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Gebremichael MA, Lema TB. Effect of behavior change communication through the health development army on birth weight of newborns in Ambo district, Ethiopia: a cluster randomized controlled community trial. BMC Womens Health 2024; 24:200. [PMID: 38532388 PMCID: PMC10964566 DOI: 10.1186/s12905-024-03009-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/01/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Poor behavior change communication on maternal nutrition and health throughout pregnancy is thought to be to blame for Ethiopia's high rate of low birthweight babies, and this has implications for neonatal morbidity and mortality. The effect of behavior change communication on birth weight in the study district was not examined. This study was to determine whether improving neonatal birthweight using nutrition and health behavior change communication (NHBCC) interventions was successful. METHODS A cluster randomized controlled trial was conducted in the Ambo district of Ethiopia from May 5, 2018-January 30, 2019. At the beginning of the study, 385 women in the 24 intervention groups and 385 women in the 24 control groups were recruited. In the intervention group, health development armies delivered the NHBCC core message every two weeks for four months by grouping pregnant women in specific clusters. Pregnant women in the control group received the routine treatment offered by the healthcare system during their ANC visits. Within 24 h of birth, the birthweights of 302 and 292 neonates in the intervention and control groups, respectively, were measured at the end point of the study. A binary generalized linear model analysis was employed. RESULT The control group had a larger absolute risk of neonates with low birthweight (0.188 vs. 0.079, p < 0.001) than the intervention group. Pregnant women in the intervention group had an absolute risk difference of 10.9% for low birthweight. Pregnant women who received the intervention were 62% less likely to have low-risk birthweight compared to pregnant women who were in the control group (ARR = 0.381, 95% CI: 0.271-0.737). CONCLUSION Nutrition and health behavior change Communication by health development armies improves birthweight. The findings demonstrated that to improve birthweight, NHBCC must be administered to pregnant women in groups via health development armies in their communities. TRIAL REGISTRATION NUMBER PACTR201805003366358.
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Affiliation(s)
- Mitsiwat Abebe Gebremichael
- Department of Public Health, College of Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia.
- Ambo University, P. O. Box 19, Ambo, Ethiopia.
| | - Tefera Belachew Lema
- Department of Nutrition and Dietetics, Faculty of Public health, Jimma University, Jimma, Ethiopia
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Uwase A, Nsereko E, Pillay N, Levin J. Dietary diversity and associated factors among pregnant women in the Southern Province of Rwanda: A facility-based cross-sectional study. PLoS One 2024; 19:e0297112. [PMID: 38394158 PMCID: PMC10889653 DOI: 10.1371/journal.pone.0297112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024] Open
Abstract
The inadequate dietary diversity of pregnant women in low- and middle-income countries, including Rwanda, is rising and leading to macro and micronutrient deficiencies. The extent of dietary diversity and the factors contributing to it are unknown in Rwanda. This cross-sectional study, with 612 women who attended antenatal care services in Rwanda's Southern Province, identified determinants of dietary diversity among pregnant women. A multistage sampling scheme was used in which four districts were sampled, thereafter one urban and one rural health centre was sampled in each district and finally, a systematic sample of pregnant women was selected in each sampled health centre. Dietary diversity was measured using Minimum Dietary Diversity for Women (MDD-W), and multiple logistic regression models were fitted to identify factors associated with dietary diversity. Only 44.1% (95% confidence interval (CI) of [40.1%, 48.0%]) of participants had adequate dietary diversity. Approximately 95.4% of participants consumed grains, white roots, and tubers. The food groups that were the least consumed consisted of eggs (n = 99, 16.4%), as well as those consisting of milk and milk products (n = 112, 18.5%). The factors which were positively associated with dietary diversity were owning a radio (adjusted odds ratio [aOR] = 1.90 [95% CI 1.27, 2.85]), maternal education (aOR = 1.85 [95% CI 1.28, 2.65]), having a kitchen garden (aOR = 1.69 [95% CI 1.11, 2.57]) and nutrition knowledge score (aOR = 1.45 [95% CI 1.21, 1.74]) for a five-point increase in nutrition knowledge score. The factors negatively associated with dietary diversity include food insecurity, which reduced the odds of dietary diversity (aOR = 0.19 [0.07, 0.50]) per five-unit increase in food insecurity. Furthermore, the odds of adequate dietary diversity were lower among urban residents than rural residents (aOR = 0.69 [0.47, 1.03]). The household size was associated with dietary diversity with the odds of dietary diversity decreasing by 12% for a five-unit increase in household size (aOR = 0.88 [0.79; 0.99]). 23% had poor nutritional status, indicated by their mid-upper arm circumference (MUAC; < 23 cm). Enhanced nutritional education is needed to improve the nutritional knowledge of this population with particular emphasis on the consumption of animal-source foods. Sensitisation activities promoting ownership of kitchen gardens and radios could improve dietary diversity among Rwanda's pregnant women.
