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Bayked EM, Yimer EM, Gelaw T, Mohammed AS, Mekonen NA. Dietary knowledge, attitude, practice, and associated factors among pregnant mothers in Ethiopia: a systematic review and meta-analysis. Front Public Health 2024; 12:1393764. [PMID: 39328997 PMCID: PMC11425043 DOI: 10.3389/fpubh.2024.1393764] [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: 02/29/2024] [Accepted: 05/31/2024] [Indexed: 09/28/2024] Open
Abstract
Background Despite global efforts, progress in reducing maternal malnutrition falls short of international goals, which is the same for Ethiopia, provided that studying dietary knowledge, attitude, and practice and their determinants is crucial to developing and implementing effective interventions, which this review tried to investigate in an Ethiopian context. Methods We searched on Scopus, HINARI, PubMed, and Google Scholar on January 3, 2024. We used the Joanna Briggs Institute's (JBI's) tools and the "preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement" to evaluate bias and frame the review, respectively. The data were analyzed using Stata 17. Certainty was assessed using sensitivity and subgroup analyses and the Luis Furuya-Kanamori (LFK) index. The random effects model was used to determine the effect estimates with a p value less than 0.05 and a 95% CI. Results The pooled good dietary knowledge, favorable attitude, and good practice were 48.0% (95% CI: 39.0-57.0%), 47.0% (95% CI: 38.0-55.0%), and 34.0% (95% CI: 28.0-40.0%), respectively. Knowledge and attitude had bidirectional relationships and were affected by sociodemographic variables and gynecological issues. The dietary practice was influenced by urban residency (OR = 6.68, 95% CI: 2.49-10.87), food security (OR = 3.51, 95% CI: 1.02-5.99), knowledge (OR = 4.53, 95% CI: 3.22-5.74), nutrition information (OR = 3.07, 95% CI: 1.13-5.02), attitude (OR = 2.32, 95% CI: 1.34-3.30), family support (OR = 2.14, 95% CI: 1.43-2.85), perceived severity of malnutrition (OR = 2.07, 95% CI: 1.82-2.31), and positive perception of dietary benefit (OR = 2.19, 95% CI: 1.56-2.82). Conclusion The good dietary practice was lower than the knowledge and the favorable attitude toward it. It was influenced by sociodemographic variables, income and wealth, knowledge and information, attitudes and intentions, gynecological and illness experiences, family support and decision-making, and expectations of nutrition outcomes and habits. Sociodemographic and gynecological issues were also found to influence both dietary knowledge and attitude, which were also found to have bidirectional relationships.Systematic review registration: PROSPERO identifier: CRD42023440688.
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Affiliation(s)
- Ewunetie Mekashaw Bayked
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Ebrahim M Yimer
- Department of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Tiruset Gelaw
- Department of Midwifery, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Abdu Seid Mohammed
- Department of Midwifery, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
| | - Nigusie Abebaw Mekonen
- Department of Midwifery, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, Ethiopia
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Bayih MT, Kassa AA, Demilew YM. Dietary practice and associated factors among elderly people in Northwest Ethiopia, 2022: Community based mixed design. PLoS One 2024; 19:e0307748. [PMID: 39190641 PMCID: PMC11349100 DOI: 10.1371/journal.pone.0307748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 07/10/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The planet's population is aging at an incredible speed. Poor dietary practices are a major problem among the elderly. However, literature is scarce on dietary practices among elders in the study area. Therefore, the results of this study may give information to decision-makers. OBJECTIVE This study aimed to assess dietary practices and associated factors among elderly people in Northwest Ethiopia, in 2022. METHODS A community-based mixed study design was employed among elderly people from May 20 to July 2, 2022. Systematic random sampling and purposive sampling techniques were used for selecting study participants in quantitative and qualitative studies, respectively. Data were collected using an interviewer-administered structured questionnaire for the quantitative part and an interview guide for the qualitative part. Binary logistic regression analysis was used. A P-value less than or equal to 0.05 was used to declare statistically significant variables. A crude odds ratio and an adjusted odds ratio with a 95% confidence interval were used to measure the strength of the association. Thematic analysis was used for qualitative data analysis. RESULTS A total of 422 participants were recruited for the study. Twenty-six in-depth interviews were done. The prevalence of adequate dietary practice was only 54.5% [95% CI: (49.8, 59.2)]. It was significantly associated with being aged between 65 to 74 years (AOR: 8.32; 95 CI: 3.9, 18.1), being aged between 75 to 84 years (AOR: 2.90; 95% CI: 1.1, 7.9), eating sometimes alone (AOR: 1.86; 95% CI: 1.03, 3.4), eating always with family members (AOR: 4.96; 95% CI: 2.6, 9.4), and food security (AOR: 3.13; 95% CI: 1.8, 5.4). Thematic analysis revealed three themes that interfere with the dietary practices of elders. A majority of in-depth interviewees mentioned that there were taboos and cultural beliefs which favor inadequate dietary practices of the elderly; the study participants reported that individual, economic, societal, and physiological factors are barriers affecting the dietary practices of the elderly, and all respondents have no experiences regarding elderly dietary practices. CONCLUSION The prevalence of adequate dietary practice was low. It was significantly associated with age, with whom feeding, and household food security status. Taboos and cultural beliefs, barriers, and experiences hampered the dietary practices of elders. Therefore, improving the dietary practices of elders focusing on advanced age, loneliness, food security, taboos, cultural beliefs, barriers, and experiences regarding dietary practices should be done.
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Affiliation(s)
- Mulat Tirfie Bayih
- School of Public Health, Department of Nutrition and Dietetics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Adane Ambaye Kassa
- School of Public Health, Department of Nutrition and Dietetics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yeshalem Mulugeta Demilew
- School of Public Health, Department of Nutrition and Dietetics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Mekonen H, Endalifer ML, Assaye BT. Maternal dietary diversity increases with women's high decision-making autonomy in Northwest Ethiopia, 2022. Heliyon 2024; 10:e31735. [PMID: 38845863 PMCID: PMC11153174 DOI: 10.1016/j.heliyon.2024.e31735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Background Dietary diversification is one of several approaches for improving micronutrient levels in women of reproductive age. Therefore, this study aimed to assess the magnitude of minimum dietary diversity among pregnant women, explore the association between women's decision-making autonomy and dietary diversity, and identify other potential determinants of dietary diversity in Northwest Ethiopia. Method A community-based cross-sectional study of 621 pregnant women was conducted from November 2022 to December 2022. A cluster random sampling technique was employed. A binary logistic regression model was used to explore the association between dietary diversity and women's decision-making autonomy. Adjusted odds ratios with 95 % CIs were estimated to identify factors associated with the dietary diversity of pregnant women, and they were considered to be statistically significant at a P-value <0.05. Results The minimum dietary diversity among pregnant women was 22.4 %. The study revealed a significant association between dietary diversity and women's decision-making autonomy (AOR: 2.82, 95 % CI: 1.73, 4.59; p value: 0.001). Primary education and above (AOR = 4.0, CI: 2.1, 7.67), monthly income 1000-2000 ETB (AOR = 4.46, CI: 2.53, 7.87) and >2000 ETB (AOR = 6.05, CI: 3.16, 11.59), having nutritional information (AOR = 2.15, CI: 1.32, 3.51), being food secure (AOR = 2.63, CI:1.6, 4.34), morbidity status (AOR: 0.278, CI: 0.14, 0.56), ANC visits one time (AOR = 2.08, CI = 1.003, 4.33) and two or three times (AOR = 2.45, CI: 1.15, 5.24) were potential predictors of pregnant women's dietary diversity. Conclusion Maternal dietary diversity was significantly associated with women's decision-making autonomy. Thus, the government should strengthen women's empowerment, rights, access to education, and economic opportunities.
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Affiliation(s)
- Habitamu Mekonen
- Department of Human Nutrition, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Melese Linger Endalifer
- Department of Human Nutrition, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bayou Tilahun Assaye
- Department of Health Informatics, College of Medicine and Health Science, Debre Markos University, Debre Markos, Ethiopia
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Sharma A, Chanda S, Porwal A, Wadhwa N, Santhanam D, Ranjan R, Shah H, Adyanthaya S, Meena R. Effect of social and behavioral change interventions on minimum dietary diversity among pregnant women and associated socio-economic inequality in Rajasthan, India. BMC Nutr 2024; 10:82. [PMID: 38845052 PMCID: PMC11154971 DOI: 10.1186/s40795-024-00887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Maternal dietary diversity is a key to improving the birth and child health outcomes. Besides socio-economic factors, the nutrition specific program- Social and Behavioural Change Communication (SBCC) interventions aimed to improve maternal dietary diversity has varied levels of impact on the socio-economic groups in poor resource setups. OBJECTIVE To measure the factors associated with the minimum dietary diversity (MDD) among pregnant women in selected districts of Rajasthan with special emphasis on the SBCC components. Additionally, it measures the socio-economic gaps in the behaviour of consumption of diversified diet during pregnancy. METHODS Data from a cross sectional survey of 6848 pregnant women, who have received a continuous SBCC counselling and registered under a state introduced conditional cash transfer program, during May to June, 2023, in five intervention districts -Banswara, Baran, Dunagrpur, Pratapgarh and Udaipur in Rajasthan was used. A 24 h recall based food consumption behaviour has been gathered to measure the MDD of pregnant women. Study has used descriptive statistics, multivariate regressions, and multivariate decomposition analysis to address the research objectives. RESULTS Study finds that only 55.2% of pregnant women are consuming diverse diet in the study duration with mean dietary diversity score is 4.8 (+/- 1.5). Logistic regression finds that SBCC components such as frontline workers (aOR = 1.3, CI: 1.1-1.4), community motivators (aOR = 1.9, CI: 1.7-2.1), and participation in MCHND (aOR = 1.0, CI: 0.9-1.2) have significant and higher likelihood on consumption of MDD food on previous day. A higher education and belonging from richer wealth quintile also show higher association for consumption of MDD. Multivariate decomposition shows, among richest and poorest wealth categories there is 19% point difference (58% difference due to coefficient vs. 42% difference due to composition) in MDD consumption. This is positively contributed by the caste and educational categories of women. CONCLUSION Despite a predominant vegetarian diet consuming population, better maternal dietary diversity was observed among those exposed to higher dose of SBCC intervention package. Educational status and caste of the respondent were significantly associated with minimum dietary diversity and contributed to the socio-economic inequality highlighting the importance of tailored and sustained SBCC interventions.
