Background/Objectives: Women of reproductive age in low-income countries are especially nutritionally vulnerable given the strain that pregnancy and lactation places on the body. The minimum dietary diversity for women of reproductive age (MDD-W) elaborated by FAO is a food group diversity indicator that has been shown to reflect micronutrient adequacy. The aim of this study was to assess diet diversification and its associated factors among mothers with young children.

Methods: It is a cross-sectional study conducted in Ampefy, Madagascar. Dietary diversity was determined using the MDD-W tool. Data were collected through face-to-face interviews using validated structured questionnaires, and anthropometric status was examined. The semi-structured, non-pre-tested questionnaire specifically designed for this study aimed to collect data on maternal education levels, attitudes towards antenatal care, dietary habits during pregnancy and breastfeeding, and the relationship between micronutrient intake adequacy, diet diversity, and sociodemographic variables. Frequencies and percentages were calculated, and the comparison of variables was performed between mothers with acceptable and unacceptable dietary diversity using the chi-square test for qualitative variables. A logistic regression analysis was also conducted.

Results: A total of 437 mothers with young children participated in the study, resulting in a response rate of 95.0%. The mean age of the participants was 25.84 years (SD = 6.30). In total, 144 (32.95%) of the women interviewed had consumed < 5 food groups in the 24 h before the interview and 293 (67.05%) had consumed #1 5 food groups. The profile associated with low bad dietary diversity included low education, no transport, homebirth not by personal choice, not breastfeeding within the first hour of birth, not breastfeed exclusively for 6 months, no dietary changes during pregnancy or lactation, and no use of folic acid supplements.

Conclusions/Recommendations: About a third of the population studied presented inadequate diet diversity and two thirds were underweight. These two markers denote that a significant part of the women present an inadequate nutritional status during a period where nutrition is critical. This study’s findings underscore the importance of providing nutrition information to women, in order to improve dietary diversity and overall maternal and child health. The results of this study may be useful in developing food-based dietary guidelines for use in locally organized nutrition education sessions targeted towards reducing the prevalence of stunting.

Funding: VI Call for Development Cooperation Projects of the Universitat de València, Grant/Award Number: 20220197.