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Affiliation(s)
- Aline Uwase
- University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Etienne Nsereko
- University of Rwanda College of Medicine and Health Sciences, Kigali, Rwanda
| | - Nirvana Pillay
- University of Witwatersrand School of Public Health, Johannesburg, South Africa
| | - Jonathan Levin
- University of Witwatersrand School of Public Health, Pretoria, South Africa
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Heri R, Malqvist M, Yahya-Malima KI, Mselle LT. Dietary diversity and associated factors among women attending antenatal clinics in the coast region of Tanzania. BMC Nutr 2024; 10:16. [PMID: 38254189 PMCID: PMC10801968 DOI: 10.1186/s40795-024-00825-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND Antenatal care (ANC) is crucial for reducing maternal morbidity and mortality, especially in low-resource settings. During antenatal care, women are provided with resources for enhancing their dietary diversity, like nutrition education and counseling. Improved nutrition knowledge influences positive nutritional behavior change, like women's improved dietary diversity, which may increase the likelihood of a healthier pregnancy and delivery experience. OBJECTIVE This study aim was to assess dietary diversity and associated factors among pregnant women attending antenatal care in the Coast region of Tanzania. METHODS The descriptive cross-sectional study design was used to assess dietary diversity and associated factors among 338 pregnant women. A semi-structured questionnaire collected information from pregnant women on social demographic characteristics, nutrition knowledge and dietary diversity. Women were classified as having a varied diet if they had consumed at least five of the ten food groups over the previous twenty-four hours. Multivariable logistic regression analyses were used to identify predictors of dietary diversity in pregnant women. RESULTS Only 28% (95% CI: 23.5-33.1) (n = 95) of pregnant women met the minimum dietary diversity, and 18% (95% CI: 13.8-21.9) (n = 59) were considered to have a high level of nutrition knowledge. Living near a health facility (AOR = 1.77, CI 1.02, 3.06), having high nutrition knowledge (AOR = 2.58, 95% CI: 1.36, 4.89), and being pregnant for the first time (AOR = 2.44, 95% CI: 1.09, 5.44) were associated with adequate dietary diversity. CONCLUSION Pregnant women in the study were found to have low knowledge about nutrition and inadequate dietary diversity intake. The findings underscore the need to improve nutrition knowledge provision in antenatal clinics by emphasizing the importance of a diversified and high-quality diet. Healthcare providers in antenatal care clinics should consistently provide nutrition education and counseling to pregnant women and promote their diversified food consumption. Such knowledge may eventually promote healthier pregnancy and child development by curbing the nutritional deficiencies experienced during pregnancy.
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Affiliation(s)
- Rashidi Heri
- Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - Mats Malqvist
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Khadija I Yahya-Malima
- Department of Nursing Management, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lilian Teddy Mselle
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Beressa G, Whiting SJ, Belachew T. Effect of nutrition education integrating the health belief model and theory of planned behavior on dietary diversity of pregnant women in Southeast Ethiopia: a cluster randomized controlled trial. Nutr J 2024; 23:3. [PMID: 38166908 PMCID: PMC10763129 DOI: 10.1186/s12937-023-00907-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/17/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Maternal anemia, miscarriage, low birth weight (LBW), preterm birth (PTB), intrauterine growth restriction (IUGR), prenatal and infant mortality, morbidity, and the risk of chronic disease later in life are all increased by a lack of dietary diversity during pregnancy. However, evidence for the effect of nutrition education on the dietary diversity score (DDS) among pregnant women was sparse in Ethiopia, particularly in the study areas. This study aimed to assess the effect of nutrition education on dietary diversity among pregnant women in urban settings in Southeast Ethiopia. METHODS A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention group and 223 control group) at health facilities from February to December 2021. A multistage cluster sampling technique, followed by systematic sampling, was used to select the pregnant women. Pregnant women who participated in the interventions were given nutrition education starting at 16 weeks of gestation and continuing for 6 months. We used a pre-tested, interviewer-administered, structured questionnaire to collect the data. A 24-hour qualitative dietary recall was used to calculate the dietary diversity score (DDS). A multivariable generalized estimating equation (GEE) model was conducted to evaluate the intervention effect. RESULTS After the intervention, the proportion of adequate dietary diversity was 14.15% higher in the intervention arm compared to the control group (45.09% versus 30.94%, P = 0.002). The overall difference in adequate dietary diversity between the two groups was 8.5%. After adjusting for background characteristics, the multivariable GEE binary logistic model revealed that having received intervention [(AOR = 1.89, 95% CI: 1.27, 2.79)], being literate [(AOR = 3.41, 95% CI: 1.13, 10.23)], and having high wealth [(AOR = 1.60, 95% CI: 1.09, 2.35)] significantly improved adequate dietary diversity. CONCLUSION The findings indicated that having received the intervention, being literate, and having a high level of wealth significantly improved maternal dietary diversity. Efforts should be made to increase nutrition education using the health belief model (HBM) and the theory of planned behavior (TPB). Moreover, there is a need to improve literacy and economic empowerment through income-generating activities to enhance adequate dietary diversification during pregnancy. TRIAL REGISTRATION Clinicaltrials.gov (PACTR202201731802989, Retrospectively registered on 24 January 2022).
