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Background: Inappropriate child feeding and caring practices are a major cause of malnutrition. To date, no studies have examined concordance and discordance of child feeding and preventive behavior and their predictors in developing countries. Methods: We used baseline data generated from A 2-year-longitudinal agriculture-nutrition panel survey conducted from February 9 to April 9, 2014, in nine districts encompassing 20 randomly selected counties in Oromiya Region and Southern Nation, Nationality and Peoples Region in Ethiopia. Households were recruited using the Expanded Program on Immunization sampling method. A total of 623 children under the age of 5 years and their respective caregivers were included in the analyses. Generalized estimating equations were used to account for clustered observations. Results: Concordance of poor child feeding and preventive behavior was observed in 45.1% of the children, while 45.5% of the children were suffering from discordance of poor child feeding and preventive behavior. Concordance and discordance of poor child feeding and preventive behavior had almost different predictors. Concordance of poor child feeding and preventive behavior was significantly associated with the age of the caretaker of ]40 years (odds ratio (OR)2.14; 95% confidence interval (CI): 1.04, 4.41), low household dietary diversity (OR3.69; 95% CI: 1.93, 7.04), medium household dietary diversity (OR2.17; 95% CI: 1.17, 4.00), severe household food insecurity (OR1.72; 95% CI: 1.01, 2.93), and increase with increasing child age. Conclusion: A substantial number of children in the southwest of rural Ethiopia are exposed to both poor child feeding and preventive behavior. Low household dietary diversity and extreme food insecurity household were predictors of concordance of poor child feeding and poor preventive behavior and provide useful entry points for comprehensive interventions to address child feeding and caring in the area.

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