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Mogi JG, Premikha M, Nabila O, Sanjaya A, Prihartono I, Gittelsohn J. Formative research to understand food beliefs and practices relating to pregnancy on Kei Besar Island, Eastern Indonesia. BMC Nutr 2024; 10:97. [PMID: 38992723 PMCID: PMC11238455 DOI: 10.1186/s40795-024-00905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 07/01/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Food-related beliefs and practices during pregnancy may contribute to the high prevalence of chronic energy deficiencies (CED) in Eastern Indonesia, particularly in Southeast Maluku regency, where 21.33% of pregnant women experience CED. Currently, little information on these issues is available. This study investigates food beliefs and practices related to pregnancy on Kei Besar Island in the Maluku province of Eastern Indonesia. METHODS A qualitative study was conducted utilizing in-depth interviews, free lists, and pile sort exercises. Data collection was conducted in January 2023 and involved married pregnant women aged 18 and above (n = 12), community health volunteers (n = 2), and traditional healers (n = 3) from 9 villages in Kei Besar District. All participants must be natives of Kei Besar Island, with community health volunteers and traditional healers being respective figures recommended by the local villagers. RESULTS The need to avoid or minimize consumption of certain foods during pregnancy, such as some kinds of fish, chili and spicy food, soda, pineapples, octopus, squid, and ice was reported by more than one-third of all participants. Consumption of prescribed foods, such as cassava leaves, papaya, coconut water, rice during early pregnancies, moringa leaves, bananas, and katok leaves was reported by five or more participants. These food proscriptions and prescriptions were due to concerns about the risks of miscarriage, adverse effects on the fetus and mother, and complications during labor. Participants also reported other practices, such as eating for two during early pregnancy and reducing food intake in late pregnancy. We found that food beliefs have shaped the dietary patterns of most participants. However, they still consumed food recommended by community health volunteers and midwives. CONCLUSIONS Food beliefs are present and practiced in the Kei Besar community and may impact the nutritional status of women and their infants. Interventions should target training healthcare providers and community health volunteers to provide culturally appropriate health education that incorporates prescribed local ingredients and provides nutritionally adequate substitutes for the proscribed food items. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Jessica Gloria Mogi
- Master of Public Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - M Premikha
- Master of Public Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Ona Nabila
- Therapeutic Feeding Center, doctorSHARE/Yayasan Dokter Peduli, Southeast Maluku, Maluku, Indonesia
| | - Adhi Sanjaya
- Head Office, doctorSHARE/Yayasan Dokter Peduli, Central Jakarta Administrative City, Jakarta, Indonesia
| | - Indira Prihartono
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
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Daba AK, Abegaz K, Muleta A, Desalegn BB. Hand Washing Practice and Food Insecurity are Associated With Undernutrition of Breastfeeding Mothers in Rural Ethiopia: A Cross-sectional Study. ENVIRONMENTAL HEALTH INSIGHTS 2024; 18:11786302241231708. [PMID: 38356920 PMCID: PMC10865933 DOI: 10.1177/11786302241231708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 01/19/2024] [Indexed: 02/16/2024]
Abstract
Background Breastfeeding mothers are prone to undernutrition. However, factors contributing to maternal undernutrition are not exhaustively understood. Hence, this study aimed to determine prevalence of undernutrition among breastfeeding mothers and identify associated factors. Methods A cross-sectional study was conducted among 606 breastfeeding mothers from selected rural districts in Oromia and Sidama regional states of Ethiopia. Data were collected through an interviewer-administered questionnaire. Nutritional status was assessed using body mass index (BMI) and mid-upper-arm-circumference (MUAC). Logistic regression analysis was used to identify factors associated with maternal undernutrition. Results One out of ten breastfeeding mothers was found undernourished as determined by BMI (12.6%) and MUAC (10.7%). Mothers who did not practice hand washing after cleaning children's bottom were 2 and 3 times more likely to be undernourished compared to their counters, as measured by BMI (AOR = 2.29, P = .002) and MUAC (AOR = 3.03, P < .001), respectively. Mothers living in mildly or moderately food insecure households (AOR = 2.37, P = .019) were more than two times more likely to be undernourished as determined by MUAC. Mothers who breastfed children in the age range of 9 to 11 (AOR = 2.79, P = .025) or 12 to 23 (AOR = 2.57, P = .018) months were more than two and half times more likely to be undernourished as determined by BMI. Conclusions Maternal undernutrition is a medium-level public health problem in rural districts of Oromia and Sidama regional states in Ethiopia. The lack of hand washing practice after cleaning a child's bottom, household food insecurity and higher child age increased the odds of maternal undernutrition. Mothers should prioritize and improve their nutritional care as the age of their breastfed child increases. Nutrition programs in rural districts of Ethiopia should also aim to improve personal hygiene practices and food insecurity integrated with implementation researches to evaluate program's impact on nutritional status of breastfeeding mothers.