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Affiliation(s)
- Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia.
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Tefera Belachew
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Mohammed F, Abdirizak N, Jibril A, Oumer A. Correlates of minimum dietary diversity among pregnant women on antenatal care follow up at public health facility in Puntland, Somalia. Sci Rep 2023; 13:21935. [PMID: 38081930 PMCID: PMC10713561 DOI: 10.1038/s41598-023-48983-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
In Somalia, where a poorly diversified diet is leading to adverse pregnancy and neonatal outcomes, there is a significant dearth of evidence that needs to be studied. Hence, this study was to identify factors associated with minimum dietary diversity among pregnant women in Somalia. A facility-based survey was conducted among 361 pregnant women attending antenatal care (ANC) using a structured questionnaire. Dietary diversity was measured using consumption of 10-food groups. Bivariable and multivariable binary logistic regression analyses were used, along with odds ratios and 95% confidence intervals. About 48.2% (42.9-53.5) of women had an inadequately diversified diet. The risk of having an inadequately diversified diet was higher among rural residents (AOR = 1.20; 0.30-4.75), multigravida (AOR = 2.85; 1.43-5.68), young women (AOR = 2.15; 0.82-5.61), extended families (AOR = 1.19; 0.68-2.10), with infrequent ANC visits (AOR = 4.12; 2.06-8.27), fewer frequent meals (AOR = 1.84; 1.09-3.10) and from food-insecure households (AOR = 3.84; 2.28-6.49) as compared to their counterparts. Consumption of poorly diversified diet was prevalent and associated with dietary diversity was prevalent among women which could be strongly predicted by parity, ante-natal care and food security, which needs to be targeted for interventions.
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Affiliation(s)
- Feiruza Mohammed
- Faculty of Nutrition, University of Health Science, Bossaso, Puntland, Somalia
| | | | - Abdulfetah Jibril
- United Nations High Commissioner for Refugees, Bossaso, Puntland, Somalia
| | - Abdu Oumer
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia.
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Haque S, Salman M, Rahman MS, Rahim ATM, Hoque MN. Mothers' dietary diversity and associated factors in megacity Dhaka, Bangladesh. Heliyon 2023; 9:e19117. [PMID: 37636472 PMCID: PMC10450986 DOI: 10.1016/j.heliyon.2023.e19117] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 08/07/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023] Open
Abstract
Mothers in developing countries are nutritionally vulnerable due to an undiversified diet. Dietary diversity and healthy dietary patterns of mothers are necessary for the health and nutrition of both the mother and the child. Keeping these in mind, the study was designed to investigate the determinants of mothers' dietary diversity in the capital city (Dhaka) of Bangladesh. A total 613 mothers who had at least one child aged 6-59 months were surveyed in 2020. Dietary diversity (DD) was measured by 24 h recall period following the established guidelines. To explore the determinants of dietary diversity, a log linear regression model was employed. The findings revealed that the overall DD of mothers was low, with less than 15% of respondents consuming more than 5 of the 9 food groups. The study found that if a mother receives one more year of formal education, her DD, on average, would increase by 0.70%. Receiving antenatal care (ANC) for four or more times during pregnancy increases DD by 5.13% compared to mothers who receive ANC less than four times. The findings also showed that mothers with access to assets have 10.18% higher DD than mothers without access to assets. On the other hand, mothers' employment status was negatively associated with DD. Redistributing the household workload between mother and other household members can play a critical role in increasing mothers' DD. Providing care facilities and counseling to mothers about the nutritional value of consuming different food groups can substantially improve the situation.
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Affiliation(s)
- Sadika Haque
- Department of Agricultural Economics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md Salman
- Department of Agricultural Economics, Bangladesh Agricultural University, Mymensingh, Bangladesh
| | - Md Sadique Rahman
- Department of Management and Finance, Sher-e-Bangla Agricultural University, Dhaka, Bangladesh
| | | | - Md Nazmul Hoque
- Students' Affairs Division, Bangladesh Agricultural University, Mymensingh, Bangladesh
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Kushi EN, Belachew T, Tamiru D. Antenatal care follow-up was significantly associated with a higher probability of high dietary diversity score among pregnant women in okra-producing areas of western Ethiopia: proportional odds model. Food Nutr Res 2023; 67:9608. [PMID: 37533449 PMCID: PMC10392863 DOI: 10.29219/fnr.v67.9608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. Objective This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. Design A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. Result This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. Conclusion More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial.
