Mothers' dietary diversity and associated factors in megacity Dhaka, Bangladesh

Undernutrition and dietary diversity score and associated factors among lactating mothers in Northwest Ethiopia

Background

Maternal undernutrition negatively influences both maternal and child health, as well as economic and social development. Limited research has been conducted on both the nutritional status and dietary diversity score among lactating mothers. Therefore, the present study aimed to determine the magnitudes of undernutrition and dietary diversity scores and their associated factors among lactating mothers in Bahir Dar City, Northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted from March to May 2021. Systematic random sampling and interview-administered questionnaires were employed. Dietary diversity score and nutritional status were measured using a 24-h recall and body mass index (BMI), respectively. Data entry and analysis were performed using EpiData version 3.02 and SPSS version 24 software, respectively. Both the bivariable and multivariable binary logistic regression analyses were performed, and the strength of association was measured in terms of odds ratio.

Results

The prevalence of undernutrition and low dietary diversity scores among respondents were 13.5% (95% CI; 10.4, 17.2) and 64.8% (95% CI, 60.0, 69.4), respectively. The significant factors for undernutrition were being young [AOR = 2.30, 95% CI (1.09, 5.43)], having low dietary diversity score [AOR = 2.26, 95% CI (1.01,5.10)], having poor nutritional knowledge [AOR = 2.56, 95% CI (1.03, 6.51)], meal frequency less or equal to 3 times per day [AOR = 4.06, 95% CI (0.71, 9.65)], educational status being primary school [AOR = 3.20, 95% CI (1.01, 9.11)], and educational status of husband being secondary school [AOR = 2.28, 95% CI (1.25, 8.53)]. Age between 20 and 30 years [AOR = 1.46, 95% CI (1.01, 2.48)], being food insecure [AOR = 3.41, 95% CI (1.21, 9.63)], and being poorest [AOR = 2.31, 95% CI (1.02, 5.32)] were associated with the dietary diversity score.

Conclusion

A high prevalence of undernutrition and low dietary diversity scores were recorded in the current study area. Age, educational status of lactating mothers and their husbands, nutritional knowledge, dietary diversity, and meal frequency were significant factors associated with undernutrition. Age, food security, and wealth index were associated with the dietary diversity score.

Factors associated with child and maternal dietary diversity in the urban areas of Bangladesh

Dietary diversity is an indicator of nutrition that has been found positively associated with diet quality, micronutrient adequacy, and improved maternal health and child growth. Due to the cultural responsibility of women in providing food at the household level, their status is very important to perform this role. Hence, this study has been conducted on the status of dietary diversity of the mother and child to understand how it relates to various factors of women in urban settings. Data were obtained from 1978 mother-child pairs living in different cities in Bangladesh. The foods taken by the women and children were categorized into 10 and 7 groups to measure women's dietary diversity (WDD) and children's dietary diversity (CDD), respectively. The study found that more than three-fourths of the mothers and half of the children had low dietary diversity. The household wealth holdings and access to resources by the women were found inadequate, while two-thirds of them had the lowest to medium level of nutritional knowledge. The binomial logistic regression model was used to measure the factors influencing WDD and CDD. The findings also indicated that children's dietary diversity was influenced by the mother's age, education, supportive attitude and behavior of husband, and access to and control over resources. While the household wealth index can enhance both child and mother's dietary variety, nutrition knowledge, dietary counseling, and access to and control over resources can improve maternal dietary diversity. This study recommends improving women's socioeconomic status by increasing their wealth and access to resources and enhancing their nutrition knowledge by providing food and nutrition counseling.