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Affiliation(s)
- Anshita Sharma
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India.
| | - Srei Chanda
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Akash Porwal
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Namita Wadhwa
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Divya Santhanam
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Raghwesh Ranjan
- Social and Economic Empowerment, IPE Global Limited, IPE Global Limited, Delhi, India
| | - Hemang Shah
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Shachi Adyanthaya
- Child Health and Development, Children's Investment Fund Foundation, Delhi, India
| | - Ramavatar Meena
- Directorate of Integrated Child Development Services, Jaipur, Rajasthan, India
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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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Tesfaye A, Adissu Y, Tamiru D, Belachew T. Nutritional knowledge, nutritional status and associated factors among pregnant adolescents in the West Arsi Zone, central Ethiopia. Sci Rep 2024; 14:6879. [PMID: 38519770 PMCID: PMC10959969 DOI: 10.1038/s41598-024-57428-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/18/2024] [Indexed: 03/25/2024] Open
Abstract
When pregnancy occur among teenagers; there is a competition for nutrients between the still-growing adolescent mother and her fetus. Pregnant adolescents' nutrition issues are not addressed well and changes are too slow in Ethiopia. This study aimed to study, nutrition knowledge, nutritional status and associated factors among pregnant adolescents in West Arsi , central Ethiopia. We conducted a cross-sectional study of 426 pregnant adolescents between January 1 and January 25, 2023. Data were collected using kobo collect and analyzed using SPSS version 25. We performed linear regression to identify independent predictors of nutritional status and multivariable logistic regression analyses to identify nutritional knowledge. Odds ratios (ORs) with 95% confidence intervals were estimated to show the strength of the association. Magnitude of good nutrition knowledge was 23.7%, 95% CI (21.4-25.3%), and the odds of having good nutrition knowledge was 7.5 times higher among participants whose education level was above college compared with illiterate participants [(AOR = 7.5, 95% CI = (5.27-9.38)],the odds of having good nutrition knowledge was 8 times higher among adolescent who had ANC visits, [(AOR = 8, 95% CI = (3.63-13.85)], and the odds of having good nutrition knowledge was 5 times higher among adolescents who received nutrition education [(AOR = 5, 95% CI = (3.67- 13.53)]. Receiving nutrition education (β = 0.25, P = 0.002) and good nutrition knowledge (β = 0.08, P < 0.001) were positively associated with nutritional status; however, food insecurity (β = - 0.93, P < 0.001) was negatively associated with nutritional status. The nutrition knowledge of pregnant adolescents was suboptimal; educational status, ANC visits and nutrition education were associated with good nutrition knowledge, whereas food insecurity, low nutrition knowledge, and not receiving nutrition education were predictors of poor nutritional status. Nutritional education interventions, increasing utilization of ANC, and interventions for improving food security are strongly recommended.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
| | - Yohannes Adissu
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Berihun GA, Tesfaye G, Adissu W, Tadasa E, Adamu K, Kombe AT, Gedefaw L. Prevalence and Associated Factors of Anemia among Newborns at Jimma Medical Center, South-west Ethiopia. J Blood Med 2024; 15:129-140. [PMID: 38510843 PMCID: PMC10950678 DOI: 10.2147/jbm.s443312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
Background Newborn anemia is among the most common hematological problems and it can cause asymptomatic or severe to acute life-threatening events. It leads to impairment in brain maturation and development, tissue hypoxia, and stunted growth and then arrested growth if left untreated. The prevalence of anemia among newborns ranges from 23.4-66% in sub-Saharan Africa. But, there is limited information in Ethiopia regarding the prevalence of newborn anemia and its risk factors. Therefore, this study aimed to determine the prevalence of newborn anemia and its associated factors at Jimma Medical Center (JMC), South-west Ethiopia. Methods A hospital-based cross-sectional study design was implemented from January 14 to February 28, 2021, involving 288 full-term newborns by employing consecutive convenient sampling technique for study participant selection. Socio-demographic data and other associated factors were collected through interviews and a review of medical records by a structured questionnaire. Three mL umbilical cord blood samples from each newborn were collected and analyzed for a complete blood count by an automated hematological analyzer. Data were entered into Epi Data version 3.1 and exported to Statistical Package for Social Science version 20 for analysis. Binary logistic regression were used to identify the predictors of newborn anemia. Results The overall prevalence of anemia among newborns was 26.4%; of them, 65.8%, 25%, and 9.2% were mild, moderate, and severe anemia types, respectively. Maternal vegetable consumption habit (AOR = 0.26, 95% CI: 0.11, 0.62) and maternal anemia (AOR = 0.34, 95% CI: 0.17, 0.69) were significantly associated with anemia in newborns. Conclusion In general, newborn anemia in this study was a moderate public health problem. Based on this study, early screening of anemia among newborns may reduce further complications. Prevention of maternal anemia during pregnancy by improving their nutritional status especially vegetable consumption had a positive impact on reducing anemia among newborns.
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Affiliation(s)
- Gebeyaw Arega Berihun
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Girum Tesfaye
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Wondimagegn Adissu
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Edosa Tadasa
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Kidist Adamu
- Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abinet Tantu Kombe
- School of Medical Laboratory Sciences, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Lealem Gedefaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Tesfaye A, Tamiru D, Belachew T. Effect of nutrition counseling on nutritional status and gestational weight gain of pregnant adolescents in West Arsi, Central Ethiopia: a cluster randomized controlled trial. Sci Rep 2024; 14:5070. [PMID: 38429426 PMCID: PMC10907709 DOI: 10.1038/s41598-024-55709-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 02/27/2024] [Indexed: 03/03/2024] Open
Abstract
When pregnancy occurs in adolescence, the growth and development of the mother and fetus may be impaired due to strong competition for nutrients between the still-growing adolescent and the fetus. Pregnant adolescents constitute an underserved population; they lack adequate nutritional knowledge. Therefore, this study investigated the effect of nutritional behavior change communication (NBCC) through alliance for development (AFD) on the nutritional status and gestational weight gain (GWG) of pregnant adolescents. A two-arm parallel cluster randomized controlled community trial was conducted in the West Arsi Zone, central Ethiopia, from August 2022 to July 2023. The nutritional status of the pregnant adolescent was assessed using mid-upper arm circumference. Weight was measured at baseline and at the end of the intervention. A total of 207 and 219 pregnant adolescents participated in the intervention and control clusters, respectively. The intervention started before 16 weeks of gestation, and the intervention group attended four NBCC sessions. The NBCC was based on the health belief model (HBM) and was given at the participants' homes with their husbands. The NBCC intervention was delivered by AFDs and community-level health actors. Pregnant adolescents in the control group received routine nutrition education from the health care system. A linear mixed-effects model and difference in difference (DID) were used to measure the intervention effect after adjusting for potential confounders. After the implementation of the trial, the mean mid-upper arm circumference (MUAC) in the intervention arm significantly increased from baseline (p ≤ 0.001), 23.19 ± 2.1 to 25.06 ± 2.9 among intervention group and 23.49 ± 2.1 to 23.56 ± 2.0 among control group and the mean difference in the MUAC (DID) was 1.89 ± 2 cm (p ≤ 0.001); the mean GWG in the intervention arm significantly increased from baseline; 51.54 ± 4.7 to 60.98 ± 4.6 among intervention group and 52.86 ± 5.27 to 58 ± 5.3 among control group; the mean GWG in the intervention group was 9.4 kg, and that in the control group was 5.14 kg, and the difference in difference was 4.23 kg and this was statically significant p ≤ 0.001). This study demonstrated that the use of the HBM for NBCC delivered through the AFD was effective at improving the nutritional status and GWG of pregnant adolescents. These results imply the need for the design of model-based nutritional counseling guidelines.Clinical trial registration: PACTR202203696996305, Pan African Clinical Trials Registry, date of first registration: 16/03/2022.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Science, Dilla University, Dilla, Ethiopia.
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Tesfaye A, Gerbaba M, Tamiru D, Belachew T. Inadequate dietary diversity practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia: a community-based cross-sectional study. Sci Rep 2024; 14:2871. [PMID: 38311634 PMCID: PMC10838914 DOI: 10.1038/s41598-024-53467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Mulusew Gerbaba
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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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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Tadesse E, Abdirahman I, Letta S, Kirby M, Mamo T, Metaferia H, Oranga B, Leight J. Barriers to appropriate complementary feeding and the use of ultra-processed foods: A formative qualitative study from rural Oromia, Ethiopia. MATERNAL & CHILD NUTRITION 2024; 20:e13576. [PMID: 38050343 PMCID: PMC10750006 DOI: 10.1111/mcn.13576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/29/2023] [Accepted: 10/02/2023] [Indexed: 12/06/2023]
Abstract
Children's consumption of ultra-processed foods (UPF) is increasing in Ethiopia, but relatively little is known about the specific feeding practices that underlie this pattern. The objective of this study was to explore patterns of consumption of UPF by infants and young children within a broader context of inappropriate complementary feeding practices in extremely poor households in rural Oromia, Eastern Ethiopia. A formative qualitative study was conducted using semistructured interview questionnaires developed drawing on a socioecological model. A total of 16 focus group discussions with mothers (45 respondents), fathers (21 respondents) and grandmothers (23 respondents) of children aged 6-23 months in households that were beneficiaries of the Productive Safety Net Program were conducted, along with four key informant interviews with health workers. Qualitative transcripts were complemented with field notes before qualitative content analysis was applied. The key findings suggest that UPF were widely provided to infants and young children as part of a pattern of suboptimal complementary feeding, including both early and late initiation of complementary foods. In particular, UPF (including juice, biscuits and lipid-based nutrient supplements) were diluted with or dissolved in water and fed to infants via bottle, often before the recommended age of initiation of 6 months. Mothers and caregivers reported that they perceived the products to be affordably priced and packaged, ready to use and convenient given their time constraints. The level of consumption of UPF and its effects on infant and young child feeding feeding practices and children's nutritional status in rural Ethiopia should be further explored.
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Affiliation(s)
- Elazar Tadesse
- Nutrition Department Menelik II Medical and Health Science CollegeAddis AbabaEthiopia
- Dunamis ConsultancyAddis AbabaEthiopia
- Department of Women's and Children Uppsala UniversityUppsalaSweden
| | - Ibrahim Abdirahman
- Department of Social Work, Faculty of Social SciencesArsi UniversityAselaEthiopia
| | - Shiferaw Letta
- Department of Nursing, College of Health Science and MedicineHaramaya UniversityHararEthiopia
| | | | | | | | | | - Jessica Leight
- Poverty, Gender and Inclusion UnitInternational Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
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Etea TD, Yalew AW, Sisay MM. Mediating effects of women's empowerment on dietary diversity during pregnancy in Central West Ethiopia: A structural equation modelling. Glob Health Action 2023; 16:2290303. [PMID: 38126365 PMCID: PMC10763841 DOI: 10.1080/16549716.2023.2290303] [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: 08/17/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Considerable proportions of pregnant women consume inadequately diversified diets in Ethiopia. On the other hand, women's empowerment is identified as a means of achieving maternal nutrition improvement. However, evidence on the relationship between multiple dimensions of women's empowerment and dietary diversity during pregnancy is limited in Ethiopia. OBJECTIVE This study aimed to assess the mediating effects of women's empowerment in the pathway between women's education and dietary diversity during pregnancy in West Shewa zone, Ethiopia. METHODS A health facility-based cross-sectional study was conducted among 1,383 pregnant women in 2021. Dietary diversity was measured using the minimum dietary diversity for women (MDD-W) tool. Exploratory and confirmatory factor analyses were employed to identify and validate women's empowerment dimensions. Structural equation modelling (SEM) was used to examine the pathways linking pregnant women's education and empowerment to dietary diversity during pregnancy. RESULTS From the latent dimensions of women's empowerment produced by factor analyses, pregnant women's education was directly associated with household decision-making power, psychological and time dimensions. In turn, household decision-making power, psychological and time dimensions were associated with dietary diversity during pregnancy. The direct relationship between pregnant women's education and dietary diversity was insignificant, but the total indirect effect and total effect were significant. Household decision-making power, psychological and time dimensions were significant mediators in the relationship between pregnant women's education and dietary diversity. However, economic dimension was related to neither pregnant women's education nor dietary diversity. CONCLUSION This study highlights pregnant women with better education are more likely to be empowered in household decision-making, psychological and time dimensions; and those empowered pregnant women are more likely to consume more diverse diets, suggesting women's access to higher education could have a positive indirect effect on consumption of more diverse diets during pregnancy by empowering women in the study area.
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Gebremichael MA, Lema TB. Prevalence and Predictors of Knowledge and Attitude on Optimal Nutrition and Health Among Pregnant Women in Their First Trimester of Pregnancy. Int J Womens Health 2023; 15:1383-1395. [PMID: 37692922 PMCID: PMC10487719 DOI: 10.2147/ijwh.s415615] [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: 04/03/2023] [Accepted: 08/30/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Evidence has demonstrated that knowledge and attitudes are indicators of nutrition and health modification among pregnant women. As a result, the objective of this study was to assess the prevalence and predictors of knowledge and attitudes about optimal nutrition and health among pregnant women in their first trimester of pregnancy. Methods A community-based cross-sectional study design was conducted between April 1 and June 1, 2018 among 750 pregnant women and sampled using the multi-stage sampling technique in the Ambo district of the West Shoa Zone, Ethiopia. Using a pre-tested, semi-structured questionnaire, data were gathered and analyzed using SPSS version 23. First, descriptive statistics were used, then bivariate and, finally, multivariable logistic regression analysis was used to assess the association of the predictors with the outcome variables. Results Overall, 33.3% and 31.3% of pregnant women had good knowledge and favorable attitudes about optimal nutrition and health, respectively. Residence, the woman's and her husband's educational status, having > five household members, being in rich households, taking distance to reach a health institution, being multiparous, having information, and receiving counseling were significantly associated with pregnant women's knowledge on optimal nutrition and health. Also, a favorable association was found between a woman's attitude toward optimal nutrition and health and her and her husband's educational status, household wealth status, and the distance traveled to a health facility. Conclusion The nutrition and health knowledge and attitudes of pregnant women in the study area were suboptimal. Improving knowledge and attitude during the first trimester of pregnancy is essential for suggesting nutrition and health-related behavior in the succeeding periods of pregnancy, which predominantly determine the pregnancy's outcomes.