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Affiliation(s)
- Alemneh Kabeta Daba
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Kebede Abegaz
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, Ethiopia
| | - Anbissa Muleta
- Department of Food Science and Nutrition, College of Natural Science, Jigjiga University, Jigjiga, Ethiopia
| | - Beruk Berhanu Desalegn
- School of Nutrition, Food Science and Technology, College of Agriculture, Hawassa University, Hawassa, 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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Abere M, Azene AG. Food Taboo and associated factors among pregnant women attending antenatal clinics at Bahir Dar City, North West Ethiopia, 2021: cross-sectional study. Sci Rep 2023; 13:7790. [PMID: 37179370 PMCID: PMC10182971 DOI: 10.1038/s41598-023-34964-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/10/2023] [Indexed: 05/15/2023] Open
Abstract
Food taboo is any unacceptable food items in the society that arise mainly based on religious, cultural, historical and social principles. Developing countries faced the triple burden of malnutrition of under nutrition, micronutrient deficiencies and overeating. Food taboos have great effect on pregnant women through prohibited essential food and/or drinks. There is a paucity of study conducted in food taboo practice among pregnant women in Ethiopia. This study aimed to assess the prevalence of food taboo practice and associated factors among pregnant women attending antenatal care (ANC) at Bahir Dar city, 2020. Institutional based cross-sectional study design was conducted among 421 pregnant women attending antenatal care clinics. Stratified sampling technique was used to approach the study participants, and interviewer administered questionnaire was used for data collection. Binary logistic regression analysis was conducted to identify predictors. The prevalence of food taboo practices among pregnant women was 27.5% (95% CI 23.2-31.8%) at the Bahir Dar city. Most food items avoided during pregnancy were meat, honey, milk, fruit and cereals. Reasons for avoidance of these food items were plastered on the fetal head, and making fatty baby which is difficult for deliver. Maternal age 20-30 years (AOR = 8.39, 95% CI 3.49-20.14), more than 30 years [AOR = 10.56, 95% CI (2.00, 51.74)], more than 2 parity [AOR = 9.83 95% CI (2.79, 34.70)], no previous experience of the ANC visit [AOR = 2.68, 95% CI (1.26, 5.73)], and no information about nutrition [AOR = 4.55, 95% CI (1.77, 11.70)] were significantly associated with practice of food taboo. This study revealed that prevalence of food taboo is high during pregnancy. The implications of this study that needs strengthening nutrition counseling components of ANC follow-up and health professionals needs to design and implement strategic health communication intended to reorient misconceptions and myths for the pregnant women regarding the food taboo.
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Affiliation(s)
- Meseret Abere
- Department of Nutrition, Bahir Dar Institution of Technology, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abebaw Gedef Azene
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia.
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Debela BG, Sisay D, Hareru HE, Ewune HA, Tesfa A, Shewaye DA, Ewunie TM. Food taboo practices and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Sci Rep 2023; 13:4376. [PMID: 36927859 PMCID: PMC10020167 DOI: 10.1038/s41598-023-30852-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 03/02/2023] [Indexed: 03/18/2023] Open
Abstract
Food taboos have a negative impact on pregnant women and their fetuses by preventing them from consuming vital foods. Previous research found that pregnant women avoided certain foods during their pregnancy for a variety of reasons. This review aimed to determine the pooled prevalence of food taboo practices and associated factors in Ethiopia. In compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, we searched the literature using PubMed/MEDLINE, AJOL (African Journal Online), HINARI, Science Direct, Google Scholar, and Google electronic databases. The random-effects model was used to estimate the pooled prevalence of food taboo and its determinants at a 95% confidence interval with their respective odds ratios. The pooled food taboo practice among Ethiopian pregnant women was 34.22% (95% CI 25.47-42.96), and after adjustment for publication bias with the trim-and-fill analysis, the pooled food taboo practice of pregnant women was changed to 21.31% (95% CI: 10.85-31.67%). Having less than a secondary education level (OR = 3.57; 95% CI 1.43-8.89), having no ANC follow-up (OR = 4.35; 95% CI 1.12-16.94), and being a rural resident (OR = 3.08; 95% CI 1.14-8.28) were the significant factors. Dairy products, some fruits, green leafy vegetables, meat, and honey are among the taboo foods. The most frequently stated reasons for this taboo practice were: fear of producing a big fetus, which is difficult during delivery; attachment to the fetus's body or head; and fear of fetal abnormality.