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Affiliation(s)
- Efrem Negash Kushi
- Department of Public Health, College of Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Tefera Belachew
- Departments of Nutrition and Dietetics, Public Health Institute, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Departments of Nutrition and Dietetics, Public Health Institute, Jimma University, Jimma, Ethiopia
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Seid A, Dugassa Fufa D, Weldeyohannes M, Tadesse Z, Fenta SL, Bitew ZW, Dessie G. Inadequate dietary diversity during pregnancy increases the risk of maternal anemia and low birth weight in Africa: A systematic review and meta-analysis. Food Sci Nutr 2023; 11:3706-3717. [PMID: 37457158 PMCID: PMC10345738 DOI: 10.1002/fsn3.3388] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/02/2023] [Accepted: 04/11/2023] [Indexed: 07/18/2023] Open
Abstract
Inadequately diversified food consumption during pregnancy can lead to micronutrient deficiencies, which can affect maternal and newborn health outcomes. Previous studies on maternal dietary diversity have either been limited to a specific geographical region or consist entirely of systematic reviews, without meta-analyses. Thus, this study aimed to determine the pooled estimate of the association between inadequate dietary diversity during pregnancy, maternal anemia, and low birth weight in Africa. A systematic review of observational studies published between January 2000 and April 2022 was undertaken using the Google Scholar, PubMed, and CINAHL databases. The PRISMA checklist was followed to present the results. Microsoft Excel was used to abstract the data. STATA version 17 was used to analyze the data, and a random-effects meta-analysis model was applied to compute the pooled estimates. The study was registered in PROSPERO with protocol number CRD42022320873. A total of 22 publications with 9,696 participants were included in the final meta-analysis. The pooled adjusted odds ratio (AOR) for inadequate dietary diversity and maternal anemia was 2.15 (95% CI, 1.66-2.65), while that for low birth weight was 2.04 (95% CI, 1.46-2.63). The highest pooled estimate of maternal anemia was reported in Cameroon (AOR = 9.8, 95% CI: 1.68-17.92), followed by Ethiopia (AOR = 2.6, 95% CI: 1.95-3.25). Similarly, the pooled estimates of low birth weight were highest in Cameroon (AOR = 3.04, 95% CI: 1.19-4.88) and Ethiopia (AOR = 1.8, 95% CI: 1.29-2.39). In Africa, pregnant mothers with inadequate dietary diversity are two times more likely to develop anemia and low birth weight. Social protection policies that prioritize pregnant women, maternal nutrition promotion in the community, and dietary counseling during antenatal care visits, using national food-based dietary guidelines, should be strengthened.
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Affiliation(s)
- Awole Seid
- Department of Adult Health NursingCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
| | - Desta Dugassa Fufa
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- Haramaya Institute of Technology, Haramaya UniversityDire DawaEthiopia
| | | | - Zuriyash Tadesse
- Department of Nutrition and DieteticsMekelle UniversityMekelleEthiopia
| | - Selamawit Lake Fenta
- Department of MidwiferyCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
| | - Zebenay Workneh Bitew
- Center for Food Sciences and NutritionAddis Ababa UniversityAddis AbabaEthiopia
- St. Paul Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Getenet Dessie
- Department of Adult Health NursingCollege of Medicine and Health Sciences, Bahir Dar UniversityBahir DarEthiopia
- National Center for Epidemiology and Population HealthAustralian National University, College of Health and MedicineAustralian Capital TerritoryCanberraAustralia
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Workneh F, Tsegaye S, Amanuel H, Eglovitch M, Shifraw T, Shiferie F, Tadesse AW, Worku A, Isanaka S, Lee ACC, Berhane Y. Dietary Perspectives and Practices during Pregnancy in Rural Amhara Region of Ethiopia: An Exploratory Qualitative Study. Curr Dev Nutr 2023; 7:100079. [PMID: 37250386 PMCID: PMC10209480 DOI: 10.1016/j.cdnut.2023.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Background Nutrition during pregnancy has lifelong impacts on the mother and fetus. In Ethiopia, nearly a third of pregnant women experience undernutrition. When designing nutrition interventions during pregnancy, it is important to understand existing dietary perspectives and practices in local communities. Objectives To explore the processes that shape dietary perspectives and practices during pregnancy in rural West Gojjam and South Gondar Zones of the Amhara region in Ethiopia. Methods From October to November 2018, we conducted 40 in-depth interviews with pregnant women (n = 16), family members (n = 12), and healthcare providers (n = 12) using a semistructured interview guide. Interviews were conducted in Amharic, transcribed in Amharic, and translated into English. We used a thematic analysis approach to organize data per the predefined topic areas and identify emerging themes, as well as barriers and enablers to healthy nutrition during pregnancy. Results Pregnant women and their family members recognized the benefits of a diversified diet to promote the health of the mother and the fetus. However, participants reported low dietary diversity because of limited access to nutritious foods and particular perspectives on food restrictions during pregnancy. The common practice of religious fasting also limited pregnant women's dietary intake. Women reported restricting their food intake in later pregnancy because of loss of appetite, as well as concerns about having a large infant, which might complicate delivery. Intake of locally made alcoholic drinks (Tella) was reported among pregnant women because participants thought it had low levels of alcohol that would not harm the fetus. Conclusions Although participants understood the importance of a healthy and diverse diet in pregnancy, we identified several barriers and perspectives regarding nutrition during pregnancy. Low income and lack of access to diverse foods, particularly in certain seasons, religious fasting, intentional food restrictions to limit the size of the infant, and alcohol use were commonly reported. Locally appropriate counseling and interventions should be developed, with an emphasis on increasing access to and consumption of diverse foods. Curr Dev Nutr 2023;x:xx.
