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Beressa G, Whiting SJ, Belachew T. Effect of nutrition education on the nutritional status of pregnant women in Robe and Goba Towns, Southeast Ethiopia, using a cluster randomized controlled trial. Sci Rep 2024; 14:19706. [PMID: 39181962 DOI: 10.1038/s41598-024-70861-1] [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: 01/03/2024] [Accepted: 08/21/2024] [Indexed: 08/27/2024] Open
Abstract
Maternal malnutrition is pervasive throughout the world, notably in sub-Saharan Africa (SSA), including Ethiopia. This study aimed to assess the effect of nutrition education on the nutritional status of pregnant women in urban settings in Southeast Ethiopia. A community-based two-arm parallel cluster randomized controlled trial was conducted among 447 randomly selected pregnant women attending antenatal care (224 intervention and 223 control). We used a multistage cluster sampling technique followed by systematic sampling to select the pregnant women. Pregnant women who participated in the intervention arm received six nutrition education sessions. Women in the control group received standard care. A nonstretchable mid-upper arm circumference (MUAC) tape was used to measure the MUAC. A linear mixed effects model (LMM) was used to evaluate the effect of the intervention on MUAC, accounting for the clustering. The net mean ± standard error of MUAC between the intervention and control groups was 0.59 ± 0.05 (P < 0.0001). The multivariable LMM indicated that having received nutrition education interventions (β = 0.85, 95% CI 0.60, 1.12, P < 0.0001) improved the MUAC measurement of pregnant women. Thus, nutrition education during pregnancy will combat undernutrition among pregnant women.Trial Registration: Clinicaltrials.gov (PACTR202201731802989), retrospectively registered on 24/01/2022.
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Affiliation(s)
- Girma Beressa
- Department of Public Health, School of Health Sciences, Madda Walabu University, Goba, Ethiopia.
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia.
| | - Susan J Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Canada
| | - Tefera Belachew
- Nutrition and Dietetics Department, Faculty of Public Health, Jimma University, Jimma, Ethiopia
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Wood EA, Stark H, Case SJ, Sousa B, Moreno M, Motuma A, Wilfong T. Khat use and related determinants among pregnant women within Haramaya, Ethiopia: a mixed methods study. Front Glob Womens Health 2024; 5:1359689. [PMID: 38784944 PMCID: PMC11112567 DOI: 10.3389/fgwh.2024.1359689] [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: 12/21/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Khat, a green leafy plant grown in East Africa and throughout the Arabian Peninsula, is chewed for its psychoactive and amphetamine-like effects, serving as a significant aspect of culture, economic livelihood, and global trade. Khat consumption during pregnancy has been associated with adverse effects, including anemia, premature rupture of membranes, and low birth weight, among others. Methods This cross-sectional, explanatory sequential mixed methods study was conducted in the Haramaya District of eastern Ethiopia using a questionnaire and focus group discussions. Questionnaires assessed socio-demographic information, pregnancy history, and diet, including khat use. Data were analyzed using SPSS v28 to include descriptive statistics, proportions, odds ratios, binary logistic regression, and chi-square analysis. FGDs expanded on the knowledge, attitudes, and practices of khat in the region, including pregnant or lactating women from two different kebeles. Two independent reviewers conducted a qualitative content analysis to examine the qualitative findings from the FGDs. Transcripts from the focus groups were entered into NVivo 14 to aid in capturing salient themes. Results A total of 444 pregnant women with a median age of 25 years completed the questionnaire. Two-thirds of the women, 66.9%, reported currently consuming khat while pregnant, and 72.7% of them reported daily consumption. The FGD analysis resulted in the discovery of five themes: Economic Livelihood, Maternal Significance, Medicinal Implications of Khat, Pesticide Use, and Social and Cultural Applications. Discussion This study revealed an alarming high prevalence of khat consumption among pregnant women in the Haramaya District, highlighting the pressing need for long-term studies to assess the health consequences. The role of khat as both an economic staple and an energy source for daily activities underscores the challenges in curbing its use. The documented health risks associated with the chemicals used in khat cultivation, including cancer, call for interventions to enhance safe agricultural practices in households involved in khat farming.