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Affiliation(s)
- Berhanu Gidisa Debela
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.
| | - Daniel Sisay
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Habtamu Endashaw Hareru
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Helen Ali Ewune
- Department of Human Nutrition, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Anene Tesfa
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Daniel Alayu Shewaye
- School of Public Health, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
| | - Temesgen Muche Ewunie
- Department of Human Nutrition, College of Health and Medical Science, Dilla University, Dilla, Ethiopia
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Chea N, Tegene Y, Astatkie A, Spigt M. Prevalence of undernutrition among pregnant women and its differences across relevant subgroups in rural Ethiopia: a community-based cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:17. [PMID: 36899418 PMCID: PMC10007751 DOI: 10.1186/s41043-023-00358-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Maternal undernutrition is one of the commonest public health problems in many low- and middle-income countries where generally more than 20% of women are undernourished. It is more common in rural areas due to unclear factors. Therefore, the aim of this study was to investigate the prevalence of undernutrition in general and in subgroups and determine risk factors among pregnant women in rural Ethiopia. METHODS A community-based cross-sectional survey was conducted from April 30 to May 30, 2019 on 550 pregnant women who were randomly selected from six districts in southern Ethiopia. Trained and experienced nurses measured undernutrition using mid-upper arm circumference and collected other data. We used multilevel mixed-effect logistic regression to identify factors associated with undernutrition among pregnant women. RESULTS The prevalence of undernutrition among pregnant women was 38% (95% CI: (34.2-42.3). The odds of undernutrition was higher among women who got pregnant previously (adjusted odds ratio [AOR]: 1.66; 95% CI: 1.02-2.71), who had a history of miscarriage (AOR: 3.18; 95% CI: 1.77-5.70), who practiced food taboos (AOR: 2.23; 95% CI: 1.47-3.39), and who did not get any nutritional counseling during pregnancy (AOR: 2.97; 95% CI: 1.79- 4.95). The prevalence of undernutrition was higher among pregnant women who had multiple risk factors and the difference was statistically significant (p < 0.001). CONCLUSION Undernutrition is a highly prevalent problem among rural Ethiopian pregnant women, especially with those who avoid food, do not get counseled, and had two or more pregnancies and a history of miscarriage. Improving the integration of nutrition programs with routine healthcare services and encouraging a multi-sectorial intervention strategy would help to reduce maternal undernutrition in the country.
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Affiliation(s)
- Nana Chea
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.Box: 1560, Hawassa, Ethiopia.
| | - Yadessa Tegene
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.Box: 1560, Hawassa, Ethiopia
| | - Ayalew Astatkie
- School of Public Health, College of Medicine and Health Sciences, Hawassa University, P.O.Box: 1560, Hawassa, Ethiopia
| | - Mark Spigt
- School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- General Practice Research Unit, Department of Community Medicine, The Arctic University of Tromsø, Tromsø, Norway
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Gebregziabher H, Kahsay A, Gebrearegay F, Berhe K, Gebremariam A, Gebretsadik GG. Food taboos and their perceived reasons among pregnant women in Ethiopia: a systematic review, 2022. BMC Pregnancy Childbirth 2023; 23:116. [PMID: 36797675 PMCID: PMC9933406 DOI: 10.1186/s12884-023-05437-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND There are foods considered as taboo across different communities in the world and in Ethiopia in particular. Although food taboos exist across all ages or physiologic states, they are predominant among pregnant women and children. Identifying such foods among pregnant women is crucial in providing focused interventions and prevents their negative consequences. Therefore, the aim of this review was to review the available evidence on food taboos and their perceived reasons among pregnant women in Ethiopia to provide comprehensive and precise evidence for decision making. METHODS Electronic search of the literature was made from Pub-Med, Google Scholar, Google Scopus, and Medline databases using search terms set based on the PICO/PS (Population, Intervention/exposure, Comparison, and Outcome) and PS (Population and Situation) search table. The search was made from December 05, 2020 - December, 29, 2021, and updated on January, 2022. All quantitative and qualitative studies published in English were included in the review. The systematic review protocol was registered at INPLASY (Registration number: INPLASY202310078). The outcome of interest was food taboo for pregnant women and its perceived reasons. The results of the review was narrated. RESULTS After identifying eighty two articles, thirteen were found eligible for the review. Vegetables, fruits, and fatty foods like meat, and dairy products were considered as taboo for pregnant women in different parts of Ethiopia. The reasons stated for the food taboo vary from fear of having a big baby, obstructed labour, and abortion to evil eye and physical and aesthetic deformities in the newborn. CONCLUSIONS Though not uniform across the country, there are foods considered as taboo for pregnant women in Ethiopia due to several perceived reasons, misconceptions, and societal influences. This could increase the risk of malnutrition and could have short and long term consequences on both the mother and her growing foetus. Therefore, context specific nutritional counseling with emphasis during ante-natal care and post-natal service is important.