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Affiliation(s)
| | - Tefera Belachew Lema
- Population and Family Health Department, Human Nutrition Unit, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia
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Hailu M, Mohammed A, Sintayehu Y, Tadesse D, Abera L, Abdurashid N, Solomon M, Ali M, Mellese D, Weldeamaniel T, Mengesha T, Hailemariyam T, Amsalu S, Dejene Y, Girma M. Cultural malpractice during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa city administration, Eastern Ethiopia, in 2021. Front Glob Womens Health 2023; 4:1131626. [PMID: 37664420 PMCID: PMC10469776 DOI: 10.3389/fgwh.2023.1131626] [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: 12/25/2022] [Accepted: 07/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background Cultural practices are any experiences or beliefs that are socially shared views and behaviors practiced in a certain society at a certain time. Cultural malpractices are defined as socially shared views and traditionally accepted behaviors experienced in a certain society that harm maternal health. Worldwide, the period of pregnancy, labor, and delivery is embedded with different beliefs, customs, and rituals in different societies that contribute a lot to maternal death. They are responsible for the annual deaths of 303,000 mothers and 2.7 million newborns globally. In developing countries, it accounts for approximately 5%-15% of maternal deaths. In Ethiopia, approximately 18% of infant deaths occur due to cultural malpractice, and 52% of pregnant mothers give birth at home following cultural customs in Dire Dawa city. The objective of this study was to assess cultural malpractices during pregnancy, childbirth, and the postnatal period and its associated factors among women who gave birth once in Dire Dawa City in 2021. Methods Community-based mixed study was conducted. A total of 624 study participants were selected through a systematic random sampling technique, and a purposive sampling method was used for qualitative data. The study was conducted in the randomly selected Kebeles of Dire Dawa City, Eastern Ethiopia, from November 1 to December 30, 2021. Data were entered into Epi Data version 4.1 and exported to SPSS version 24 for analysis. Bivariate and multivariate analyses were done, and the degree of association was measured by using the odds ratio with 95% CI and significance was declared at a p-value of <0.05. The qualitative data were analyzed thematically using ATLAS-ti version 7. Results The overall prevalence of cultural malpractice during pregnancy, childbirth, and the postnatal period was 74.6% [95% CI: 70.59%, 77.49%]. Women over the age of 35 were two times more likely [AOR 2.61, 95% CI, 1.45-4.72] to commit cultural malpractice than women aged 15-24 and 25-34. Those with no antenatal care (ANC) follow-up were three times more likely to commit cultural malpractice [AOR 3.57, 95% CI, 1.72-7.40], those who were absent from health education were nearly two times more likely to commit cultural malpractice [AOR 1.83, 95%CI, 1.25-2.67], and women whose culture allows harmful traditional practices were nearly two times more likely to commit cultural malpractices than their counterparts [AOR 1.69, 95%CI, 1.29-2.54]. Conclusion In this study, nearly three-fourths of participants were involved in cultural malpractices. Therefore, strengthening community education and behavioral change messages on the importance of ANC and avoiding unhealthy care during pregnancy, childbirth, postnatal and neonatal periods, especially with pregnancy at old age (age > 35), may help to reduce cultural malpractices.
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Affiliation(s)
- Mickiale Hailu
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Aminu Mohammed
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yitagesu Sintayehu
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Daniel Tadesse
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Legesse Abera
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Neil Abdurashid
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Milkiyas Solomon
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Momina Ali
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Dawit Mellese
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Tadesse Weldeamaniel
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Teshale Mengesha
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | | | - Sewmehon Amsalu
- College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Yesuneh Dejene
- College of Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Meklit Girma
- College of Health Sciences, Mekelle University, Mekelle, Ethiopia
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Alamirew SK, Lemke S, Stadlmayr B, Freyer B. Dietary Behaviour and Sociocultural Determinants of Dietary Diversity among Rural Women of Reproductive Age: A Case of Amhara Region, Ethiopia. Nutrients 2023; 15:3369. [PMID: 37571306 PMCID: PMC10420930 DOI: 10.3390/nu15153369] [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: 07/03/2023] [Revised: 07/21/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Women of reproductive age have specific nutritional requirements due to pregnancy and lactation. Little is known about the sociocultural determinants of dietary diversity among women of reproductive age. This study assesses trends of dietary behaviour and associated determinants of dietary diversity of women of reproductive age. A community-based cross-sectional study was conducted in the Amhara region of Ethiopia in 2019. Using multistage systematic random sampling, the dietary diversity of n = 421 women of reproductive age was assessed by a qualitative 24 h dietary recall. Descriptive analysis revealed characteristics of dietary behaviour and a chi-square test enabled the identification of associated determinants of women's dietary diversity. Only about a quarter (26.8%) of the women consumed five or more food groups per day and met the minimum dietary diversity score (MDD-W). Drawing on the socioecological framework, at an intrapersonal/individual level, women's education, age, perception of nutritious diet, and frequency of consumption of animal-sourced foods, vegetables, and fruit were significantly associated with MDD-W. At an interpersonal/household level, the husbands' education, women's decision-making regarding food purchase/consumption, the family's actual eating occasion, and women's engagement in domestic and farming tasks were significantly associated with MDD-W. At a community level, access to clean water and especially cultural beliefs were significant determinants of MDD-W. Amharic proverbs and sayings prioritise men and pose severe restrictions on women regarding food allocation. The majority (76.7%) of women of reproductive age practise frequent religious fasting, relating to the institutional/national level. This undermines efforts to support healthy dietary behaviour of women of reproductive age. Indepth studies on religious and cultural practices are needed, to assess not only their negative effects on the dietary diversity of women of reproductive age but also on women's lives.
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Affiliation(s)
- Simegn Kassa Alamirew
- Institute of Development Research (IDR), University of Natural Resources and Life Sciences, Vienna, 1190 Vienna, Austria; (S.L.); (B.S.)
| | - Stefanie Lemke
- Institute of Development Research (IDR), University of Natural Resources and Life Sciences, Vienna, 1190 Vienna, Austria; (S.L.); (B.S.)
| | - Barbara Stadlmayr
- Institute of Development Research (IDR), University of Natural Resources and Life Sciences, Vienna, 1190 Vienna, Austria; (S.L.); (B.S.)
| | - Bernhard Freyer
- Division of Organic Farming, University of Natural Resources and Life Sciences, Vienna, 1190 Vienna, Austria;
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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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Fite MB, Tura AK, Yadeta TA, Oljira L, Wilfong T, Mamme NY, Asefa G, Gurmu DB, Habtu W, Waka FC, Demiss NT, Woldeyohannes M, Tessema M, Alemayehu D, Hassen TA, Motuma A, Roba KT. Co-occurrence of iron, folate, and vitamin A deficiency among pregnant women in eastern Ethiopia: a community-based study. BMC Nutr 2023; 9:72. [PMID: 37353841 DOI: 10.1186/s40795-023-00724-x] [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: 12/09/2022] [Accepted: 06/09/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND It is well known that the magnitude of undernutrition in Ethiopia is unacceptably high. The burden of co-occurrence of iron, folate, and vitamin A deficiency, on the other hand, has received less attention. Thus, in this study, we looked at the prevalence of iron, folate, and vitamin A deficiency in pregnant women in eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among 397 pregnant women in Haramaya district, eastern Ethiopia. An interview-assisted questionnaire and blood serum were collected from pregnant women using standard techniques and shipped to an EPHI for micronutrient analysis. Factors associated with the co-occurrence of iron, folate, and vitamin A deficiency were identified using binary and multiple logistic regressions. RESULTS According to this study, 81.6% of the participants were deficient in at least one micronutrient, and 53.53.2% were deficient in two or more. Women who did not receive iron-folic acid supplementation (AOR = 2.44; 95% CI = 1.52-3.92), did not attend Antenatal care (ANC) follow up (AOR = 2.88; 95% CI = 1.81-4.61), and reported low consumption of diversified diet (AOR = 2.18 (95% CI = 1.35-3.51) had a higher risk of co-occurrence of iron, folate, and vitamin A deficiency. CONCLUSION This study found that more than half of pregnant women were in multiple micronutrients, indicating a major public health issue. In addition to the IFA supplementation programs that are already in place, there is a need for multiple micronutrient supplementation.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tara Wilfong
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Newas Yusuf Mamme
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gemechu Asefa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Demiraw Bikila Gurmu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Feyissa Challa Waka
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Nahom Tefera Demiss
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Meseret Woldeyohannes
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Masresha Tessema
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dawit Alemayehu
- Food Science and Nutrition Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Tahir Ahmed Hassen
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Aboma Motuma
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, 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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Leung T, Schoenmakers S, Willemsen S, van Rossem L, Dinnyes A, Rousian M, Steegers-Theunissen RP. The Effect of an eHealth Coaching Program (Smarter Pregnancy) on Attitudes and Practices Toward Periconception Lifestyle Behaviors in Women Attempting Pregnancy: Prospective Study. J Med Internet Res 2023; 25:e39321. [PMID: 36719733 PMCID: PMC9929732 DOI: 10.2196/39321] [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: 05/06/2022] [Revised: 10/03/2022] [Accepted: 11/25/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Lifestyle behaviors during the periconception period contribute to achievement of a successful pregnancy. Assessment of attitudes and practices toward these modifiable behaviors can aid in identifying gaps in unhealthy lifestyle behaviors with impact on intervention effectiveness. OBJECTIVE This study investigates the effectiveness of coaching by the eHealth program Smarter Pregnancy during the periconception period on improvement of attitudes and practices toward fruit and vegetable intake and smoking in women attempting pregnancy through assisted reproductive technology (ART) or natural conception. METHODS Women attempting pregnancy through ART (n=1060) or natural conception (n=631) were selected during the periconception period. The intervention groups, conceived through ART or naturally, received Smarter Pregnancy coaching for 24 weeks, whereas the control group conceived through ART and did not receive coaching. Attitudes and practices at baseline and follow-up periods were obtained from self-administered online questionnaire provided by the program. Attitudes were assessed in women with unhealthy behaviors as their intention to increase their fruit and vegetable intake and to quit smoking using a yes/no question. Outcomes on practices, suggesting effectiveness, included daily fruit (pieces) and vegetable (grams) intake, and if women smoked (yes/no). Changes in attitudes and practices were compared at 12 and 24 weeks with baseline between the ART intervention and ART control groups, and within the intervention groups between ART and natural conception. Changes in practices at 12 and 24 weeks were also compared with baseline between women with negative attitude and positive attitude within the intervention groups: ART and natural conception. Analysis was performed using linear and logistic regression models adjusted for maternal confounders and baseline attitudes and practices. RESULTS The ART intervention group showed higher vegetable intake and lower odds for negative attitudes toward vegetable intake after 12 weeks (βadj=25.72 g, P<.001; adjusted odds ratio [ORadj] 0.24, P<.001) and 24 weeks of coaching (βadj=23.84 g, P<.001; ORadj 0.28, P<.001) compared with ART controls. No statistically significant effect was observed on attitudes and practices toward fruit intake (12 weeks: P=.16 and .08, respectively; 24 weeks: P=.16 and .08, respectively) and smoking behavior (12 weeks: P=.87; 24 weeks: P=.92). No difference was observed for the studied attitudes and practices between the ART intervention and natural conception intervention groups. Women with persistent negative attitude toward fruit and vegetable intake at week 12 showed lower fruit and vegetable intake at week 24 compared with women with positive attitude (βadj=-.49, P<.001; βadj=-30.07, P<.001, respectively). CONCLUSIONS The eHealth Smarter Pregnancy program may improve vegetable intake-related attitudes and practices in women undergoing ART treatment. Women with no intention to increase fruit and vegetable intake had less improvement in their intakes. Despite small changes, this study demonstrates again that Smarter Pregnancy can be used to improve vegetable intake, which can complemented by blended care that combines face-to-face and online care to also improve fruit intake and smoking behavior.