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Affiliation(s)
- Elizabeth A. Wood
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States
| | - Heather Stark
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Stuart J. Case
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Barbara Sousa
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Melanie Moreno
- College of Public Health & Health Professions, University of Florida, Gainesville, FL, United States
| | - Aboma Motuma
- School of Nursing and Midwifery, 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
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Abdalla M, Zein MM, Sherif A, Essam B, Mahmoud H. Nutrition and diet myths, knowledge and practice during pregnancy and lactation among a sample of Egyptian pregnant women: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:140. [PMID: 38365622 PMCID: PMC10870649 DOI: 10.1186/s12884-024-06331-3] [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: 09/27/2023] [Accepted: 02/07/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Globally, the burden of maternal malnutrition remains an enormous public health problem; malnourished pregnant women are at increased risk of having low-birth-weight (LBW) infants. Several reports suggest a possible association between malnutrition among lactating mothers and the production of smaller quantities of breast milk. Many women have incorrect nutrition knowledge during pregnancy due to false beliefs derived from popular practices. Our study was conducted to assess nutritional knowledge, myths, and practices among Egyptian women during pregnancy and lactation. METHODOLOGY A pretested 2-page interview questionnaire was used to collect data from the study participants after written informed consent was obtained from them after clarification of the study's aim. Obstetrics and gynecology experts collected the data from pregnant females who agreed to participate in private and university hospital antenatal care clinics in Cairo, Egypt. RESULTS A total of 468 pregnant females completed the interview questionnaire. The mean knowledge score was 5 ± 3, with a median score of 5 and an IQR of 3-7, and the mean holding myths score was 3 ± 2, with a median score of 2 and an IQR of 2-4. Regarding the correct answers to the knowledge questions, more than 70% of the participants correctly answered that during the first six months of life, breast milk is the only food a baby requires, and less than 20% of them correctly answered that caffeine consumption could provoke premature birth. Regarding the holding myths questions, more than half of the participants held the myth that drinking moghat and helba increases the breast milk supply. We found that the most common source of knowledge during pregnancy and lactation among the participants was family and friends' advice (60%), followed by others (doctors, previous education in school or university) (45%). CONCLUSION Among a sample of Egyptian women, more than half held at least one myth about nutrition and diet during pregnancy and breastfeeding, so health education at antenatal outpatient clinics should be directed toward those myths to correct them. Older women with sufficient family income showed significantly higher knowledge scores than others.
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Affiliation(s)
- Marwa Abdalla
- Kasr Al Ainy Hospital, Department of Obstetrics and Gynecology, Cairo University, Cairo, 12256, Egypt.
| | - Marwa M Zein
- Kasr Al Ainy Hospital, Department of Public Health, Cairo University, Cairo, 12256, Egypt
| | - Ahmed Sherif
- General practitioner, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Bassam Essam
- General practitioner, Kasr Al Ainy Hospital, Cairo University, Cairo, Egypt
| | - Hend Mahmoud
- Kasr Al Ainy Hospital, Department of Obstetrics and Gynecology, Cairo University, Cairo, 12256, Egypt
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Miele MJ, Souza RT, Vieira MC, Pacagnella RC, Cecatti JG. Maternal diet and interactions with nutritional evaluation during pregnancy. Int J Gynaecol Obstet 2023; 163:782-789. [PMID: 37401116 DOI: 10.1002/ijgo.14974] [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: 02/04/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/05/2023]
Abstract
This narrative review aims to describe the knowledge regarding nutritional evaluation and monitoring in pregnant women. We discuss care provided by non-specialists in nutrition, regarding dietary information and risks during pregnancy, from a theoretical or conceptual viewpoint. A narrative review was conducted following a literature search when scientific databases were investigated, including SciELO, LILACS, Medline, PubMed, theses, government reports, books, and chapters in books. Finally, the material was fully read, categorized, and critically analyzed. National and international protocols of prenatal nutritional care were included and discussed. Different protocols describe the complexity of evaluating and monitoring nutrition among pregnant women during the prenatal period according to each country. The understanding of social conditions and eating habits has an important role in providing nutritional advice during pregnancy. The lack of dietitians in care overwhelms the healthcare workers and characterizes a missed opportunity. Therefore, it is important to consider rapid support tools that can track adverse nutritional status, and ways to recommend a diet that meets eating habit dynamics, according to the reality of each public health system.