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Affiliation(s)
- Hadush Gebregziabher
- grid.30820.390000 0001 1539 8988Department of Nutrition and Dietetics School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Amaha Kahsay
- grid.30820.390000 0001 1539 8988Department of Nutrition and Dietetics School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Fereweini Gebrearegay
- grid.30820.390000 0001 1539 8988Department of Nutrition and Dietetics School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Kidanemaryam Berhe
- grid.30820.390000 0001 1539 8988Department of Nutrition and Dietetics School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Alem Gebremariam
- grid.472243.40000 0004 1783 9494Department of Public Health, College of Medicine and Health Science, Adigrat University, Tigray, Ethiopia
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Tsegaye Negash B, Ayalew M. Trend and factors associated with anemia among women reproductive age in Ethiopia: A multivariate decomposition analysis of Ethiopian Demographic and Health Survey. PLoS One 2023; 18:e0280679. [PMID: 36689422 PMCID: PMC9870172 DOI: 10.1371/journal.pone.0280679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/20/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND In developing countries like Ethiopia, anemia is a public health problem. Unfortunately, the progress of anemia reduction has been slow. Although the issue of anemia has received considerable critical attention nowadays, trends and factors associated with anemia among women of reproductive age have not been explored in Ethiopia. OBJECTIVE This study aimed to determine trends and factors associated with anemia among women of reproductive age in Ethiopia from 2005 to 2016. METHOD Data from three consecutive Ethiopian Demographic and Health Survey (EDHS) from 2005-2016 were analyzed in this study. EDHS is a two-stage cluster sampling survey. Data were weighted to correct sampling bias in all surveys. A total of 46,268 samples were analyzed using a fixed effect model. For a measure of proportion, differences and slopes were computed. Bivariate and multivariable logistic regression analyses were done to identify predictors of the trend of anemia among women. Adjusted odds ratio (AOR) with a 95% Confidence Interval(CI) was computed, and the p-value < 0.05 is considered significant. RESULT Prevalence of anemia among women was 68%, 20.3%, and 27.3% in 2005, 2011 and 2016, respectively. The trend of anemia was reduced by 47.7 percentage points from 2005 to 2011; however, it increased by 7% points again from 2011 in 2016. Lack of mobile phones (AOR = 1.4, 95%CI, 1.2,1.6), Afar women (AOR = 1.5, 95%CI, 1.1,2.3) and Somali women (AOR = 1.5, 95%CI, 1.1,1.9) were associated with anaemia among women. On the contrary, the history of heavy menstruation in the last six months (AOR = 0.9; 95%CI, 0.85,0.98) was a factor negatively associated with anemia in 2005. In 2011, single women (AOR = 0.8,95%CI,0.7,0.9), watching TV less than once per wk (AOR = 0.9,95%CI,0.7,0.95), watching TV at least once per week (AOR = 0.8,95%CI,0.7,0.98) were variables associated with anemia. On the contrary, widowed women (AOR = 1.7,95%CI,1.4,2.0) were affected by anemia. In 2016, the richest women (AOR = 0.7, 95%CI, 0.6,0.8) and single (AOR = 0.8, 95%CI, 0.7,0.9) were affected little by anemia. Women of traditional belief followers (AOR = 2.2,95%CI,1.6,2.9) were more highly influenced by anemia than their counterparts. CONCLUSION The prevalence of anemia declined rapidly from 2005 to 2011, and increased from 2011 to 2016. Stakeholders should develop policies and programs to enhance the socio-demographic status of women and basic infrastructure for the community. Furthermore, they should design strategies for extensive media coverage of the prevention of anemia. The federal government should balance the proportion of anemia among regions by ensuring health equality.
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Affiliation(s)
- Berhan Tsegaye Negash
- Department of Midwifery, College of Medicine and Health sciences, Hawassa University, Hawassa, Ethiopia
| | - Mohammed Ayalew
- Department of Psychatric Nursing, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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Dietary diversity practice and its influencing factors among pregnant women in Afar region of Ethiopia: mixed method study. BMC Pregnancy Childbirth 2022; 22:291. [PMID: 35387620 PMCID: PMC8988420 DOI: 10.1186/s12884-022-04641-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Pregnancy can aggravate nutritional deficiencies, especially micronutrient deficiencies, which can have major health impact for the fetus and mother. Women in low-income countries are frequently malnourished when they become pregnant. Identifying the magnitude of dietary diversity and its influencing factors among pregnant women in the pastoral region of Afar, where no study has been conducted, is critical for establishing an intervention program in the region. Method A mixed study comprising 241 pregnant women and six focus group discussions was conducted from October 1 to November 10, 2018. Participants in the quantitative study were selected