Minimum Meal Frequency 6-23 months (MMF)

What:   This indicator measures the proportion of children who consumed meals/snacks at least the recommended number of times.   Why: Feeding meals less frequently than recommended by WHO/UNICEF (see below) can compromise a child’s total energy and micronutrient intake, which in turn may cause growth faltering, stunting and micronutrient deficiencies resulting malnutrition. When: Which projects should use the indicator?  To measure the outcome of nutrition programs linked to MIYCF activities

Determine the indicator's value by using the following methodology: 

There are two main ways to determine the indicator’s value. Both require conducting individual interviews with the caregivers of a representative sample of children aged 6 - 23 months: 

1) Using Data from Measuring Dietary Diversity  

When measuring children’s dietary diversity (see guidance), the questionnaire recommended by WHO/UNICEF also records data on the number and type of meals / snacks. You can use this data to determine the indicator’s value (it is the easiest option).  

2) Asking Directly 

If you do not use the questionnaire mentioned above, you should then only use the following questions: 

Q1: Yesterday, during the day or at night, was [child’s name] given any breast milk? 

A1: yes / no / does not know 

Q2: Did [child’s name] consume any soft, semi-solid or solid food yesterday? (i.e. other than a fluid feed) 

A2: yes / no / does not know 

Q3: Can you please count how many times [child’s name] ate soft, semi-solid or solid food yesterday, during the entire day? 

A3: 

1) ..... meals / snacks 

2) does not know 

Count the number of surveyed children who met the minimal meal frequency, which WHO/UNICEF (see below) define as: 

  - two feedings of solid, semi-solid or soft foods for breastfed infants aged 6 - 8 months; 

  - three feedings of solid, semi-solid or soft foods for breastfed children aged 9 - 23 months; and 

  - four feedings of solid, semi-solid or soft foods or milk feeds for non-breastfed children aged 6 - 23 months whereby at least one of the four feeds must be a solid, semi-solid or soft food (i.e. non-fluid food). 

To calculate the indicator's value, divide the number of children aged 6 - 23 months who met the "minimum meal frequency" by the total number of surveyed children aged 6 - 23 months (excluding those where a "does not know" answer was provided). Multiply the result by 100 to convert it to a percentage. 

Disaggregate the data by gender, age group and wealth 

1) Meal frequency can be prone to seasonal differences (during the lean season, poor households commonly reduce the number of meals eaten). Do your best to collect baseline and endline data from the same times of year; otherwise, you will receive two sets of data which are not comparable. Avoid collecting data during the fasting periods (such as pre-Easter or Ramadan) and during the fasting days. 

2) Prior to asking the questions above, the questionnaire should ask whether yesterday was a special day when the child ate more or less than usual (e.g. a celebration) – if so, the enumerators should not proceed with collecting the data as it is not likely to reflect a typical diet.  

3) This indicator relies on accurate age assessment. Since people often do not remember the exact dates of their children’s birth, the data collectors should always verify the child’s age. This can be done by reviewing the child’s birth certificate, vaccination card or other document; however, since many caregivers do not have such documents (and since they can include mistakes), it is essential that your data collectors are able to verify the child’s age by using local events calendars. Read FAO’s Guidelines (see below) to learn how to prepare local events calendars and how to train data collectors in their correct use. 

4) Ensure that enumerators clearly understand and explain to the respondent that even snacks, such as fruit, need to be counted in.  

5) If the caregiver takes 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 identified as the primary sampling unit, then data should only be collected for the sampled child.