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Affiliation(s)
- Maria J Miele
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Renato T Souza
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - Matias C Vieira
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
- Division of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, London, UK
| | - Rodolfo C Pacagnella
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
| | - José G Cecatti
- Department of Obstetrics and Gynecology, School of Medicine, University of Campinas (UNICAMP), Campinas, Brazil
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Tafasa SM, Darega J, Dida N, Gemechu FD. Dietary diversity, undernutrition and associated factors among pregnant women in Gindeberet district, Oromia, Ethiopia: a cross-sectional study. BMC Nutr 2023; 9:115. [PMID: 37833770 PMCID: PMC10576272 DOI: 10.1186/s40795-023-00773-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Appropriate levels of dietary diversity are essential for proper physiology of human being and it is crucial to consume healthy foods at every phase of life, especially during pregnancy. Inadequate dietary diversity and malnutrition are risk factors for low birth weight, intrauterine growth reduction and small for gestational age. This study was aimed to assess dietary diversity, undernutrition and associated factors among pregnant women in Gindeberet district, Oromia, Ethiopia, 2020. METHOD A community based cross-sectional study was conducted among 627 pregnant women in Gindeberet district selected by systematic random sampling from October 10/2020- November 10/2020. Data were collected through interviewer administered questionnaires. The collected data were coded and entered to Epi-info version 7.2.2.6 and analyzed by SPSS version 23. Logistic regression analysis was carried out to identify factor associated with undernutrition and dietary diversity. Level of statistical significance was declared at p-value < 0.05. RESULTS overall prevalence of inadequate dietary diversity and undernutrition were 276 (44.4%) and 110 (17.7%) respectively. Pregnant women who did not receive antenatal care (AOR = 2.32, [95% CI: 1.38, 3.90]), family size ≥ 5 (AOR: 2.93; [95%CI: 1.10, 7.79]), unprotected sources of water (AOR: 4.14; [95% CI: 1.63, 10.52]) were significantly associated with undernutrition. Rural residence (AOR = 2.59, [95% CI: 1.66-4.04]), pregnant women who did not received ANC (AOR = 2.52, [95% CI: 1.58-4.03]) and nutrition information (AOR = 1.43; [95% CI: 1.10, 2.10]) were significantly associated with dietary diversity among pregnant women. CONCLUSION undernutrition and inadequate dietary diversity among pregnant women were high in study area. Source of drinking water, ANC visit and family size were significantly associated with pregnant women undernutrition. Place of residence, ANC visit and nutrition information were significantly associated with inadequate dietary diversity. Therefore, pregnant women, government, non-governmental organization and stakeholders should focus on importance of ANC visit, clean source of drinking water and adequate dietary diversity to improve nutritional status of pregnant women.
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Affiliation(s)
- Segni Mulugeta Tafasa
- Department of Public Health, Institute of Health Sciences, Wallaga University, Nekemte, Ethiopia.
| | - Jiregna Darega
- Department of Public Health, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia
| | - Nagasa Dida
- Department of Public Health, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia
| | - Feyisa Dudema Gemechu
- Department of Public Health, College of Medicine & Health Sciences, Ambo University, Ambo, Ethiopia
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Belew AK, Awoke T, Gelaye KA, Atnafu A, Guadu T, Azale T, Yitayal M, Assefa YA, Getachew R, Amare T, Yitayih S, Shitu K, Demilew D, Dellie E, Aschalew AY, Fanta B, Worku N, Yalew ES, Abich Y, Azeze G, Worku C, Kibret AK, G/Medhin T, Hunegnaw MT, Salelew E, Nenko G, Fekadu H, Molla A. Determinants of Malnutrition and its associated factors among pregnant and lactating women under armed conflict areas in North Gondar Zone, Northwest Ethiopia: a community-based study. BMC Nutr 2023; 9:102. [PMID: 37667397 PMCID: PMC10478398 DOI: 10.1186/s40795-023-00758-1] [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: 01/10/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023] Open
Abstract
INTRODUCTION Maternal malnutrition remains a major public health problem, particularly in low and middle-income countries and war-affected areas like Ethiopia. Malnourished pregnant and lactating women with low nutrient stores have babies with poor mental and physical development, increasing the risk of poor birth outcomes. Despite the fact that the majority of Ethiopian mothers are malnourished, there is little evidence in war-affected areas. Therefore, the objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant and lactating mothers in the war affected area of North Gondar Zone, northwest Ethiopia. METHODS A community-based cross-sectional study was conducted from April 10 to May 25, 2022. A multistage random sampling technique was used to select 1560 pregnant and lactating mothers. MUAC was to ascertain