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Affiliation(s)
| | - Sam Schoenmakers
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Sten Willemsen
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Lenie van Rossem
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
| | - Andras Dinnyes
- BioTalentum Ltd, Godollo, Hungary.,Department of Physiology and Animal Health, Institute of Physiology and Animal Nutrition, Hungarian University of Agriculture and Life Sciences, Godollo, Hungary
| | - Melek Rousian
- Department of Obstetrics and Gynecology, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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Mesfin BA, Argaw AT, Getahun Negash F, Emiru DA, Aserese AD, Matebe GY. Minimum Dietary Diversity and Associated Factors Among Pregnant Women Living in Arba Minch Health and Demographic Surveillance Sites, Southern Ethiopia, 2022. Health Serv Res Manag Epidemiol 2023; 10:23333928231166671. [PMID: 37122558 PMCID: PMC10134103 DOI: 10.1177/23333928231166671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 05/02/2023] Open
Abstract
Background Worldwide 1.2 billion women suffer from micronutrient deficiency. Feeding diversified foods during pregnancy prevents pregnancy complications such as severe anemia, low birth weight, and birth defects. However, the status of minimum dietary diversity and associated factors among pregnant women were not explored in the study area; therefore, this study was conducted at the Arba Minch Health and Demographic Surveillance Sites (AMHDSS). Method A community-based cross-sectional study was conducted from December 19, 2021, to October 30, 2022, on randomly selected 635 pregnant women. The data were collected through face-to-face interviews, and measurements of mid-upper arm circumference using a tablet; then exported to Statistical Package for Social Sciences version 25. Descriptive statistics were used to describe the characteristics of the study participants and presented by text, figures, and tables. Binary logistic regression was used to determine factors associated with pregnant women MDD-W. Independent variables with a P-value < .05 were considered as associated factors. Findings 98.2% of the pregnant women responded to this survey, more than half, (53.3%) of them achieved MDD-W, and 24.2% of the pregnant women were undernourished. The MDD-W was associated with household food security (AOR = 0.55, CI: .36, .83), meal frequency, (AOR = 1.62, CI: 1.1, 2.5), house ownership (AOR = 0.52, CI: .29, .9), ownership of banana farms (AOR = 1.7, CI: 1.02, 2.8), antenatal follow-up (ANC) (AOR = 1.9, CI: 1.1, 3.3), and occupational status (AOR = 6, CI: 2.1, 17.6). Conclusion The MDD-W outcome in this study was higher than that in other studies. The MDD-W is associated with, ANC follow-up, meal frequency, living in a food-secured household, ownership of a house, and pregnant women's merchant occupation. For optimal pregnancy outcomes; the AMHDSS and stakeholders might need to work in collaboration to increase ANC coverage and meal frequency for pregnant women. In addition, micronutrient supplementation, and increasing the availability/production capacity of food-insecure households are expected.
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Affiliation(s)
- Bezawit Afework Mesfin
- Department of Midwifery, Arba Minch University College of Medicine and Health Sciences, Arba Minch, Ethiopia
- Bezawit Afework Mesfin, Department of Midwifery, Arba Minch University College of Medicine and Health Sciences, Arba Minch, P.O. Box 21, Ethiopia.
| | - Abinet Teshome Argaw
- Department of Biomedical Sciences, Arba Minch University College of Medicine and Health Sciences, Arba Minch, Ethiopia
| | - Firdawek Getahun Negash
- Department of Epidemiology, Arba Minch University College of Medicine and Health Sciences School of Public Health, Arba Minch, Ethiopia
| | - Dagninet Alelign Emiru
- Department of Medical Laboratory Science, Arba Minch University College of Medicine and Health Sciences, Arba Minch, Ethiopia
| | - Adisalem Damtei Aserese
- School of Public Health Department of Human Nutrition, Arba Minch University College of Medicine and Health Sciences School of Public Health, Arba Minch, Ethiopia
| | - Girum Yihun Matebe
- Department of Health Economics, Addis Ababa University College of Health Sciences, School of Public Health, Arba Minch, Ethiopia
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Factors associated with undernutrition among pregnant women in Haramaya district, Eastern Ethiopia: A community-based study. PLoS One 2023; 18:e0282641. [PMID: 36893154 PMCID: PMC9997975 DOI: 10.1371/journal.pone.0282641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Although undernutrition in pregnancy has continued to get global attention as pregnancy is considered a critical period in the life cycle owed to increase the metabolic and physiological demands, evidence is scarce on undernutrition and associated factors among pregnant women in eastern Ethiopia. Therefore, this study assessed the undernutrition and associated factors among pregnant women in Haramaya district, Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-to-face interviews, anthropometric measurement, and hemoglobin analysis by trained research assistants. An adjusted Prevalence ratio (aPR), and a 95% confidence interval (CI), were used to report associations. Poisson regression analysis model with a robust variance estimate identified variables associated with undernutrition. Data were double entered using Epi-data 3.1 and cleaned, coded, checked for missing and outliers, and analyzed using Stata 14 (College Station, Texas 77845 USA. Finally, the p-value <0.05 was the cut-off point for the significant association. RESULTS A total of 448 pregnant women with a mean age of 25.68 (± 5.16) were included in the study. The prevalence of undernutrition among pregnant women was 47.9% (95% CI: 43%-53%). From the analysis, the undernutrition was more likely higher among respondents who had five or more family members (APR = 1.19; 95% CI = 1.02-1.40), lower dietary diversity (APR = 1.58; 95% CI = 1.13-2.21) and those who were anemic (APR = 4.27; 95% CI = 3.17-5.76). CONCLUSION Nearly half of the pregnant women in study area were undernourished. High prevalence was found among women who had large family sizes, low dietary diversity and anemia during pregnancy. Improving dietary diversity, strengthening family planning services and giving special attention to pregnant women, supplementation of iron and folic acid, and early detection and treatment of anemia is essential to improve the high burden of undernutrition and the adverse effect on pregnant women and the fetus.
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Wakwoya EB, Belachew T, Girma T. Determinants of nutritional status among pregnant women in East Shoa zone, Central Ethiopia. Front Nutr 2022; 9:958591. [PMID: 36590215 PMCID: PMC9797973 DOI: 10.3389/fnut.2022.958591] [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: 05/31/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Undernutrition is an insufficient intake of energy and nutrients to meet an individual's needs to maintain good health. Undernutrition during pregnancy severely affects the health of mothers and her baby. Globally it contributes directly or indirectly to 3.5 million maternal deaths annually. This study aimed to determine the level of undernutrition and identify factors associated with undernutrition among pregnant women attending public health facilities in the East Shoa Zone, Central Ethiopia. Methods Institution-based cross-sectional study was conducted among 472 randomly selected pregnant women from June to August 2021. Sociodemographic, obstetrics, and knowledge related data were collected using a structured interviewer-administered questionnaire, and maternal nutritional status was measured using the Mid Upper Arm Circumference (MUAC). The collected data were entered to EPI-info version 3.5.4 and then exported to SPSS for windows version 26.0 software for analysis. Multivariable regression analysis was fitted to identify determinants of undernutrition. An adjusted odds ratio with 95% confidence intervals and a p-value < 0.05 was considered a statistically significant. Results The prevalence of undernutrition among pregnant women was 13.9% [95% CI: 11.0-17.4]. On multivariable logistic regression model after adjusting background variables, wealth (AOR: 4.9, 95% CI 1.34-18.20), women's decision making power (AOR: 3.31, 95% CI 1.18-7.79), and nutritional counseling (AOR: 3.53, 95% CI 1.29-9.60) were independently associated with nutritional status of pregnant women. Conclusion Findings indicated that significant number of pregnant women in the study were undernourished. Higher wealth index, nutritional counseling, and women's decision-making power were inversely associated with undernutrition. The findings imply the need for economic empowerment of women, enhancing decision-making ability of women and routine and consistent nutritional counseling to decrease undernutrition among pregnant women.
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Affiliation(s)
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
- Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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Kebede AN, Sahile AT, Kelile BC. Dietary Diversity and Associated Factors Among Pregnant Women in Addis Ababa, Ethiopia, 2021. Int J Public Health 2022; 67:1605377. [PMID: 36405528 PMCID: PMC9668879 DOI: 10.3389/ijph.2022.1605377] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 10/25/2022] [Indexed: 08/04/2023] Open
Abstract
Objective: This study aimed to assess the dietary diversity and its associated factors among pregnant women in Addis Ababa, Ethiopia, 2021. Methods: An institution-based Cross-sectional was conducted among 320 participants from four health facilities in Addis Ababa selected based on a simple random sampling method from 01 September to 30 December 2021. An Interviewer-administered structured questionnaire was used, following informed consent. Binary (Bivariate and multivariate) logistics regression was applied for the identification factors associated with dietary diversity with their respective 95% confidence interval and less than 5% p-value. Results: The prevalence of inadequate dietary diversity during pregnancy was 51.6% (95% CI: 46.1%-57.0%). Being illiterate (AOR: 0.591; 95% CI: 1.88-1.901; p < 0.05) and primary education (AOR: 0.347; 95% CI: 0.166-0.728; p < 0.05), having poor knowledge (AOR: 0.437; 95% CI: 0.252-0.757; p < 0.05) and lower monthly income (AOR: 0.395; 95% CI: 0.184-0.845; p < 0.05) were factors associated with inadequate dietary diversity. Conclusion: A higher level of inadequate dietary diversity was reported. Being illiterate, having primary education, having poor knowledge, and having lower monthly income were associated with inadequate dietary diversity during pregnancy. Concerned bodies were suggested to work on the identified factors.
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Basu S, Rajeev A, Anand A, Hossain S, Singh MM. Calorie- and Protein-Deficient Diets Despite Adequate Dietary Diversity among Pregnant Women in a Low-Income Urban Area in Delhi, India. Indian J Community Med 2022; 47:609-612. [PMID: 36742950 PMCID: PMC9891045 DOI: 10.4103/ijcm.ijcm_48_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023] Open
Abstract
We interviewed 221 antenatal women in the second or third trimester of pregnancy attending a primary care antenatal clinic at a low-income area in Delhi, India, during 2019-20. The Minimum Dietary Diversity-Women (MDD-W) score for 10 food groups was calculated using the open recall method during a 24-h recall period. The median MDD-W score was 6 (IQR 4-7). Low dietary diversity (MDD-W <5) was observed in 65 (29.4%) participants. Low SES and higher age (≥25 years) were statistically significant predictors of lower dietary diversity, but it was unrelated to parity. Furthermore, protein deficit was observed in 185 (83.7%) and calorie deficit in 210 (95%) participants.