by a systematic sampling method, whereas those in the focus group discussions were selected by a purposive sampling method. The data were collected using pretested questionnaires administered via face-to-face interviews. Logistic regression determines the association between the dietary diversity practice and its influencing factors. The results were presented by the odds ratio with a 95% confidence interval. A P-value of < 0.05 is used to declare a statistically significant. A thematic framework was used to analyze the qualitative data. Results Seventy-three percent of pregnant women had poor dietary diversity. Dietary diversity was higher in younger pregnant women who were under the age of 20 years (AOR = 5.8; at 95% CI: 1.6–13.5) and aged between 21 and 25 years (AOR = 3.9; at 95% CI: 1.1–12.2) than those pregnant women over the age of 30 years. Those participants with a high average family income (above 4500 birr) had good dietary diversity compared to those with an average family income of less than 1500 birr (AOR = 0.1: 95% CI; 0.02–0.7) and 1500–3000 birr (AOR = 0.05: 95% CI; 0.01–0.2). Pregnant women who had one antenatal care visit had less dietary diversity practice than those who had four or more antenatal care visits (AOR = 0.18: 95% CI; 0.04–0.8). Protein-rich foods (meat and eggs), cereal-based semi-solid foods (porridge and soup), milk, bananas and cabbage, were the most commonly tabooed foods during pregnancy. Protein-rich foods were thought to increase the size of the fetus. Semi-solid foods (porridge and soup), bananas, and cabbage, on the other hand, were thought to stick to the fetus's body. Conclusion Most of the study participants had poor dietary diversity. Older women have lower dietary diversity practices than younger women. Pregnant women with a low family income and only one prenatal care visit were less likely to practice dietary diversity than pregnant women with a high family income and those with four or more antenatal care visits. Pregnant women practiced food taboos due to misconceptions that were producing large babies and attached to the babies’ bodies. A public health campaign emphasizing the necessity of antenatal care follow-ups should be launched. Community nutrition education should be provided to reduce the traditional beliefs about certain foods, especially for older women.
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Abebe H, Beyene GA, Mulat BS. Harmful cultural practices during perinatal period and associated factors among women of childbearing age in Southern Ethiopia: Community based cross-sectional study. PLoS One 2021; 16:e0254095. [PMID: 34214133 PMCID: PMC8253409 DOI: 10.1371/journal.pone.0254095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 06/19/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Although the maternal mortality ratio has decreased by 38% in the last decade, 810 women die from preventable causes related to pregnancy and childbirth every day, and two-thirds of maternal deaths occur in Sub-Saharan Africa alone. The lives of women and newborns before, during, and after childbirth can be saved by skilled care. The main factors that prevent women from receiving care during pregnancy and childbirth are harmful cultural practices. The aim of this study was to assess the level of harmful cultural practices during pregnancy, childbirth, and postnatal period, and associated factors among women of childbearing age in Southern Ethiopia. METHODS A community-based cross-sectional study design was conducted in the Gurage zone, among representative sample of 422 women of reproductive age who had at least one history of childbirth. A simple random sampling technique was used to recruit participants. Data were collected by six experienced and trained data collectors using a pretested structured questionnaire with face to face interviews. Harmful cultural practices are assessed using 11 questions and those who participate in any one of them are considered as harmful cultural practices. Descriptive statistics were performed and the findings were presented in text and tables. Binary logistic regression was used to assess the association between each independent variable and outcome variable. RESULTS Harmful cultural practices were found to be 71.4% [95%CI, 66.6-76.0]. The mean age of study participants was 27.6 (SD ± 5.4 years). Women with no formal education [AOR 3.79; 95%CI, 1.97-7.28], being a rural resident [AOR 4.41, 95%CI, 2.63-7.39], having had no antenatal care in the last pregnancy [AOR 2.62, 95%CI, 1.54-4.48], and pregnancy being attended by untrained attendants [AOR 2.67, 95%CI, 1.58-4.51] were significantly associated with harmful cultural practice during the perinatal period. CONCLUSION In this study we found that low maternal education, rural residence, lack of antenatal care and lack of trained birth attendant were independent risk factors associated with women employing harmful cultural practices during the perinatal period. Thus, strong multi-sectoral collaboration targeted at improving women's educational status and primary health care workers should take up the active role of women's health education on the importance of ANC visits to tackle harmful cultural practices.