the outcome variable. Data was entered and analyzed by using EPI INFO version 3.5.3 and SPSS version 24, respectively. A multivariable logistic regression analysis was employed to identify the factors associated with acute malnutrition. An adjusted odds ratio (AOR) with a 95% confidence interval was used to show the strength of the association, while a P-value of 0.05 was used to declare the significance of the association. RESULTS The prevalence of acute malnutrition among pregnant and lactating women was 34.3% at the 95% CI (31.9-36.8). The age of the mothers (AOR = 0.73; 95% CI: 0.54, 0.99), family size 6-8 (AOR = 1.21; 95% CI: 1.03, 1.82), and greater than or equal to 9 family sizes (AOR = 0.44; 95% CI: 0.19, 0.97), were significantly associated with acute malnutrition. CONCLUSIONS In the current study, the prevalence of acute malnutrition among pregnant and lactating mothers is high in the study area. Mother's age and family size were factors associated with acute malnutrition in war-affected areas. As a result, mothers with large families will require special assistance to reduce the impact of malnutrition.
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Affiliation(s)
- Aysheshim Kassahun Belew
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Tadesse Awoke
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Asmamaw Atnafu
- Department of Health system and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Guadu
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Telake Azale
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mezigebu Yitayal
- Department of Health system and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Awoke Assefa
- Department of occupational therapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rediet Getachew
- Department of occupational therapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Amare
- Department of physiatriy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sewbesew Yitayih
- Department of physiatriy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of physiatriy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalkachew Dellie
- Department of Health system and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Andualem Yalew Aschalew
- Department of Health system and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Fanta
- Department of physiatriy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Netsanet Worku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ermias Solomon Yalew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Azeze
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Chanyalew Worku
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaye G/Medhin
- Department of Health system and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Tamir Hunegnaw
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endalamaw Salelew
- Department of physiatriy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of physiatriy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hailab Fekadu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fahim SM, Das S, Rasul MG, Zaman MU, Alam MA, Afrin S, Saqeeb KN, Hasan MM, Alam AFMM, Chowdhury M, Ahmed T. Nutritional status and dietary diversity of pregnant and nonpregnant reproductive-age Rohingya women. Food Sci Nutr 2023; 11:5523-5531. [PMID: 37701197 PMCID: PMC10494628 DOI: 10.1002/fsn3.3508] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 09/14/2023] Open
Abstract
There are no data on the nutritional status and dietary diversity of the pregnant and nonpregnant reproductive-age Rohingya women who have recently shifted to the Bhasan Char Relocation Camp located on an island in the Bay of Bengal. A cross-sectional survey was conducted in November-December, 2021 to assess the nutritional status and evaluate the dietary diversity of two vulnerable groups of the forcibly displaced Rohingya population: nonpregnant reproductive-age women and pregnant mothers. Multivariable logistic regression was applied to identify the factors associated with nutritional impairments. Overall, 7.6% of the nonpregnant reproductive-age women were underweight (Body Mass Index [BMI] < 18.5 kg/m2), and nearly one-third of them had a BMI ≥ 25 kg/m2. However, 26.7% of the pregnant mothers were undernourished (BMI < 20.0 kg/m2) and almost one-fourth of them were either overweight or obese (BMI ≥ 25.0 kg/m2). The prevalence of thinness (Mid Upper Arm Circumference [MUAC] < 23 cm) was 34.5% among pregnant mothers, and 10.1% of them were severely thin (MUAC < 21 cm). The mean (±SD) of the Women's Dietary Diversity Score (WDDS) was 3.3 (±1.1) for nonpregnant reproductive-age women and 3.7 (±1.3) for pregnant mothers enrolled in this study. Overall, 63.8% of the nonpregnant women of childbearing age and 46% of the pregnant mothers had a low WDDS (WDDS < 4). The WDDS was found to be protective against thinness among nonpregnant reproductive-age women (AOR = 0.61; 95% CI = 0.37, 0.93; p-value = .03) and low BMI in pregnant mothers (AOR = 0.71; 95% CI = 0.55, 0.91; p-value = .01). The results of this survey will assist in early recognition of the nutritional demands, and act as a guide to planning nutrition-based programs among Rohingya reproductive-age women relocated to the Bhasan Char Island.