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Affiliation(s)
- Saurav Basu
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Anjali Rajeev
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Aanchal Anand
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Samar Hossain
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
| | - Mongjam M. Singh
- Department of Community Medicine, Maulana Azad Medical College, New Delhi, India
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Girma A, Genetu A, Ayalew E, Getachew D. Determinants of dietary practice among pregnant women at the public hospitals in Bench-Sheko and Kaffa Zones, Southwest Ethiopia. BMC Nutr 2022; 8:88. [PMID: 36002906 PMCID: PMC9400258 DOI: 10.1186/s40795-022-00588-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUNDS The frequency of poor dietary practice due to inappropriate dietary habits is higher during pregnancy compared to any other stage of the life cycle. Suboptimal dietary practices during pregnancy can increase the risk of intrauterine growth restriction, low birth weight, anemia, prenatal and infant mortality, and morbidity. Therefore, this study aimed to determine the dietary practice and associated factors among pregnant women at the public hospitals of Bench-Sheko and Kaffa zone. METHODOLOGY An institutional-based cross-sectional study design was conducted among 566 pregnant women who attended antenatal care at the public hospitals of the Bench-Sheko and Kaffa zones. A systematic random sampling technique was employed to select the study units. The data were entered into Epi Data 3.1 and exported to Statistical Package for Social Science (SPSS) version 21 software for further analysis. Both Binary and Multivariable logistic regression analyses were used to examine the association between dependent and independent variables. The Crude Odd Ratio (COR) and Adjusted Odd Ratio (AOR) with 95% Confidence interval (CI) were calculated and the variable with P-value < 0.05 was considered statistically significant. RESULT According to this study, only 23.7% (95% CI: 20.1, 27.4) of the study participants had a good dietary practice. The urban residents (AOR = 2.64; 95% CI:1.18, 5.92), monthly income of > 2000ETB (AOR = 2.47; 95% CI: 1.31,4.65), having nutrition information (AOR = 2.5; 95% CI: 1.14,5.52), good dietary knowledge (AOR = 2.79; 95% CI: 1.48,5.27), mothers occupation of employer (AOR = 1.88; 95% CI: 1.04,3.42) and a family size < 5 (AOR = 3.37; 95% CI: 1.32,8.65) were determinate of dietary practice. CONCLUSION Generally, the prevalence of good dietary practice is suboptimal in the study area. Urban residency, monthly income > 2000ETB, good dietary knowledge, having nutrition information, family size < 5, and government employed mothers were the predictors of the good dietary practice in the Bench-Sheko and Kaffa zone. Therefore, providing in-service training for health professionals and assigning nutritionist to each public hospital should be done to provide health and nutrition education; and strengthen the existed nutrition counseling service for pregnant women. Moreover, the government should create sustainable income-generating activities for pregnant women.
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Affiliation(s)
- Abel Girma
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.
| | - Amare Genetu
- Department of Midwifery, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Ermias Ayalew
- Departements of Nursing, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dawit Getachew
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Fite MB, Bikila D, Habtu W, Tura AK, Yadeta TA, Oljira L, Roba KT. Beyond hemoglobin: uncovering iron deficiency and iron deficiency anemia using serum ferritin concentration among pregnant women in eastern Ethiopia: a community-based study. BMC Nutr 2022; 8:82. [PMID: 35978383 PMCID: PMC9382738 DOI: 10.1186/s40795-022-00579-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the high burden of anemia among pregnant women in low-resource settings like Ethiopia is well documented, evidence is scarce on the underlying causes using biochemical tests. Therefore, this study assessed the iron status and factors associated with iron deficiency (ID) using serum ferritin concentration among pregnant women in Haramaya district, eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. The serum ferritin (SF) concentration was measured in the National Biochemical Laboratory of Ethiopia on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer using the electro-chemiluminescence (ECL) method and standard procedures. A log-binomial regression analysis identified variables associated with iron deficiency, and defined as serum ferritin concentration < 15 μg/L (per the World Health Organization recommendation in developing countries). An adjusted risk ratio (aRR), and a 95% confidence interval (CI), were used to report associations. Finally, the p-value < 0.05 was the cut-off point for the significant association. RESULTS A total of 446 pregnant women with a mean age of 24.78 (+ 5.20) were included in the study. A total of 236 (52.91%; 95% CI: 48.16-57.63) had iron deficiency. The overall prevalence of anemia and iron deficiency anemia (IDA) was 45.96% (95% CI: 41.32-50.71) and 28.03% (95% CI: 21.27-32.44), respectively. The risk of iron deficiency was more likely among women with low dietary diversity (aRR = 1.36; 95% CI = 1.07-1.72) and those who skipped meals (aRR = 1.29; 95% CI = 1.05-1.57), but less among women who had antenatal care (aRR = 0.73 (95% CI = 0.61-0.88). CONCLUSION More than half of the pregnant women in eastern Ethiopia had iron deficiency. Improving dietary diversity, meal frequency, and prenatal follow-up is essential to improve the high burden of ID and the adverse effect on pregnant women and the fetus. Moreover, a prospective study comparing maternal and perinatal outcomes among these spectra-iron depletion, ID, and IDA-is crucial for understanding their impact on maternal and perinatal mortality and morbidity.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Demiraw Bikila
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Wossene Habtu
- Department of National Clinical Chemistry Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Pregnant Mothers Diversified Dietary Intake and Associated Factors in Southwest Ethiopia: A Cross-Sectional Study. J Nutr Metab 2022; 2022:4613165. [PMID: 35958030 PMCID: PMC9363205 DOI: 10.1155/2022/4613165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 06/28/2022] [Indexed: 11/27/2022] Open
Abstract
Background Dietary diversity is very critical for fetal growth and development, as well as for the health and wellbeing of the mother. In Ethiopia, 41% of pregnant mothers consume diversified diets. There has been no study assessing whether pregnant women in southwest Ethiopia consume a varied diet. Objective To estimate the proportion of adequate diversified dietary intake and to determine whether there is an association between diversified dietary intake and mothers' social capital. Design A community-based cross-sectional study was conducted on 367 pregnant women in South West Ethiopia. A 24-hour multiple-pass dietary recall method was used to measure dietary intake and the 10 food groups of FANTA/FAO 2016 were used to analyze dietary diversity. Social capital was assessed based on the number of social networks in which a mother participated. Result The proportion of diversified dietary intake was 14.7% (95% CI: 11.1, 18.3). Pregnant mothers who had social capital, had their own income, had emotional support from their husbands, were from a rich family, and had a frequent dietary intake were statistically associated with a diversified dietary intake, with an AOR of 7.8 (95% CI 1.02, 2.3 (95% CI 1.12, 4.44), 4.0, (95% CI 1.16, 13.7), 59.19), 2.3 (95% CI 1.04, 5.26), and 1.5 (95% CI 1.04, 2.07), respectively. Conclusion Diversified dietary intake was found to be lower than previously reported, and it was associated with social capital. Methodologically rigorous studies are required to verify the association between social capital and adequate diversified dietary intake.
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Prevalence, predictors of low birth weight and its association with maternal iron status using serum ferritin concentration in rural Eastern Ethiopia: a prospective cohort study. BMC Nutr 2022; 8:70. [PMID: 35883202 PMCID: PMC9327330 DOI: 10.1186/s40795-022-00561-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 07/12/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Low birth weight (LBW) is one of the major predictors of perinatal survival, infant morbidity, and mortality, as well as the risk of developmental disabilities and illnesses in future lives. The effect of the nutritional status of pregnant women on birth outcomes is becoming a common research agenda, but evidence on the level of low birth weight (LBW) and its association with prenatal iron status in Ethiopia, particularly among rural residents, is limited. Thus, this study aimed to assess the prevalence, predictors of LBW, and its association with maternal iron status using serum ferritin concentration in Haramaya district, eastern Ethiopia, 2021. Methods A community-based prospective cohort study design was conducted. Of a total of 427 eligible pregnant women followed until birth, 412 (96.48%) were included in the final analysis. Iron status was determined using serum ferritin (SF) concentration from venous blood collected aseptically from the ante-cubital veins analyzed on a fully automated Cobas e411 (German, Japan Cobas 4000 analyzer series) immunoassay analyzer. Iron deficiency(ID) and iron deficiency anemia (IDA) were classified as having SF less than 15 μg/L and SF less than 15 μg/L and Hb level of < 11.0 g/dl during the first or third trimester or < 10.5 g/dl during the second trimester as well, respectively. Birthweight was measured within 72 h of birth and < 2500 g was considered LBW. Birthweight was measured within 72 h of birth and < 2500 g was considered as LBW. A Poisson regression model with robust variance estimation was used to investigate the factors associated with LBW and the association between maternal iron status and LBW. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results About 20.2% (95% CI: 16%-24%) of neonates were born with LBW. The prevalence of LBW was 5.04 (95% CI = 2.78–9.14) times higher among women who were iron deficient during pregnancy compared to those who were normal. The neonates of women who were iron deficient during pregnancy had lower birth weight (aPR=5.04; 95% CI = 2.78–9.14) than the neonates of women who were normal. Prevalence of LBW was higher among mothers who were undernourished (MUAC < 23cm) (aPR = 1.92; 95% CI= 1.33–2.27), stunted (height <145cm) (aPR=1.54; 95% CI=1.04–2.27) and among female neonates (aPR=3.70; 95% CI= 2.28–6.00). However, women who were supplemented with iron and folic acid (IFAS) during pregnancy had a 45% decreased chance of delivering low birth weight (aPR= 0.55; 95% CI=0.36–0.84). Conclusion We found that LBW is of public health significance in this predominantly rural setting. ID during pregnancy is found to have a negative effect on birth weight. IFA supplementation, the maternal under-nutrition, height, and sex of neonates were identified as predictors of low weight at birth. To improve maternal nutritional status, health interventions must address targeted strategies promoting desirable food behavior and nutritional practices. These include; promoting the consumption of diversified and rich iron food to improve the maternal nutritional status. A continued effort is needed in enhancing universal access and compliance with IFA supplementation to improve maternal health. Intervention strategies that are complementary and comprehensive across the vulnerable periods for women during pregnancy and their neonates that are based on a life-cycle approach are suggested.
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Consumption of animal source food and associated factors among pregnant women in eastern Ethiopia: A community-based study. PLoS One 2022; 17:e0270250. [PMID: 35714168 PMCID: PMC9205500 DOI: 10.1371/journal.pone.0270250] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/07/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction Animal source foods contain quality nutrients, immunity, and behavioral outcome and are important for growth, and development. However, evidence on the level of animal source food consumption frequency and associated factors among pregnant women in Ethiopia, particularly rural residents are limited. Therefore, this study aimed to assess the consumption frequency of animal source food and to identify associated factors among pregnant women in the Haramaya district. Methods A community-based cross-sectional study was conducted among 448 pregnant women. Data were collected through face-to-face interviews by trained research assistants, using a validated frequency questionnaire. Consumption of animal food sources was assessed by counting the frequency of each food from animal sources that pregnant women ate over a seven-day reference period. The highest tertile for animal source food consumption was considered as the high frequency of animal source food consumption; whereas the two lower tertiles were taken as the low frequency of animal source food consumption. A binary logistic regression model was used to investigate the association of the independent variables with the animal source food consumption. An adjusted odds ratio with a 95% confidence interval was reported to show an association using a p-value <0.05. Results The high frequency of animal source food consumption among the study participants was 24.78% (95% CI = 21%-29%). High animal source food consumption was more likely higher among respondents who were literate (AOR = 1.80; 95% CI = 1.048–3.095), and those who owned milk cows (ARO = 1.70; 95% CI = 1.003–2.863). However, respondent who reported chewing khat (AOR = 0.51; 95% CI = 0.313–0.805) (AOR = 0.56; 95% CI = 0.349–0.903), were less likely experienced animal source food consumption. Conclusion We found low animal source food consumption among pregnant women in this predominantly rural setting. Women’s educational level and milk cow ownership were positively associated with animal source food consumption. Additionally, a lower frequency of animal source food consumption was observed among women who reported chewing khat. Therefore, nutrition policy programs and interventions aimed at encouraging maternal nutritional guidance and counseling are recommended.