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Affiliation(s)
- Firehiwot Workneh
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sitota Tsegaye
- Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Hanna Amanuel
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Michelle Eglovitch
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Tigest Shifraw
- Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Fisseha Shiferie
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Amare W. Tadesse
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sheila Isanaka
- Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Anne CC Lee
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Debela BG, Sisay D, Hareru HE, Ewune HA, Tesfa A, Shewaye DA, Ewunie TM. Food taboo practices and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Sci Rep 2023; 13:4376. [PMID: 36927859 PMCID: PMC10020167 DOI: 10.1038/s41598-023-30852-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Food taboos have a negative impact on pregnant women and their fetuses by preventing them from consuming vital foods. Previous research found that pregnant women avoided certain foods during their pregnancy for a variety of reasons. This review aimed to determine the pooled prevalence of food taboo practices and associated factors in Ethiopia. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, we searched the literature using PubMed/MEDLINE, AJOL (African Journal Online), HINARI, Science Direct, Google Scholar, and Google electronic databases. The random-effects model was used to estimate the pooled prevalence of food taboo and its determinants at a 95% confidence interval with their respective odds ratios. The pooled food taboo practice among Ethiopian pregnant women was 34.22% (95% CI 25.47-42.96), and after adjustment for publication bias with the trim-and-fill analysis, the pooled food taboo practice of pregnant women was changed to 21.31% (95% CI: 10.85-31.67%). Having less than a secondary education level (OR = 3.57; 95% CI 1.43-8.89), having no ANC follow-up (OR = 4.35; 95% CI 1.12-16.94), and being a rural resident (OR = 3.08; 95% CI 1.14-8.28) were the significant factors. Dairy products, some fruits, green leafy vegetables, meat, and honey are among the taboo foods. The most frequently stated reasons for this taboo practice were: fear of producing a big fetus, which is difficult during delivery; attachment to the fetus's body or head; and fear of fetal abnormality.
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Affiliation(s)
- Berhanu Gidisa Debela
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.
| | - Daniel Sisay
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Habtamu Endashaw Hareru
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Helen Ali Ewune
- Department of Human Nutrition, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Anene Tesfa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Daniel Alayu Shewaye
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Temesgen Muche Ewunie
- Department of Human Nutrition, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
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The assessment of dietary diversity score and associated factors among pregnant women of Batu district, Southern Ethiopia, 2021: a community-based cross-sectional study. Ann Med Surg (Lond) 2023; 85:383-389. [PMID: 36923764 PMCID: PMC10010828 DOI: 10.1097/ms9.0000000000000239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 01/02/2023] [Indexed: 03/18/2023] Open
Abstract
Malnutrition remains a global problem, particularly in sub-Saharan Africa, where Ethiopia is located. During pregnancy, inadequate nutritional diversification increases the risk of unfavorable maternal and fetal outcomes. Therefore, the aim of this study was to assess the dietary diversity score and associated factors among pregnant women in Batu district, Southern Ethiopia, in 2021. Methods A community-based cross-sectional study was conducted among randomly selected 594 pregnant women. Data were collected with a two-stage sampling technique through face-to-face interviews. The data were coded and entered into Statistical Package for the Social Sciences (SPSS) version 23. Bivariate and multivariable logistic regression analyses were applied to identify independent predictors of dietary diversity. Results The magnitude of the unmet minimum dietary diversity score among pregnant women was 356 (59.9%). Furthermore, pregnant women with no formal education [adjusted odds ratio (AOR)=3.46; 95% CI: 1.99, 5.66], poor by the wealth index (AOR=2.23, 95% CI: 1.33, 3.73), having five or more children (AOR=1.75, 95% CI: 1.14, 2.71), multigravida (AOR=2.18, 95% CI: 1.34, 3.56), and pregnant women from only male-headed households (AOR=4.46, 95% CI: 2.86, 6.94) were associated with an unmet minimum dietary diversity score among pregnant women. Conclusion The prevalence of unmet minimum dietary diversity scores among pregnant women was found to be high. Moreover, low dietary diversity was linked to pregnant women with no formal education, multigravida, having more than five family members, male-headed households, and being poor by household wealth. As a result, nutritional diversity education should be prioritized, and health experts should provide guidance on dietary diversity and family planning services.