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Affiliation(s)
- Shah Mohammad Fahim
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | - Subhasish Das
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Md. Golam Rasul
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Mahabub Uz Zaman
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Md. Ashraful Alam
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Sazia Afrin
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | - Kazi Nazmus Saqeeb
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
| | | | | | | | - Tahmeed Ahmed
- Nutrition and Clinical Services DivisionInternational Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
- Office of the Executive Director, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)DhakaBangladesh
- Department of Global HealthUniversity of WashingtonSeattleWashingtonUSA
- Department of Public Health Nutrition, James P Grant School of Public HealthBRAC UniversityDhakaBangladesh
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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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Mengstie MA, Worke MD, Belay Y, Chekol Abebe E, Asmamaw Dejenie T, Abdu Seid M, Azezew MT. Undernutrition and associated factors among internally displaced lactating mothers in Sekota camps, northern Ethiopia: A cross-sectional study. Front Nutr 2023; 10:1108233. [PMID: 36866050 PMCID: PMC9971014 DOI: 10.3389/fnut.2023.1108233] [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: 11/25/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
Background Undernutrition is the term used to describe when a person consumes insufficient amounts of nutrients and energy to meet their needs for maintaining health. Despite substantial progress, undernutrition remains a serious public health concern in many low and middle-income nations, including Ethiopia. Women and children are, in reality, the most nutritionally vulnerable individuals, particularly in times of crisis. In Ethiopia, 27 percent of lactating women are thin or malnourished, and 38% of children are stunted. Although the issue of undernutrition may worsen in times of emergency, like war, there are limited studies available in Ethiopia that show the nutritional status of lactating mothers in humanitarian settings. Objectives The main aim of this study was to determine the prevalence and investigate the factors associated with undernutrition among internally displaced lactating mothers in Sekota camps, in northern Ethiopia. Methods A cross-sectional study through a simple random sampling technique was conducted among 420 randomly selected lactating mothers in Sekota Internally Displaced Persons (IDP) camps. Data were collected using a structured questionnaire and anthropometric measurements. Logistic regression analysis was employed to identify independent factors associated with maternal undernutrition. Results Using a cut-off mid-upper arm circumference <23 cm, the prevalence of undernutrition among internally displaced lactating mothers was 54.8%. Large family size [adjusted odds ratio (AOR) = 4.35; 95% CI: 1.32, 10.22], short birth interval (AOR = 4.85; 95% CI: 1.24, 10.00), low maternal daily meal frequency (AOR = 2.54; 95% CI: 1.12, 5.75), and low dietary diversity score (AOR = 1.79; 95% CI: 1.03, 3.10) were all significantly associated with undernutrition. Conclusion The prevalence of undernutrition among internally displaced lactating mothers is relatively high. Governments and other concerned organizations involved in providing care and support to Sekota IDP camps should increase their efforts to improve the nutritional status of lactating mothers.
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Affiliation(s)
- Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia,*Correspondence: Misganaw Asmamaw Mengstie, ; orcid.org/000-0002-9711-8640
| | - Mulugeta Dile Worke
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yalemshet Belay
- Department of Physiology, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Department of Physiology, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Muluken Teshome Azezew
- Department of Physiology, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Alemayehu GM, Cherie KT, Chernet AG. Severity of malnutrition among underweight children and family-related factors: A cross-sectional analysis of data from the 2019 Ethiopian Demographic and Health Survey (EDHS). Health Sci Rep 2022; 5:e860. [PMID: 36210870 PMCID: PMC9528949 DOI: 10.1002/hsr2.860] [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: 02/25/2022] [Revised: 09/01/2022] [Accepted: 09/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Aims Malnutrition is one of the key factors in children's inappropriate physical and mental development. It is a significant issue that results in the deaths of 3.5 million children under the age of 5 every year worldwide. This study's primary goal was to pinpoint important family‐related causes of underweight child malnutrition in Ethiopia. Methods The data were gathered from the Central Statistical Agency's 2019 Ethiopian Demographic and Health Survey. Data were examined using descriptive statistics and an ordinal logistic regression model after the sample was chosen using a stratified, two‐stage cluster sampling approach. Results Overall 6101 underweight children were involved in the study of which 5019 (82.27%) were severely underweight, 28 (0.46%) were moderately underweight and 1054 (17.28%) were mild. The result showed that, birth order (p < 0.001), partners education, (p < 0.001), partner occupation (p < 0.001) and type of place of residence (p < 0.001) were associated with child malnutrition and also child from poorest family (p = 0.01, adjusted odds ratio [AOR]: 0.745, CI: −0.534, −0.056), children from workless partner (p = 0.169 AOR:CI: 1.855, −0.262, 1.498), and female children (p < 0.001, AOR: 0.793, CI: −0.369, −0.093) were severely malnourished. Conclusions wealth index combined, sex, and region have statistically significant effect on Severity of malnutrition. Female children were highly malnourished. Children in Amhara, Afar, and Tigray region were highly affected by severe malnutrition relative to other regions. Hence, the government is recommended to impose action on child nutrition in the area as it is a public health issue.