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Oumer A, Abraham M, Nuri A. Predictors of Major Dietary Patterns Among Pregnant Women Attending Public Health Facilities in Eastern Ethiopia: A New Epidemiological Approach. Front Nutr 2022; 9:855149. [PMID: 35548559 PMCID: PMC9085216 DOI: 10.3389/fnut.2022.855149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Dietary pattern analysis is a robust statistical procedure that efficiently characterize the dietary intakes of individuals. However, there is a lack of robust dietary intake evidence beyond nutrient intake in Ethiopia. This study was to answer, what are the major dietary consumption patterns and its predictors among pregnant women in Ethiopia. Methods A facility-based survey among 380 randomly selected pregnant women using a contextualized food frequency questionnaire (FFQ) over 1 month recall was used. The frequency of food consumption was standardized to daily frequency equivalents, and a sequential exploratory factor analysis was used to derive major dietary patterns. A multivariable ordinary logistic regression model was fitted with all its assumptions. Results Three major dietary patterns (“fruits and animal-source foods,” “cereals, tubers, and sweet foods,” “legumes and vegetables”), explaining 65% of the total variation were identified. Women snacks (AOR = 1.93; 1.23–2.75), without food aversion (AOR = 1.59; 1.08–2.35), non-fasting (AOR = 0.75; 1.12–2.12), and receiving nutritional counseling (AOR = 1.96; 1.25–3.07) were significantly positively associated with a higher tercile of fruits and animal-source food consumption. Non-working mothers (AOR = 1.8;1.23–2.76), chronic disease (AOR = 1.88; 1.14–3.09), or received nutritional counseling (AOR = 1.33; 0.88–2.01), were fasting (AOR = 1.33;0.88–2.01), and no food cravings (AOR = 4.27;2.67–6.84), and aversion (AOR = 1.60;1.04–2.44) had significantly higher odds of consuming cereals, tubers, and sweet foods. Literacy (AOR = 1.87; 1.14–3.09), urban residence (AOR = 2.10; 1.10–3.93), low socioeconomic class (AOR = 2.68; 1.30–5.23), and skipping meals (AOR = 1.73; 1.15–2.62) were associated with higher odds of legume and vegetable consumption. Conclusion Socioeconomic class, literacy, occupation, getting nutritional counseling, habits of food craving, food aversion, and fasting can predict a woman’s dietary pattern.
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Affiliation(s)
- Abdu Oumer
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mihret Abraham
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Aliya Nuri
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
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Sebeta A, Girma A, Kidane R, Tekalign E, Tamiru D. Nutritional Status of Postpartum Mothers and Associated Risk Factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia: A Community Based Cross-Sectional Study. Nutr Metab Insights 2022; 15:11786388221088243. [PMID: 35493421 PMCID: PMC9044780 DOI: 10.1177/11786388221088243] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 02/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Malnutrition affects millions of people in developing countries and contributes to poor health outcomes and nutritional status among women in the postpartum period. Lactation increases high nutritional demands and marks a significant life transition that can impact diet quality and subsequently predispose woman to high risk of overweight and undernutrition. Although, studies have been conducted on the nutritional status of lactating women, there is a gap especially on women's nutritional status during the postpartum period. Therefore, this study aimed to assess the nutritional status of postpartum women and associated factors in Shey-Bench District, Bench-Sheko Zone, Southwest Ethiopia, 2020. Method A community-based cross-sectional study was conducted in Shey-Bench District from March 1 to 30/2020 among 359 postpartum mothers. Bivariate analysis was employed to select candidate variables at P-value <.25 as a cut-off point. Multiple multinomial logistic regression analysis was used to identify variables significantly associated with nutritional status of the mother at P < .05 with 95% CI. Results The study revealed that 10.3% of women were underweight and 16.7% were overweight. Employed mothers (AOR = 4.467, 95% CI [1.05-19.04]), employed husband (AOR = 0.087, 95% CI [0.021-0.370]), farmer husband (AOR = 0.084, 95% CI [0.024-0.293]), trader husband (AOR = 0.19, 95% CI [0.0614-0.616]), married mother (AOR = 0.222, 95% CI [0.088-0.560]), dietary diversity (AOR = 0.181, 95% CI [0.075-0.436]) were significantly associated with underweight and while being overweight was associated with dietary diversity, maternal age of between 15 to 24 and 25 to 34, exclusive breastfeeding, and frequency of breastfeeding. Conclusion This study found a lower prevalence of underweight compared with overweight in the study area. Occupational status, marital status, age of the mother, dietary diversity, exclusive and frequency of breastfeeding were significantly associated factors with nutritional status of postpartum mother. We recommend strengthening the provision of nutrition education on modifiable factors with collaboration of other sectors.
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Affiliation(s)
- Asresash Sebeta
- Department of Emergency Medicinal
Technique, Mizan-Aman Health Science College, Mizan-Aman College, Ethiopia
| | - Abel Girma
- School of Public Health, College of
Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Rediet Kidane
- Institute of Health, Faculty of Public
Health, Department of Nutrition and Dietetics, Jimma University, Jimma,
Ethiopia
| | - Eyob Tekalign
- Department of Biomedical, College of
Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dessalegn Tamiru
- Institute of Health, Faculty of Public
Health, Department of Nutrition and Dietetics, Jimma University, Jimma,
Ethiopia
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Dietary practice among cohort pregnant women who gave birth to neonates with and without neural tube defect: a comparative cross-sectional study. J Nutr Sci 2022; 11:e24. [PMID: 35399554 PMCID: PMC8943563 DOI: 10.1017/jns.2022.20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 01/19/2023] Open
Abstract
Despite the high burden of neural tube defects (NTD) in eastern Ethiopia, there is no evidence that it is related to maternal dietary practice. The aim of the present study was to compare dietary practice between women who gave birth to newborns with and without NTDs. A comparative cross-sectional study was performed on a total of 276 (138 in each group) mothers who delivered neonates with or without NTD. Study participants were selected from three hospitals found in the eastern part of Ethiopia. The dietary practice was determined using the indicators including meal frequency, dietary diversity score (DDS), food variety score (FVS) and consumption of animal source food (ASF) generated from the dietary data collected using validated and pre-tested Food Frequency Questionnaire (FFQ). A multivariable logistic regression model was fitted to isolate independent predictors of dietary practices. The prevalence of good dietary practice was 29 % (95 % CI 23·6 %, 34·3 %). There was a significant difference in dietary practices (P = 0·034), in FVS (P = 0·01), in DDS (P = 0·045) between the two groups. In multivariable logistic regression, independent predictors of having good dietary practice were: not being the mother of a newborn with NTDs [adjusted odds ratio (AOR) 2·1, 95 % CI 1·07, 4·1], being from a rural residence area (AOR 0·29, 95 % CI 0·1, 0·7) and being illiterate (AOR 0·16, 95 % CI 0·03, 0·8). The present study found that dietary practice is associated with the development of NTDs. Nutrition education, food fortification and supplementation are needed to address this issue, and further research is needed to explore the mechanism.
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Factors associated with food consumption score among pregnant women in Eastern Ethiopia: a community-based study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2022; 41:6. [PMID: 35232495 PMCID: PMC8889778 DOI: 10.1186/s41043-022-00286-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 02/10/2022] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Although assessing the nutritional status of pregnant women is becoming a common research agenda, evidence on food consumption scores, particularly among rural residents, is limited. This study aimed to assess the level of food consumption score and associated factors among pregnant women in Haramaya district, eastern Ethiopia, 2021. METHODS A community-based cross-sectional study was conducted among 448 pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-to-face interviews by trained research assistants, using a validated food frequency questionnaire. Food consumption score, a proxy measure for food security, was assessed through a seven-day dietary recall of consumption of food items. Each food item was given a score of 0-7 depending on the number of days it was consumed then grouped into food groups and summed up each food group. The pregnant women were labeled as "acceptable food consumption score" when they had a food composite score of > 42 during the reference period. Otherwise, they were defined as "unacceptable." A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the food consumption score. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p value < 0.05. RESULTS The acceptable food consumption score among the study participants was 54.46% (95% CI 49-59%). The level of acceptable food consumption score was higher among respondents who were in the richest class (APR = 1.31; 95% CI 1.04-1.66), those who had ANC follow-up (APR = 1.78; 95% CI 1.40-2.27), those who had a favorable attitude toward dietary practice (APR = 1.30; 95% CI 1.12-1.52), and those who consumed high animal source foods (APR = 1.28; 95% CI 1.01-1.51). However, acceptable food consumption score was lower among women who were not owned agricultural land (APR = 0.84; 95% CI 0.72-0.99). CONCLUSION We found a low acceptable food consumption score among pregnant women in this predominantly rural setting. Nutritional counseling in pregnancy should address the importance of food diversity and consumption of animal source foods to improve nutrition in pregnancy. Our findings highlight the imperative requirement for policies and programs to support farmers who had no farmland to improve their overall food security and maximize their food consumption score. Assessing perinatal outcomes associated with food consumption score is essential for unraveling the spectrum of nutrition in pregnancy and beyond.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Belay WS, Cherkos EA, Taye EB. Dietary practice during pregnancy and associated factors among pregnant women in Farta district, South Gondar Zone, Northwest Ethiopia, 2021. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.100968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Fite MB, Tura AK, Yadeta TA, Oljira L, Roba KT. Prevalence and determinants of dietary practices among pregnant women in eastern Ethiopia. BMC Nutr 2022; 8:3. [PMID: 35012664 PMCID: PMC8751267 DOI: 10.1186/s40795-021-00494-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
Introduction Appropriate dietary practices in pregnancy are critical to meet the increased metabolic and physiological demands; however, information about dietary practices among pregnant women, particularly rural residents, is limited. The study aimed to assess the level of appropriate dietary practices and associated determinants among pregnant women in Haramaya District, eastern Ethiopia, 2021. Methods A community-based cross-sectional study was conducted among 448 pregnant women in Haramaya District, Eastern Ethiopia. Data was collected through face-to-face interviews by trained research assistants, using a validated frequency questionnaire. The pregnant women were labeled as “appropriate dietary practice” when they consumed at least four meals daily, had a good food variety score, high dietary diversity score, and high consumption of animal source foods during the reference period. Otherwise, they were defined as “inappropriate.” A Poisson regression model with robust variance estimation was used to investigate the association of the independent variables with the dietary practice. An adjusted prevalence ratio with a 95% confidence interval was reported to show an association using a p-value < 0.05. Results The appropriate dietary practice among the study participants was 15.2% (95% CI = 12–18%). Of the respondents, 29.46, 37.5, and 24.7% had a high dietary diversity, high food variety score, and high consumption of animal source foods. The appropriate dietary practice was more prevalent among merchant women (APR = 2.07; 95% CI 1.07–4.02) and those whose husbands have at least a high school educational level (APR = 1.96; 95% CI 1.06–3.46). However, the prevalence of appropriate dietary practice was significantly lower among those who chewed khat (APR = 0.58; 95% CI 0.37–0.90) and among respondents who reported restriction of the intake of some foods (APR = 0.36; 95% CI 0.20–0.65). Conclusion We found sup-optimal appropriate dietary practice among pregnant women in this predominantly rural setting. Additionally, the lower appropriate dietary practice was observed among women who reported chewing khat and experienced restriction of dietary consumption during pregnancy. Therefore, nutrition policy programs and interventions aimed at encouraging maternal nutritional guidance and counseling are recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00494-4.
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Affiliation(s)
- Meseret Belete Fite
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia.