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Affiliation(s)
- Haimanot Abebe
- Department of Public Health, College of Health Sciences and Medicine, Wolkite University, Wolkite, Ethiopia
| | - Girma Alemayehu Beyene
- Department of Public Health, College of Health Sciences and Medicine, Wolkite University, Wolkite, Ethiopia
| | - Berhanu Semra Mulat
- Department of Public Health, College of Health Sciences and Medicine, Wolkite University, Wolkite, Ethiopia
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11
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Kibr G. A Narrative Review of Nutritional Malpractices, Motivational Drivers, and Consequences in Pregnant Women: Evidence from Recent Literature and Program Implications in Ethiopia. ScientificWorldJournal 2021; 2021:5580039. [PMID: 34248425 PMCID: PMC8236338 DOI: 10.1155/2021/5580039] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 05/27/2021] [Accepted: 06/08/2021] [Indexed: 11/17/2022] Open
Abstract
Maternal nutrition is very important for the wellbeing of pregnant women, childbirth, and lactating women, which are crucial and meant for the wellbeing of a mother and newborn baby. This narrative review discusses nutritional malpractices, motivational drivers, and their consequences typically from Ethiopian pregnant women's context. Different studies (regarding less of study design and type) done among pregnant women (aged 15-49 years) by considering pregnancy-related outcomes and timing of nutritional malpractices were included mostly. Accordingly, taboos of healthy diets, craving for unhealthy foods (sweet, fat, raw, and salty/spicy foods), and nonfood items (soil, coffee residue, stone, and ash) were practiced majorly by the women. The birth difficulty, fetal head plastering, fetus discoloration, fetus burns, abortion, and abdominal cramp are the primary drivers of taboos of healthy diets. Hormonal change and social and nutrient-seeking behavior are the most prevalent drivers to the consumption of unhealthy foods. Additionally, personal interest, flavor, and color of items are important motivators to practice pica. Such pica practice hurts nutrient intake, absorption of iron/zinc, abdominal health, and diarrhea occurrence. Food taboos are high predictors of health disorders, such as intrauterine growth restriction, infection, bleeding, preeclampsia, stillbirth, early birth, low birth weight, retarded development of cognitive, and anemia. Craving and eating unhealthy foods were interconnected with chronic disease development (hypertension, diabetes, heart disease, and cancer), discomforts, preterm labor, preeclampsia, and intrauterine growth restriction in women. Additionally, it is also associated with stillbirth, low birth weight, obesity, birth defect/deficit, hypertension, cancer, diabetes, metabolic syndrome, renal disease, decreased fetal growth, behavioral change, heart failure, and poor cognitive development in the infant. Overall, these nutritional malpractices are significantly associated with many argumentative pregnancies as well as developmental consequences leading to the direction of infant and maternal mortality and morbidity. Therefore, urgent implementation of health and nutrition education programs considering food misconceptions and beliefs regarding pregnancy and use of ground-breaking ways to play down the negative and maximize potential positive dietary effects designed by the government of Ethiopia could also serve as a long-term solution to the problem.
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Affiliation(s)
- Gesessew Kibr
- Department of Food and Nutritional Sciences, Faculty of Agriculture, Shambu Campus, Wollega University, P. O. Box: 38, Shambu, Ethiopia
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What stops us from eating: a qualitative investigation of dietary barriers during pregnancy in Punjab, Pakistan. Public Health Nutr 2021; 25:760-769. [PMID: 33866982 DOI: 10.1017/s1368980021001737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Adequate dietary intake during pregnancy is vital for the health and nutritional status of both mother and fetus. The nutritional status of reproductive age women in Pakistan is poor, with 14 % being underweight (BMI < 18·5) and 42 % experiencing Fe deficiency anaemia. This may stem from beliefs, practices and other barriers influencing dietary intake. This qualitative study seeks to determine which factors impact dietary intake during pregnancy in rural Punjab. DESIGN In-depth interviews and focus group discussions were conducted and then analysed using thematic analysis. SETTING Three purposively selected rural districts (Sahiwal, Okara and Pakpatan) with the highest prevalence of maternal and child malnutrition in the province of Punjab, Pakistan. PARTICIPANTS Mothers with children under age two (n 29) and healthcare providers with at least 5 years of experience working in the district (n 12). RESULTS We identified a combination of physiological, socio-cultural and structural barriers that inhibited healthful dietary intake during pregnancy. The primary physiological barriers to optimal dietary intake and dietary practices included food aversions and food cravings. Food classification, fear of a difficult childbirth, fear of high blood pressure and household food politics were the principal socio-cultural barriers. Additionally, two structural barriers, inadequate antenatal counseling and a lack of affordable food options, were identified. CONCLUSIONS Our study demonstrates that complex barriers prevent pregnant women in the Punjab area from consuming adequate dietary intake and that antenatal health education programmes and structural interventions are needed to support healthful dietary practices during this critical period.