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Affiliation(s)
- Gedif M. Alemayehu
- Statistics Department, College of Natural and Computational ScienceInijibara UniversityInjibaraEthiopia
| | - Kebadu T. Cherie
- Statistics Department, College of Natural and Computational SciencesDebre Markos UniversityDebre MarkosEthiopia
| | - Ayele G. Chernet
- Statistics Department, College of Natural and Computational SciencesWolkite UniversityWolkiteEthiopia
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Under-Nutrition and Associated Factors Among Lactating Mothers in Ethiopia: A Systematic Review and Meta-analysis. Matern Child Health J 2022; 26:2210-2220. [PMID: 36040618 DOI: 10.1007/s10995-022-03467-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION Under-nutrition (body mass index < 18.5 kg/m2) is a global problem with an increasing trend in recent years. The burden is high in low and middle-income countries, especially in Africa. Lactating mothers are among the most vulnerable groups for under nutrition; particularly in sub-Saharan Africa. In Ethiopia, the prevalence of under-nutrition among this group is inconsistent and inconclusive. Therefore, we aimed to assess the pooled prevalence of under-nutrition and its associated factors among lactating mothers in Ethiopia. METHODS To write this review and meta-analysis, we followed the preferred reporting items for systematic review and meta-analysis guidelines. Primary articles were searched from PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar. STATA version 16 software and a standardized Microsoft excel format were used for analysis and data extraction, respectively. Heterogeneity between studies was checked. To determine the pooled prevalence of under-nutrition, we used a random-effect model. Begg's and Egger's tests were done to detect publication bias. Subgroup analysis was also steered and association was uttered by a pooled odds ratio with 95% CI. RESULTS The pooled prevalence of under-nutrition among lactating mothers was 23.84% [95% CI (19.40, 28.27)]. Educational status (no formal education) {Pooled OR 2.30 [95% CI (1.34, 3.96)]} was significantly associated with under-nutrition. CONCLUSION The pooled prevalence of under-nutrition was high. Maternal educational status was significantly associated with under-nutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups and strengthen the implementation of the previously designed strategies.
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Gebremichael B, Misgana T, Tamiru D, Tariku M, Tesfaye D, Alemu D, Weldesenbet AB, Dheresa M. Undernutrition and associated factors among rural pregnant women in Eastern Ethiopia. SAGE Open Med 2022; 10:20503121221104430. [PMID: 35722439 PMCID: PMC9201300 DOI: 10.1177/20503121221104430] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives: Maternal undernutrition is a burning issue in Ethiopia. However, updated
evidence is limited in the eastern part of the country; particularly the
mental health-related factors of undernutrition. The study, hence, aimed at
assessing the prevalence and predictors of undernutrition among rural
pregnant women in eastern Ethiopia. Methods: A cross-sectional research was carried out at a community level among 1015
randomly selected pregnant women. A structured questionnaire was used to
collect the data through face-to-face interviews. The characteristics of
participants were described and summarized by frequencies, percentages, and
summary measures. Logistic regression was performed to find out factors
related to undernutrition. Results: The prevalence of undernutrition was 43.8% (95% confidence interval: 40.8,
47.0). Early marriage (adjusted odds ratio = 2.63, confidence interval:
2.00, 3.47), no antenatal care follow-up (adjusted odds ratio = 1.73, 95%
confidence interval: 1.31, 2.29), inadequately diversified diet (adjusted
odds ratio = 2.48, 95% confidence interval: 1.77, 3.48), current substance
use (adjusted odds ratio = 1.50, 95% confidence interval: 1.02, 2.19),
history of mental illness (adjusted odds ratio = 2.44, 95% confidence
interval: 1.02, 5.82), and common mental disorders (adjusted odds
ratio = 1.81, 95% confidence interval: 1.34, 2.43) were the significant
predictors of undernutrition among pregnant women. Conclusions: Undernutrition was a significant public health issue among rural pregnant
women. Age at first marriage, antenatal care follow-up, dietary diversity,
current substance use, history of mental illness, and common mental disorder
were the independent predictors of undernutrition. Therefore, the health
offices of Kersa and Haramaya districts should invest their efforts to
prevent undernutrition among pregnant women through nutrition counselling
and education, and mental health and psychosocial support.