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.,Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemessa Oljira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kedir Teji Roba
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Molla W, Mengistu N, Madoro D, Assefa DG, Zeleke ED, Tilahun R, Bayisa Y, Meshesha MD, Ayele GM, Kabthyme RH, Alemu A, Eshetu MA, Shumye S, Funga ML, Eritero AC, Aregawi S, Wodaynew T, Muche T, Wudneh A. Dietary diversity and associated factors among lactating women in Ethiopia: Cross sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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LEÃO GMMS, CRIVELLENTI LC, BRITO MFSF, SILVEIRA MF, PINHO LD. Quality of the diet of pregnant women in the scope of Primary Health Care. REV NUTR 2022. [DOI: 10.1590/1678-9865202235e210256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACT Objective To evaluate the quality of the diet of the pregnant women monitored by the Family Health Strategy teams and associated factors. Methods This is a population-based cross-sectional study, carried out with 1244 pregnant women between 2018 and 2019. The Diet Quality Index Adapted for Pregnant Women was used to measure the quality of the diet and associate it with risk factors (sociodemographic, obstetric, clinical, behavioral, nutritional status) during the pregnancy. A hierarchical model composed of three blocks was used. A multinomial logistic regression was applied. Results The general average of this Diet Quality Index was 72.75 points, the average of the 1st tercile was 56.06 points, the average of the 2nd tercile was 73.71 points and the average of the 3rd was 88.51 points. The worst diet quality was related to pregnant women with lower education (OR=2.36; 95% CI=1.39-4.01), sedentary women (OR=1.37; 95% CI=1.17-2, 61), those who had a negative self-perception of food (OR=2.00; 95% CI=1.45-2.76) and who had 3 to 5 meals a day (OR=1.83; 95% CI=1.26-2.77), and less than 3 (OR=2.64; 95% CI=1.13-6.18). Conclusion The present study identified that pregnant women with less education, sedentary, and with inadequate nutritional characteristics presented worse diet qualities.
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Girma Tilahun A, Molla Kebede A, Ejigu AG. Dietary Practice and Associated Factors Among Pregnant Women at Public Health Institution in Mizan-Aman Town, Southwest Ethiopia. Nutr Metab Insights 2021; 14:11786388211057796. [PMID: 34819735 PMCID: PMC8606983 DOI: 10.1177/11786388211057796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 10/17/2021] [Indexed: 11/21/2022] Open
Abstract
Background: A poor dietary intake of key macronutrients and micronutrients adversely affects pregnancy outcomes and neonatal health. The occurrence of dietary inadequacy during pregnancy is higher compared to any other stage of the life cycle. Therefore, this study aimed to assess dietary practice and associated factors among pregnant women. Methods: A facility-based cross-sectional study design was conducted among 378 pregnant women from March to May 2021 at the public health institution of Mizan-Aman town, southwest Ethiopia. A systematic random sampling technique was used to reach the study participants. The short food-frequency questionnaires and nutrition-behaviors checklist measurement were used to assess the dietary practice. Nine questions were applied to assess the dietary attitudes of the respondents. After the summation of the score, the respondent was categorized as favorable attitude if their score was > the median and unfavorable attitude if their score was ⩽ to the median of the score. The data were entered into Epi Data 3.1 and exported to Statistical Package for Social Science (SPSS) version 21 software for analysis. Variables of P-value <.25 during bivariate logistic regression analysis were considered for multivariate analysis. Finally variables with an adjusted odds ratio of P-value <.05 along with a 95% Confidence interval (CI) were declared statistically significant. Results: The overall magnitude of good dietary practice among pregnant women was 25.1% (95% CI: 20.9, 29.71%). In multivariate logistic regression analysis, the variables having television/radio (AOR = 4.2, 95% CI: 1.8, 10.2), household food security (AOR = 3.1, 95% CI: 1.0, 9.9), good dietary knowledge(AOR = 4.1, 95% CI: 1.98, 8.6), favorable dietary attitude (AOR = 4.34, 95% CI: 1.2, 8.7), monthly income of 1000 to 2000 Ethiopian birr (AOR = 3.7, 95% CI: 1.3,11.2) and >2000 Ethiopian birr (AOR = 7.0;95% CI: 3.3,15.4) were significantly associated with good dietary practice. Conclusion: The dietary practice among pregnant women was very low. The factors like having television/radio, good dietary knowledge, household food security, favorable dietary attitude, and monthly income of 1000 to 200 and greater than 2000 Ethiopian birr were significantly associated with the good dietary practice of pregnant women.
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Affiliation(s)
- Abel Girma Tilahun
- Schooll of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan-Aman, Ethiopia
| | - Abebaw Molla Kebede
- Schooll of Public Health, College of Medicine and Health Science, Mizan Tepi University, Mizan-Aman, Ethiopia
| | - Amare Genetu Ejigu
- Department of Midwifery, 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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Dearden KA, Bishwakarma R, Crookston BT, Masau BT, Mulokozi GI. Health facility-based counselling and community outreach are associated with maternal dietary practices in a cross-sectional study from Tanzania. BMC Nutr 2021; 7:45. [PMID: 34412681 PMCID: PMC8377836 DOI: 10.1186/s40795-021-00447-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/26/2021] [Indexed: 11/22/2022] Open
Abstract
Background Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania. Methods Data come from a cross-sectional baseline survey among 5000 female primary caregivers who were randomly selected via two-stage sampling, prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression. Results A third of the sample (34.1%) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0%). 68.0% had never had a community health worker (CHW) speak to them about their children’s health and 9.4% had participated in a women’s group. Only 8.0% of mothers ate more than usual during pregnancy and 7.1% ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95% CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving antenatal care (ANC) and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 h. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 h. Conclusions Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.
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Affiliation(s)
- Kirk A Dearden
- IMA World Health/Corus International, Washington DC, USA.
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Azene AG, Aragaw AM, Wubetie HT, Wassie GT, Tsegaye GW, Derebe MA, Mitiku HD. Dietary diversity among pregnant women and associated factors in Ethiopia: Systematic review and meta-analysis. PLoS One 2021; 16:e0251906. [PMID: 34111140 PMCID: PMC8191951 DOI: 10.1371/journal.pone.0251906] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 05/06/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUNDS Pregnancy related complications are major causes of maternal morbidity and mortality worldwide. Diversified food consumption is essential to produce hormones during pregnancy and it reduced complications. In Ethiopia, many researchers were investigated about the proportion of pregnant women with dietary diversity and its determinant factors. However, those studies are inconsistent and fragmented. Therefore, the aim of this study was to estimate the pooled proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia. METHODS We conducted a systematic electronic web-based search of PubMed/ /MEDLINE, EMBASE, Web of Science, Google Scholar and Google online databases for identifying studies on proportion of pregnant women with dietary diversity practice and its associated factors in Ethiopia using pre-defined quality and inclusion criteria. STATA version 14 statistical software was used to analyze the data. We extracted relevant data and presented in tabular form. The I2 test was used to assess heterogeneity across studies. Funnel plot asymmetry and Begg's test were used to check for publication bias. The final effect size was determined by applying a random-effects model. RESULTS Our search identified 170 studies. Of which, 23 were included in the final analysis stage. The pooled proportion of dietary diversity among pregnant women in Ethiopia was 41% (95% CI: 33, 49). Mothers can read and write (OR = 1.82 (95% CI: 1.25, 2.64)), maternal primary school and above educated (OR = 2.11 (95% CI: 1.10, 4.05)), nutritional information (OR = 4.1 (95% CI: 2.1, 7.99), dietary diversity knowledge (OR = 3.4 (95% CI: 2.73, 4.73)) and household had rich wealth index (OR = 3.45 (95% CI: 1.19, 10.1)) were significantly associated with dietary diversity practice during pregnancy. CONCLUSIONS In this meta-analysis; we found that low proportion of pregnant women with adequate dietary diversity in Ethiopia (41%). Maternal education, nutritional information, dietary diversity knowledge and wealth index level of household were significantly associated factors of pregnant woman with dietary diversity practice. This finding implies that improving the awareness of woman about dietary diversity during pregnancy and empowering women economically would play a significant role to improve dietary diversity practice.
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Affiliation(s)
- Abebaw Gedef Azene
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abiba Mihret Aragaw
- Department of Statistics, College of Natural and Computational Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Habtamu Tilaye Wubetie
- Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
| | - Gizachew Tadesse Wassie
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gebiyaw Wudie Tsegaye
- Department of Epidemiology and Biostatistics, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Muluwork Ayele Derebe
- Department of Statistics, College of Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Habitamu Dessie Mitiku
- Department of Statistics, College of Natural and Computational Sciences, Injibara University, Injibara, Ethiopia
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Bitew ZW, Alemu A, Ayele EG, Worku T. Dietary diversity and practice of pregnant and lactating women in Ethiopia: A systematic review and meta-analysis. Food Sci Nutr 2021; 9:2686-2702. [PMID: 34026082 PMCID: PMC8116864 DOI: 10.1002/fsn3.2228] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/21/2021] [Accepted: 02/25/2021] [Indexed: 11/17/2022] Open
Abstract
The dietary diversity of pregnant and lactating women remains unacceptably poor in resource-limited countries such as Ethiopia. Despite the presence of inconsistent and inconclusive small-scale studies, it is difficult to portray an actual picture of dietary diversity and dietary practices of women in Ethiopia. This study aimed to identify the prevalence of dietary diversity, dietary practice, and dietary patterns of pregnant and lactating women in Ethiopia. Electronic and gray literature sources were explored. A total of 3,256 articles were found, of which 38 were included in the final analysis. The data were analyzed by using STATA version 15. The pooled estimates were presented using random-effects models due to considerable heterogeneities among studies. In this study, 16,412 pregnant and lactating women were included. The pooled prevalence of low, medium, and high dietary diversity scores of pregnant women was 37.1%, 41.55%, and 39.3%, respectively. Likewise, low, medium, and high dietary diversity scores of lactating women were 50.31%, 41.22%, and 9.1%, respectively. The mean dietary diversity of pregnant and lactating women was 3.99 ± 0.20. Regarding the minimum dietary diversity, 56.6% of pregnant women and 50.21% of lactating women were found to have inadequate dietary diversities. Two-third (65.7%) of pregnant women were found to have poor dietary practice. Starchy foods were the main staple foods of study subjects, whereas organ meats were least consumed food types. The dietary diversity score, minimum dietary diversity, and dietary practices of women are suboptimal and below WHO and FAO recommendations. This could lead to both macro- and micronutrient deficiencies. Policymakers, program managers, healthcare workers, and stakeholders need to redesign nutrition promotion and intervention programs to alleviate this issue.
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Affiliation(s)
- Zebenay Workneh Bitew
- Department of Pediatric NursingSchool of NursingSt. Paul’s Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | | | - Ermias Getaneh Ayele
- Department of Pediatric NursingSchool of NursingSt. Paul’s Hospital Millennium Medical CollegeAddis AbabaEthiopia
| | - Teshager Worku
- College of Health and Medical SciencesSchool of Nursing and MidwiferyHaramaya UniversityHararEthiopia
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Delil R, Zinab B, Mosa H, Ahmed R, Hassen H. Determinants of dietary diversity practice among pregnant women attending antenatal clinic at Wachemo University Nigist Eleni Mohammed memorial referral hospital, Southern Ethiopia. PLoS One 2021; 16:e0250037. [PMID: 33836030 PMCID: PMC8034717 DOI: 10.1371/journal.pone.0250037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/29/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dietary diversity has continued to receive a global attention among pregnant women as they have been considered susceptible to malnutrition because of their increased nutrient demands. Thus, a variety of foodstuffs in their diet are necessary for ensuring the appropriateness of their nutrient consumptions. This study, therefore assessed the dietary diversity practice and its determinants among pregnant women attending antenatal clinic at Wachemo University Nigist Eleni Mohammed memorial referral hospital, Southern Ethiopia. METHODS A hospital-based cross-sectional study was carried out on 303 participants from May 1 to June 15, 2019 using a systematic random sampling technique. Data were entered and analyzed using SPSS (version24.0). Both bivariate and multivariable logistic regression analyses were used to decide the association of each explanatory variable with the outcome variable. Odds ratio with their 95% confidence intervals was calculated to identify the presence and strength of association, and statistical significance was declared at p < 0.05. RESULTS The overall prevalence of adequate dietary diversity practices was observed to be 42.6%. The determinants of dietary diversity practice included earning of a monthly income ≥2000 Ethiopian birr (AOR = 1.62; 95%CI:1.19-2.85), maternal educational level (AOR = 2.50; 95% CI: 1.05-6.12), educational status of partner (AOR = 2.45; 95% CI:1.20, 9.57), having a partner who was a government employee (AOR = 4; 95% CI:2.18-7.21), and the receiving of nutritional information (AOR = 1.35; 95% CI: 3.39-6.94). CONCLUSIONS The study indicated that the overall consumption of adequate dietary diversity practice was found to be low. Therefore, increasing household income, enhancing nutritional related information, advancing the academic level of both wife and her partner is essential to improve women's dietary diversity practice.