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Tsegaye D, Tamiru D, Belachew T. Food-related taboos and misconceptions during pregnancy among rural communities of Illu Aba Bor zone, Southwest Ethiopia. A community based qualitative cross-sectional study. BMC Pregnancy Childbirth 2021; 21:309. [PMID: 33865339 PMCID: PMC8052673 DOI: 10.1186/s12884-021-03778-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 04/05/2021] [Indexed: 11/24/2022] Open
Abstract
Background Poor maternal nutrition adversely affects pregnancy and birth outcomes. In many societies, there are dietary restrictions due to misconceptions or food taboos during pregnancy which consequently results in the depletion of important nutrients. These cultural malpractices and beliefs can influence the dietary intake of pregnant women which subsequently affects the birth outcome. The study aimed at exploring the extent of food taboos and misconceptions during pregnancy in rural communities of Illu Aba Bor Zone, Southwest Ethiopia. Methods A qualitative study was conducted using an in-depth interviews of key informants and focus group discussions among purposively selected pregnant women and their husbands, health care workers, health extension workers, and elderly people. Data were transcribed verbatim, thematized; color-coded, and analyzed manually using the thematic framework method. Result Thorough reading and review of the transcripts generated three major themes. The primary theme was the belief and practice of taboos related to the intake of certain food items during pregnancy. Pregnant women, their husbands, and mothers-in-law believed that certain foods should be avoided during pregnancy. The second theme was foods that were held as taboo and the reason attached to it. The most common food items held as taboo were related to the consumption of vegetables like cabbage, pumpkin, milk and milk products, sugar cane, fruits like bananas and avocado and egg. The main reasons to avoid these foods were beliefs that it can be plastered on the fetal head, making fatty baby which is difficult for delivery. The third theme was the reasons underlying adherence to food taboos which is deeply embedded in the person’s believes and attitudes of the pregnant women, who were nested within the influence of the social environment surrounding them and the traditional beliefs and values of the society in general. Conclusions The results showed a widespread practice of food taboos during pregnancy in the study area. The finding suggested that there is a need for strengthening the nutrition counseling components of antenatal care follow-up and planning comprehensive nutrition education through involving important others to dispel such traditional beliefs and prevent food taboo practices in the study community. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03778-6.
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Affiliation(s)
- Dereje Tsegaye
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Ethiopia, Jimma, Ethiopia. .,College of Health Science, Department of Public Health, Mettu University, Metu, Ethiopia.
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Ethiopia, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Institute of Health, Jimma University, Ethiopia, Jimma, Ethiopia
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Tirore LL, Mulugeta A, Belachew AB, Gebrehaweria M, Sahilemichael A, Erkalo D, Atsbha R. Factors associated with anaemia among women of reproductive age in Ethiopia: Multilevel ordinal logistic regression analysis. MATERNAL AND CHILD NUTRITION 2020; 17:e13063. [PMID: 32761751 PMCID: PMC7729796 DOI: 10.1111/mcn.13063] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 06/08/2020] [Accepted: 06/17/2020] [Indexed: 12/27/2022]
Abstract
Anaemia has prevailed as a mild to severe public health problem in Ethiopian women of reproductive age. Many studies carried out on anaemia have been limited to subnational assessments and subgroups of women. The effects of potential factors thought to affect anaemia and severity levels of anaemia have not been well considered. Therefore, this study identifies individual, household and community level factors associated with anaemia among women of reproductive age in Ethiopia applying multilevel ordinal logistic regression models. Proportional odds assumption was tested by likelihood ratio test. About 35.6% of the variation on anaemia was due to between household and community level differences. Pregnancy (adjusted odds ratio [AOR] = 2.30, 95% confidence interval [CI]: 1.82, 2.91), HIV (AOR = 2.40, 95% CI: 1.76, 3.25), giving birth once (AOR = 1.2, 95% CI: 1.05, 1.40), giving birth more than once (AOR = 1.4, 95% CI: 1.19, 1.71), living with five or more family members (AOR = 1.24, 95% CI: 1.05, 1.47), living in poorest households (AOR = 1.34, 95% CI: 1.2, 1.61) and rural area (AOR = 1.57, 95% CI: 1.28, 1.92) were associated with greater odds of more severe anaemia compared with their respective counter parts. Secondary and above education (AOR = 0.83, 95% CI: 0.70, 0.97) and use of pills, implants or injectable (AOR = 0.67, 95% CI: 0.59, 0.77) were associated with lower odds of more severe anaemia. Anaemia prevention and control programmes need to be strengthened for women living with HIV/AIDS and during pregnancy. Household poverty reduction and social protection services need to be strengthened and integrated in anaemia prevention and management activities in women.