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Sisay G, Tesfaye A. Effects of nutrition education and counseling intervention on maternal weight and obstetric outcomes among pregnant women of Gedeo Zone, Southern, Ethiopia: A cluster randomized control trial. Nutr Health 2023; 29:97-105. [PMID: 34775857 DOI: 10.1177/02601060211056745] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Due to the scarcity of intervention trials, especially in Ethiopia, the effect of nutrition education and counseling intervention on pregnancy outcomes is not well studied. Aim: To assess the effect of nutrition education and counseling on the outcomes of pregnancy among pregnant mothers in public health care institutions of Gedeo Zone, Southern, Ethiopia. Methods: A cluster randomized control trial study design was undertaken. Simple random sampling followed by cluster sampling was used to reach eligible study participants. A total sample of 235 (115 intervention vs.120 control group) pregnant women who followed anti-natal care service in public health facilities of Gedeo Zone was included in the study. Independent t-test was used to analyze the group difference for continuous variable and chi-square test for categorical variables. The post-intervention values between the two groups were compared using analysis of covariance by adjusting to baseline variable. Results: After nutrition education, pregnant women in the control group had less weight gain than in the intervention. The proportion of LBW neonate was 17.8% in the intervention group and 38.2% in the control group (P < 0.001). Multivariable logistic regression analysis showed that the risk of LBW in the control group was 2.43 more likely than in the intervention group (AOR = 2.43; 95% CI: (1.2, 4.92)). Conclusion: Nutrition education delivered to pregnant women during pregnancy could reduce maternal malnutrition and low birth weight. Recommendation: The intervention is easy to implement in the health facilities of Gedeo zone and would be implemented without delay to achieve the sustainable development goals.
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Affiliation(s)
- Gizaw Sisay
- Department of Public Health, 374327College of Medicine and Health Science, Dilla University, Ethiopia
| | - Adane Tesfaye
- Department of Human Nutrition, 374327College of Medicine and Health Science, Dilla University, Ethiopia
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Gudayu TW. Epidemiology of neonatal mortality: a spatial and multilevel analysis of the 2019 mini-Ethiopian demographic and health survey data. BMC Pediatr 2023; 23:26. [PMID: 36647037 PMCID: PMC9843859 DOI: 10.1186/s12887-023-03838-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Sub-Saharan African countries are a high-burden region of neonatal mortality and showed slow progress in its reduction. In developing countries, as long as the current trend of mortality persists, achieving a sustainable development target for neonatal mortality would be challenging. The aim of this study was to detect significant geographic areas and identify community and individual-level predictors of neonatal mortality in Ethiopia to draw attention to a policy. METHODS A weighted total sample of 24,136 mothers from the 2019 mini-Ethiopian demographic and health survey data were included in the analysis. Global Moran's I statistics was run to check the clustering of neonatal mortality and then kriging interpolation was done to predict the magnitude of neonatal mortality in Ethiopia. In addition, SaTScan analysis was also executed to identify hot spot clusters of neonatal mortality. Finally, a multilevel mixed-effect logistic regression model was used to identify community and individual-level predictors of early neonatal and neonatal mortality. RESULTS The lifetime early neonatal and neonatal mortality among mothers in Ethiopia was 5.08 (95% CI: 4.13-6.03) and 6.54 (5.55, 7.52) per 1000 births respectively. Neonatal mortality was spatially clustered in the country and the SaTScan analysis identified significant hotspot areas of neonatal mortality in the Amhara and Afar regions and some areas of the Somali and Oromia regions. Its predicted magnitude was > 8 per 1000 births in wide areas of the Amhara and Benishangul regions. A multilevel mixed-effect logistics regression analysis identified that a lower level of maternal education, being a twin neonate, and being a male neonate were predictors of both early neonatal and neonatal mortality. Whereas, the younger age of mothers predicted neonatal mortality. CONCLUSIONS Neonatal mortality in Ethiopia is geographically clustered and sociodemographic and obstetric factors played a significant role. Policy direction should focus on evidence-based practices like midwives-led community and facility-based continuum of care from preconception to postnatal periods to possibly reduce neonatal mortality.
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Affiliation(s)
- Temesgen Worku Gudayu
- grid.59547.3a0000 0000 8539 4635Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kundu S, Das P, Rahman MA, Al Banna MH, Fatema K, Islam MA, Srivastava S, Muhammad T, Dey R, Hossain A. Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis. Sci Rep 2022; 12:21712. [PMID: 36522494 PMCID: PMC9755277 DOI: 10.1038/s41598-022-26305-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.
