practices can vary by season. For comparisons over time, collect survey rounds in the same season and document major contextual factors that may have affected children’s diets.

3) For further guidance (including the recommended survey questions), please read the UNICEF/WHO 2021 guidance (see below).

 

4) Another way of presenting dietary diversity data is by using UNICEF’s concept of Child Food Poverty. According to UNICEF’s report (see below), if children are fed:

      - 0–2 food groups/day, they are living in severe child food poverty

      - 3–4 food groups/day, they are living in moderate child food poverty

      - 5 or more food groups/day, they are not living in child food poverty

 

5) Minimum Acceptable Diet is one of DG ECHO’s Key Outcome Indicators, phrased as “% of children aged 6–23 months in the target population who receive a minimum acceptable diet (MAD)”.

6) Minimum Acceptable Diet is a population-level indicator. Do not use it to screen, diagnose or target individual children.

Also consider using the following indicators:

• Minimum Dietary Diversity - Children (component of MAD and helps identify whether dietary diversity is the main gap)

• Minimum Meal Frequency (component of MAD and helps identify whether feeding frequency is the main gap)

• Minimum Milk Feeding Frequency for Non-Breastfed Children (required MAD component for non-breastfed children and helps identify milk-feeding gaps)