{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T16:21:02Z","timestamp":1762273262792,"version":"3.37.3"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000200","name":"United States Agency for International Development","doi-asserted-by":"publisher","award":["AID-OAA-A-17-00018"],"award-info":[{"award-number":["AID-OAA-A-17-00018"]}],"id":[{"id":"10.13039\/100000200","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To identify potential gateway factors and behaviors that are associated with infant and young child feeding (IYCF) practices in the Maradi and Zinder regions of Niger through application of the Integrated Gateway Model.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We analyzed data from 2,727 married women of reproductive age including details on child feeding practices for their 2,551 children between the ages of 0 to 23 months. We assessed the association of three gateway behaviors (i.e., any antenatal care, facility delivery, and communication on nutrition practices) and gateway factors (i.e., behavioral determinants, exposure to information, decision-making agency, and woman\u2019s group participation) on four IYCF practices (i.e., early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency, and minimum dietary diversity) while controlling for age, parity, educational attainment, and household wealth.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We found antenatal care was associated with exclusive breastfeeding of children 0\u20135 months [adjusted odds ratio (aOR): 1.17 (95% confidence interval (CI): 1.03\u20131.33)], and minimum meal frequency of children 6\u201323 months [aOR: 1.10 (95% CI: 1.03\u20131.17)], and facility delivery was associated with early initiation of breastfeeding among children 0\u20135 months [aOR: 2.08 (95% CI: 1.39\u20133.12)]. We found negative associations with exclusive breastfeeding and communication on nutrition practices with husbands, family\/friends, and health workers. Exposure to nutrition messages through radio, women\u2019s groups participation, and with health workers was positively associated with minimum dietary diversity. Self-efficacy was positively associated with both early initiation of breastfeeding, exclusive breastfeeding among children 0\u20135 months and minimum dietary diversity among children 6\u201323 months. Women\u2019s agency was positively associated with early initiation of breastfeeding.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The association of antenatal care and facility delivery with child nutrition outcomes suggest intervening before a woman becomes pregnant or early in her pregnancy could improve nutrition outcomes. Programs strengthening the continuum of care should identify gateway behaviors to maximize adoption of priority health behaviors.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0297466","type":"journal-article","created":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T17:29:31Z","timestamp":1711992571000},"page":"e0297466","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Application of the integrated gateway model on child nutrition behaviors in Niger: An exploratory analysis"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5702-9328","authenticated-orcid":true,"given":"Leanne","family":"Dougherty","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaibou","family":"Dadi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,4,1]]},"reference":[{"key":"pone.0297466.ref001","unstructured":"UN Interagency Group for Child Mortality Estimation. 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