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Affiliation(s)
- Satyajit Kundu
- grid.443020.10000 0001 2295 3329Global Health Institute, North South University, Dhaka, 1229 Bangladesh ,grid.263826.b0000 0004 1761 0489School of Public Health, Southeast University, Nanjing, 210096 China ,grid.443081.a0000 0004 0489 3643Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Pranta Das
- grid.24434.350000 0004 1937 0060Department of Statistics, University of Nebraska–Lincoln, Lincoln, NE 68583-0963 USA ,grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Ashfikur Rahman
- grid.412118.f0000 0001 0441 1219Development Studies Discipline, Khulna University, Khulna, 9208 Bangladesh
| | - Md. Hasan Al Banna
- grid.443081.a0000 0004 0489 3643Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali, 8602 Bangladesh
| | - Kaniz Fatema
- grid.8198.80000 0001 1498 6059Department of Statistics, University of Dhaka, Dhaka, 1000 Bangladesh
| | - Md. Akhtarul Islam
- grid.412118.f0000 0001 0441 1219Statistics Discipline, Science Engineering & Technology School, Khulna University, Khulna, 9208 Bangladesh
| | - Shobhit Srivastava
- grid.419349.20000 0001 0613 2600Department of Survey Research and Data Analytics, International Institute for Population Sciences, Mumbai, 400088 India
| | - T. Muhammad
- grid.419349.20000 0001 0613 2600Department of Family & Generations, International Institute for Population Sciences, Mumbai, 400088 India
| | - Rakhi Dey
- grid.472353.40000 0004 4682 8196Department of Statistics, Government Brajalal College, National University of Bangladesh, Gazipur, 1704 Bangladesh
| | - Ahmed Hossain
- grid.412789.10000 0004 4686 5317College of Health Sciences, University of Sharjah, 27272 Sharjah, United Arab Emirates ,grid.443020.10000 0001 2295 3329Department of Public Health, North South University, Dhaka, 1229 Bangladesh
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Geta TG, Gebremedhin S, Omigbodun AO. Dietary Diversity Among Pregnant Women in Gurage Zone, South Central Ethiopia: Assessment Based on Longitudinal Repeated Measurement. Int J Womens Health 2022; 14:599-615. [PMID: 35497262 PMCID: PMC9048948 DOI: 10.2147/ijwh.s354536] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 04/12/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Dietary diversity is a key proxy indicator of nutrient adequacy; however, limited studies have been done on it among pregnant women in Ethiopia. The study aimed to examine the prevalence of sub-optimal dietary diversity and its associated factors among pregnant women in Gurage zone, South Central Ethiopia. Materials and Methods A mixed-method approach, a longitudinal study complemented with an exploratory qualitative study, was conducted. In the longitudinal study, a consecutively included sample of 668 pregnant women was followed in three rounds of survey. Dietary diversity was assessed using the minimum dietary diversity score for women (MDD-W) tool. The average of three dietary diversity scores was used to define overall diversity. Consuming less than 5 of 10 standard food groups was considered as suboptimal dietary diversity. Multivariable logistic regression analysis was used to identify predictors of suboptimal dietary diversity. Qualitative data were analysed using the thematic analysis method. Results During the 16 to 20, 28 to 29 and 36 to 37 weeks of gestation surveys, 75.0, 78.7 and 76.5% of the women had sub-optimal dietary diversity. In aggregate, 84.4% (95% CI: 81.6, 87.3) of the women had sub-optimal dietary diversity. Rural residents (AOR: 1.91, 95% CI: 1.01, 3.62), women with no formal education (AOR: 5.51, 95% CI: 1.96, 15.53) and from food insecure households (AOR: 2.44, 95% CI: 1.07, 5.59) had higher odds of suboptimal dietary diversity. Women with higher nutritional knowledge (AOR: 0.92, 95% CI: 0.87, 0.98) were less likely to have suboptimal dietary diversity. Food taboos, poor nutritional literacy and pregnancy complications were also reported as factors affecting dietary diversity. Conclusion Majority of pregnant women in the area had sub-optimal dietary diversity. Improving the socio-economic status and promoting nutrition knowledge may improve women’s dietary diversity.