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Affiliation(s)
- Lire Lemma Tirore
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Afework Mulugeta
- Department of Nutrition, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abate Bekele Belachew
- Department of Biostatistics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Menaseb Gebrehaweria
- Department of Public Health, College of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia
| | | | - Desta Erkalo
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Rigeat Atsbha
- Saesie Tsaeda Emba District Health Office, Tigray Regional Health Bureau, Mekelle, Ethiopia
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15
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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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Mohammed SH, Taye H, Larijani B, Esmaillzadeh A. Food taboo among pregnant Ethiopian women: magnitude, drivers, and association with anemia. Nutr J 2019; 18:19. [PMID: 30904017 PMCID: PMC6431010 DOI: 10.1186/s12937-019-0444-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Accepted: 03/18/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There are pervasive pregnancy-related food taboos and myths (PRFT) in Ethiopia. The evidence, however, is limited on whether PRFT contributes to the burden of maternal anemia. Thus, this study was aimed to determine the magnitude of PRFT, the reasons for adherence to PRFT, and the association of adherence to PRFT with anemia, among pregnant Ethiopian women. METHODS The study was case-control in design and recruited a sample of 592 pregnant women attending antenatal care in four health facilities in Addis Ababa, Ethiopia. Participants were classified into anemic cases (n = 187) and non-anemic controls (n = 405) based on their hemoglobin level. PRFT was assessed by the participants' subjective reporting of avoidance of certain food items during the current pregnancy due to taboo reasons. The specific types of food items avoided and the underlying reasons for the avoidance were also assessed. The relation of PRFT with anemia was evaluated by multiple logistic regression analysis, controlling for covariate factors. RESULT Almost a fifth of the study participants (18.2%) avoided one or more food items due to PRFT. Adherence to PRFT was 26.2 and 14.6% among the anemic and the non-anemic individuals, respectively. The food items most avoided due to adherence to PRFT were green chili pepper, organ meat, and dark green leafy vegetables like spinach, lettuce, kale, and broccoli. The underlying reasons for the adherence to PRFT were largely traditionally held beliefs and misconceptions. After controlling for covariates, PRFT was significantly and independently associated with a higher odds of anemia [adjusted odds ratio (AOR) = 2.12, 95% confidence interval (CI) = 1.32-3.42, P = 0.002]. CONCLUSION PRFT might be contributing to the burden of maternal anemia in Ethiopia. It is time for public health authorities in Ethiopia to recognize PRFT as a public health risk, strengthen maternal nutrition counseling, and create public awareness of the consequences of PRFT. TRIAL REGISTRATION ClinicalTrials.gov (NCT03251664), 16 August 2017.
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Affiliation(s)
- Shimels Hussien Mohammed
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Iran
| | - Hailu Taye
- Unit of Reproductive Health, Addis Ababa City Administration Health Bureau, Addis Ababa, Ethiopia
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
- Food Security Research Center, Department of Community Nutrition, Isfahan University of Medical Sciences, Isfahan, Iran
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Desalegn BB, Lambert C, Riedel S, Negese T, Biesalski HK. Ethiopian Orthodox Fasting and Lactating Mothers: Longitudinal Study on Dietary Pattern and Nutritional Status in Rural Tigray, Ethiopia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1767. [PMID: 30126089 PMCID: PMC6121597 DOI: 10.3390/ijerph15081767] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 07/28/2018] [Accepted: 08/10/2018] [Indexed: 12/16/2022]
Abstract
About half of Ethiopians belong to the Orthodox Tewahedo religion. Annually, more than 200 days are dedicated to religious fasting, which includes abstaining from all types of food, animal source foods, and water. However, the association of fasting with undernutrition remains unknown in Ethiopia. Therefore, dietary pattern and nutritional status of lactating women during lent fasting and non-fasting periods were studied, and predictor variables for maternal underweight were identified. To achieve this, lactating mothers in lent fasting (N = 572) and non-fasting (N = 522) periods participated from rural Tigray, Northern Ethiopia. Average minimum diet diversity (MDD-W) was computed from two 24-h recalls, and nutritional status was assessed using body mass index (BMI). Binary logistic regression was used to identify potential predictors of maternal underweight. Wilcoxon signed-rank (WSRT) and McNemar's tests were used for comparison of the two periods. The prevalence of underweight in fasting mothers was 50.6%. In the multivariate logistic regression model, younger age, sickness in the last four weeks preceding the survey, fasting during pregnancy, lactation periods, grandfathers' as household decision makers, previous aid experience, non-improved water source, and not owning chicken were positively associated with maternal underweight. In WSRT, there was no significant (p > 0.05) difference on maternal body weight and BMI between periods. The average number of meals, diet diversity, and animal source foods (ASFs), consumption scores were significantly increased in non-fasting compared to fasting periods in both fasting and non-fasting mothers (p < 0.001, p < 0.05, and p < 0.001, respectively). Consumption of dark green leafy vegetables was higher in the fasting period (11%) than non-fasting (3.6%), in the study population. As a conclusion, Ethiopian Orthodox fasting negatively affected maternal nutritional status and dietary pattern in rural Tigray, Northern Ethiopia. To reduce maternal malnutrition in Ethiopia, existing multi-sectoral nutrition intervention strategies, should include religious institutions in a sustainable manner.
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Affiliation(s)
- Beruk Berhanu Desalegn
- College of Agriculture, Hawassa University, Postal code: 05, Hawassa, Ethiopia.
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Garbenstr. 30, 70593 Stuttgart, Germany.
| | - Christine Lambert
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Garbenstr. 30, 70593 Stuttgart, Germany.
| | - Simon Riedel
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Garbenstr. 30, 70593 Stuttgart, Germany.
| | - Tegene Negese
- College of Agriculture, Hawassa University, Postal code: 05, Hawassa, Ethiopia.
| | - Hans Konrad Biesalski
- Institute of Biological Chemistry and Nutrition, University of Hohenheim, Garbenstr. 30, 70593 Stuttgart, Germany.
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