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Affiliation(s)
- Romedan Delil
- Department of Clinical Nursing, Hossana College of Health Science, Hossana, Ethiopia
| | - Beakal Zinab
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Hassen Mosa
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Ritbano Ahmed
- Department of Midwifery, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Habtamu Hassen
- Department of Medical Emergency, Hossana College of Health Science, Hossana, Ethiopia
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Yalewdeg M, Birhane M, Adissu Y. Dietary Practices and Their Determinants Among Pregnant Women in Gedeo Zone, Southern Ethiopia: A Community-Based Cross-Sectional Study . NUTRITION AND DIETARY SUPPLEMENTS 2020. [DOI: 10.2147/nds.s267453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Dietary Practice and Associated Factors among Pregnant Women in Misha Woreda, South Ethiopia: A Community-Based Cross-Sectional Study. J Nutr Metab 2020; 2020:5091318. [PMID: 33062324 PMCID: PMC7533019 DOI: 10.1155/2020/5091318] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/02/2020] [Accepted: 09/07/2020] [Indexed: 11/23/2022] Open
Abstract
Background Proper food and good nutrition are essential for survival, physical growth, mental development, performance and productivity, and health and well-being. Pregnancy is a critical phase in a woman's life. The aim of this study is to assess the dietary practice and associated factors among pregnant women in Misha woreda, south Ethiopia. Methods A cross-sectional study was conducted in Misha woreda, South Ethiopia, on pregnant women. Data were collected by using a structured interviewer-administered questionnaire. The data were entered in EpiData V-3.1 and analyzed using SPSS version 21. Binary logistic regression analysis was also employed to examine the association between dependent and independent variables. A P value of <0.05 was considered as the cutoff point to declare statistical significance. Result Out of 618 pregnant women, almost all of them 618 interviewed with the response rate of 100%. The mean age of pregnant women was 27.31 years (±5.622). From total study participants, 54.1% of the respondents were followers of protestant religion and 80.2% of husband occupation were farmers and 78.7% pregnant women occupation were house wives. From the total participants, 43.6% had illness on the current pregnancy. Almost two third 66.2% of the pregnant women travel ≥ 1 hr to reach HF. Majority of the participants (62%) had moderate knowledge about dietary practice in pregnancy, and 29.5% practiced good dietary practice. Educational status (AOR = 4.07 [2.13, 9.18]), occupation (AOR = 5.32 [1.08, 13.95]), dietary knowledge (AOR = 7.2 [3.9, 17.09]), and food craving (AOR = 2.07 [1.41, 5.5]) were variables having a significant association with dietary practice. Conclusion The prevalence of good dietary practice among pregnant women in Misha district was low when compared to other studies. According to the study result, educational status, occupation, dietary knowledge, and food craving were factors that affect dietary practice.
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Demilew YM, Alene GD, Belachew T. Effects of guided counseling during pregnancy on birth weight of newborns in West Gojjam Zone, Ethiopia: a cluster-randomized controlled trial. BMC Pediatr 2020; 20:466. [PMID: 33023521 PMCID: PMC7542400 DOI: 10.1186/s12887-020-02363-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 09/28/2020] [Indexed: 11/23/2022] Open
Abstract
Background The high proportion of birth weight in Ethiopia is hypothesized to be due to inadequate maternal diet which is associated with poor nutrition education during pregnancy. There was no study that evaluated the effect of nutrition education on birth weight in the study area. This study aimed to assess the effects (overall, direct and indirect effects) of guided counseling on the birth weight of neonates. Methods A two-arm parallel cluster randomized controlled community trial was conducted from May 1, 2018, to April 30, 2019, in West Gojjam Zone, Northwest Ethiopia. At the baseline, 346 pregnant women in the 11 intervention clusters and 348 pregnant women in the 11 control clusters were recruited. However, birth weight was measured from 258 and 272 newborns in the intervention and control groups, respectively. In the intervention group, counseling was given monthly for four consecutive months in the participant’s homes. Besides, leaflets with key counseling messages were distributed to each woman in the intervention arm. Pregnant women who attended routine nutrition education given by the health system were recruited as control. Dietary practice, nutritional status, and birth weight were the primary, secondary and tertiary outcomes of this intervention. Data were collected using a structured data collection tool. Birth weight was measured within 48 h after birth. Independent sample t-test, linear mixed-effects model, and path analysis were fitted to assess effects of the intervention. Results The intra-cluster correlation coefficient was 0.095. The average birth weight of newborns in the intervention group was 0.257 kg higher compared with their counterparts in the control arm (β = 0.257, P < 0.001). The direct effect of this intervention on birth weight was 0.17 (β = 0.17, P<0.001 ) whereas the indirect effect of this intervention was 0.08 (β = 0.08, P<0.001 ). Conclusion Counseling using the health belief model and the theory of planned behavior has a positive effect on improving birth weight. The findings suggest the need for enhancing nutrition education of pregnant women through the application of theories to improve birth weight. Trial registration Clinical Trials.gov NCT03627156, “Retrospectively registered Jun, 13, 2018”.
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Affiliation(s)
- Yeshalem Mulugeta Demilew
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia.
| | - Getu Degu Alene
- Department of Biostatics and Epidemiology, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University
- , P.O. Box 378, Jimma, Ethiopia
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Burden and Determinant of Inadequate Dietary Diversity among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis. J Nutr Metab 2020; 2020:1272393. [PMID: 32855822 PMCID: PMC7443217 DOI: 10.1155/2020/1272393] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/11/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
Background Inadequate dietary diversity intake during pregnancy results in increased risks of negative maternal and perinatal outcomes. About one million neonates die on the first day of life due to inadequate dietary intake during pregnancy as a result of maternal complication and adverse birth outcomes. This review summarizes the burden of inadequate dietary diversity and its determinants among pregnant women at the national level of Ethiopia. Methods Studies were retrieved from selected electronic databases, including PubMed, Cochrane Library, and Google Scholar. Random-effects model meta-analysis was used to estimate the pooled burden of inadequate dietary diversity and its determinants at a 95% confidence interval with its respective odds ratio (OR) using statistical R-software version 3.6.1. Moreover, quality appraisal of the included studies, publication bias, and level of heterogeneity were checked with subgroup analysis and sensitivity influential test. The searches were restricted to articles published in the English language only, and Medical Subject Headings (MeSH terms) was used to help expand the search in advanced PubMed search. Result A total of 850 articles were identified through the initial search of which 21 studies were included in the final review yielding a total sample size of 9,230 pregnant women. The pooled prevalence of inadequate dietary diversity was 53% (95% CI: 44%, 62%). Food insecurity [AOR = 2.18, (95% CI: 1.02, 4.63)], family size of greater than four [AOR = 1.46, (95% CI: 1.10, 1.95)], rural residence [AOR = 4.52, (95% CI: 1.02, 20.09)], no formal educational status [AOR = 4.50, (95% CI: 1.02, 20.09)], and a lack of counseling about dietary diversity [AOR = 2.75, (95% CI: 2.17, 3.48)] were among the significantly associated factors for inadequate dietary diversity. Conclusion In this review, there was a high prevalence of inadequate dietary diversity among pregnant women at the national level in Ethiopia. Therefore, strengthening early counseling and diagnosis of dietary intake and undernutrition during the antenatal care period is important.
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Demilew YM, Alene GD, Belachew T. Effect of guided counseling on dietary practices of pregnant women in West Gojjam Zone, Ethiopia. PLoS One 2020; 15:e0233429. [PMID: 32453774 PMCID: PMC7250435 DOI: 10.1371/journal.pone.0233429] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 05/05/2020] [Indexed: 11/22/2022] Open
Abstract
Background In Ethiopia, although nutrition education has been given during pregnancy, most women have inadequate nutrient intakes. As a result, the prevalence of malnutrition is high during pregnancy. In this study, we set out to evaluate the effect of guided counseling based on the health belief model and the theory of planned behavior on the dietary practices of pregnant women. Methods A two-arm parallel cluster randomized controlled community trial was carried out among pregnant women in West, Gojjam Zone, Ethiopia from May 1, 2018, to April 30, 2019. A total of 346 and 348 pregnant women were recruited from the intervention and control clusters, respectively. Of which endline data were collected from 313 and 332 pregnant women in the intervention and control groups, respectively. Each woman in the intervention group attended four counseling sessions. Women in the control group attended the routine nutrition education given by the health care system. Data were collected using a structured questionnaire. McNemar test and Generalized Estimating Equations were used to evaluate the intervention effect. Results The average difference of appropriate dietary practice between the two groups was 30.7%. After controlling for the possible confounders, women in the intervention group had 7.2 times [AOR = 7.187, 95% CI: (4.49, 11.49)] higher odds of having appropriate dietary practices compared with the control group. Dietary diversity and meal frequency of counseled women were 7 [AOR = 6.994, 95% CI: (4.59, 10.66)] and 8 [AOR = 8.146, 95% CI: (5.377, 12.341)] times higher than dietary diversity and meal frequency of women in the control group, respectively. Conclusion Counseling based on the health belief model and the theory of planned behavior is an effective approach in increasing the proportion of women who had appropriate dietary practices. Thus, these findings suggest the need for employing trimester based counseling using the HBM and the TPB to improve the dietary practices of pregnant women. Trial registration The trial was registered in Clinical Trials.gov (NCT03627156).
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Affiliation(s)
- Yeshalem Mulugeta Demilew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- * E-mail:
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Demilew YM, Alene GD, Belachew T. Effect of guided counseling on nutritional status of pregnant women in West Gojjam zone, Ethiopia: a cluster-randomized controlled trial. Nutr J 2020; 19:38. [PMID: 32345286 PMCID: PMC7189500 DOI: 10.1186/s12937-020-00536-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/26/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Undernutrition during pregnancy affects birth outcomes adversely. In Ethiopia, despite nutrition counseling on the maternal diet being given by the health workers during pregnancy, maternal undernutrition is still high in the country. Hence, this study aimed to assess the effect of guided counseling using the health belief model and the theory of planned behavior on the nutritional status of pregnant women. METHODS A two-arm parallel cluster randomized controlled community trial was conducted in West Gojjam Zone, Ethiopia, from May 1, 2018, to April 30, 2019. The nutritional status of the women was assessed using mid-upper arm circumference. A total of 694 pregnant women were recruited from the intervention (n=346 ) and control (n=348) clusters. Of which endline data were collected from 313 and 332 pregnant women in the intervention and control clusters, respectively. The intervention was started before 16 weeks of gestation and pregnant women in the intervention group attended 4 counseling sessions. Counseling was given at the participants' homes using a counseling guide with the core contents of the intervention. Leaflets with appropriate pictures and the core messages were given for women in the intervention arm. Women in the control group got the routine nutrition education given by the health care system. Data were collected using interviewer administered structured questionnaires and mid-upper arm circumference was measured using an adult MUAC tape. Descriptive statistics and linear mixed-effects model were used to assess the intervention effect after adjusting for potential confounders. RESULTS After the intervention, the prevalence of undernutrition was 16.7% lower in the intervention group compared with the control arm (30.6% Vs 47.3%, P = < 0.001). Women in the intervention group showed significant improvement in nutritional status at the end of the trial than the control group (β = 0.615, p = < 0.001). CONCLUSION This study demonstrated that guided counseling using the health belief model and the theory of planned behavior was effective in improving the nutritional status of pregnant women. The results imply the need for the design of model and theory based nutrition counseling guidelines. The trial was registered in Clinical Trials.gov (NCT03627156).
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Affiliation(s)
- Yeshalem Mulugeta Demilew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia.
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, P.O. Box 79, Bahir Dar, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Jimma University, P.O. Box 378, Jimma, Ethiopia
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