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Affiliation(s)
- Teshome Gensa Geta
- Department of Biomedical Science, College of Medicine and Health Science, Wolkite University, Wolkite, Ethiopia.,Pan African University, Life and Earth Science Institutes (Including Health and Agriculture), Ibadan, Nigeria
| | - Samson Gebremedhin
- School of Public Health, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Akinyinka O Omigbodun
- Pan African University, Life and Earth Science Institutes (Including Health and Agriculture), Ibadan, Nigeria.,Department of Obstetrics & Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Tilahun AG, Kebede AM. Maternal minimum dietary diversity and associated factors among pregnant women, Southwest Ethiopia, 2021. BMC Nutr 2021; 7:66. [PMID: 34706770 PMCID: PMC8555354 DOI: 10.1186/s40795-021-00474-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 09/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inadequate dietary diversity intake during pregnancy increases risks of intrauterine growth restriction, abortion, low birth weight, preterm birth, prenatal and infant mortality,and morbidity and has long-lasting health impacts. Dietary diversity during pregnancy promotes the health status of the mother and her fetus. This study aimed to assess the magnitude of minimum dietary diversity and associated factors among pregnant women attending antenatal care. METHODS A facility-based cross-sectional study was conducted among 274 pregnant women who attended antenatal care at Wacha primary hospital from January to February 2021. A systematic sampling method was used to select the study participants. The data were collected through face-to-face interviews using a structured and semi-structured questionnaire. Bivariate logistic regression was done to identify factors associated with maternal dietary diversity. Finally, multivariate logistic regression was done, and variables that showed P values of < 0.05 were considered statistically significant. RESULT The magnitude of minimum dietary diversity was 51% (95% CI: 44.5, 56.7). The mean (±SD) minimum dietary diversity score was 4.5 (± 1.268) with a minimum of 1 anda maximum of 8 food groups consumed out of ten food groups. Age fewer than 25 years (AOR 4.649; 95% CI; 1.404, 15.396), and the age group between 25 to 34 years (AOR 3.624; 95% CI: 1.315, 10.269), husband age group of 26 to 34 years (AOR 2.238; 95% CI; 1.028,4.873), and 35 to 44 years (AOR 3.555; 95% CI; 1.228,10.292) and nutrition awareness of women (AOR 2.182; 95% CI; 1.243, 3.829) were significantly associated with minimum dietary diversity. CONCLUSION The consumption of minimum dietary diversity of the pregnant mothers was found to be low. Women aged less than 25 and age between 25 to 34 years, husband's age between 26 to 34 and 35 to 44 years, and nutrition awareness were the factors significantly associated with minimum dietary diversity. Therefore, providing nutrition education and counseling service warranted to promote maternal dietary diversity.
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Affiliation(s)
- Abel Girma Tilahun
- Department of Reproductive Health and Human Nutrition, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.
| | - Abebaw Molla Kebede
- Department of Reproductive Health and Human Nutrition, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Kuma MN, Tamiru D, Belachew T. Level and predictors of dietary diversity among pregnant women in rural South-West Ethiopia: a community-based cross-sectional study. BMJ Open 2021; 11:e055125. [PMID: 34697127 PMCID: PMC8547499 DOI: 10.1136/bmjopen-2021-055125] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the magnitude of dietary diversity and associated factors among pregnant women in the rural communities of Jimma Zone, south-west Ethiopia. DESIGN A community-based cross-sectional study was conducted from 1 June to 30 June 2020. SETTINGS The study was conducted in Seka Chekorsa and Mana districts. From a total of 63 listed kebeles, 21 were randomly selected. PARTICIPANTS Three hundred sixty first-trimester pregnant women have participated in this study. We used a systematic random sampling method to select the participants after a home-to-home census. PRIMARY AND SECONDARY OUTCOMES Dietary diversity was assessed using a 24 hours dietary recall method. Descriptive statistics were computed to describe the study subjects. Bivariate and multivariable logistic regression was run to control for all possible confounding effects and measure the strength of association between the outcome of interest and predictor. RESULTS The overall magnitude of adequate dietary diversity was found to be 186 (51.7%); 95% CI 46.1% to 56.4%). Having attended elementary education (adjusted OR (AOR)=2.45; 95% CI 1.33 to 4.51), completed grade 8 (AOR=6.05; 95% CI 2.65 to 13.80), attended high school (AOR=11.69; 95% CI 3.76 to 36.27), completed high school and above (AOR=2.92; 95% CI 1.16 to 7.32), husbands attended high school (AOR=2.92; 95% CI 1.15 to 7.47), family size of less than five (AOR=3.44; 95% CI to 1.77-6.66) were positively significantly associated with adequate dietary diversity. On the other hand, not had additional meal during pregnancy (AOR=0.42; 95% CI 0.21 to 0.83) was negatively associated with adequate dietary diversity. CONCLUSIONS We observed that the adequate dietary diversity score of pregnant women was low compared with the pooled proportion of dietary diversity conducted in Ethiopia. Therefore, strengthening and promoting female education through intersectoral collaborations and additional meal counselling during pregnancy is indispensable.
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Affiliation(s)
- Melesse Niguse Kuma
- Department of Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Oromia, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Oromia, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University College of Public Health and Medical Sciences, Jimma, Oromia, Ethiopia
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