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Affiliation(s)
- Berhe Gebremichael
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Misgana
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dawit Tamiru
- Department of Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Mandaras Tariku
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Daniel Alemu
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Adisu Birhanu Weldesenbet
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Tesfaye A, Sisay G, Kabthymer RH, Tesfaye T. Under-nutrition and associated factors among pregnant women in public health care hospitals of Gedeo Zone, southern Ethiopia: A cross-sectional study. Heliyon 2022; 8:e09511. [PMID: 35647358 PMCID: PMC9136312 DOI: 10.1016/j.heliyon.2022.e09511] [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: 07/30/2021] [Revised: 11/03/2021] [Accepted: 05/16/2022] [Indexed: 10/31/2022] Open
Abstract
Background Balanced and adequate nutritious food during pregnancy helps to improve maternal weight and for the healthy growth of the fetus. There has been little progress in reducing pregnant undernutrition in Ethiopia; it has been too slow. Objective The objective of this study was to assess the prevalence of undernutrition and associated factors among pregnant women in public health care hospitals of Gedeo Zone, Southern Ethiopia. Method A cross-sectional study design was used in public hospitals of Gedeo Zone, Southern Ethiopia from February 01 to March 01, 2019. Pretested structure questionnaire was used to collect data on the socio-economic and demographic characteristics of the study participants. Epi-data was used to code and enter the data and SPSS-25 was used to analyse and interpret the data. To assess the relationship between the dependent and the independent variables, bi-variable and multivariable logistic regression analysis was done. Results In this study, the prevalence of undernutrition among pregnant women was 21% (95% CI: 20.8-21.2). After controlling other co-variables, the multivariable logistic regression model revealed that average monthly income, women's educational status, nutrition education and counseling, and parity were found to have a significant association with pregnant women's nutritional status. The odds of under-nutrition among pregnant women whose monthly income is <800 ETB were 2.8 times higher than those whose monthly incomes were >1500 (AOR: 2.89; 95%CI: 1.49-5.6). Conclusion In this study the magnitude of undernutrition among pregnant women was found to be higher than the previously reported findings. Average household monthly income, family size, mother's educational status, nutrition education and counseling, current health condition of the mother, and parity were factors significantly associated with undernutrition of pregnant mothers. Therefore, Interventions should be initiated in earlier stages of pregnancy to prevent the high level of undernutrition during the second and third trimester in this study area.
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Affiliation(s)
- Adane Tesfaye
- Department of Human Nutrition, College of Medicine and Health Science, Dilla University, Ethiopia
| | - Gizaw Sisay
- School of Public Health, College of Medicine and Health Science, Dilla University, Ethiopia
| | - Robel Hussen Kabthymer
- Department of Human Nutrition, College of Medicine and Health Science, Dilla University, Ethiopia
| | - Tizalegn Tesfaye
- School of Public Health, College of Medicine and Health Science, Dilla University, Ethiopia
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Afrinis N, Verawati B, Rizqi ER, Lasepa W, Alini A, Syuryadi N. Energy Intake and Food Restriction as Determinant Factors of Chronic Energy Deficiency among Pregnant Women in Rural Area of Sungai Sembilan, Riau, Indonesia. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9042] [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] Open
Abstract
BACKGROUND OF THE STUDY: Maternal malnutrition is a major public health problem in Indonesia which is shown by high prevalence of chronic energy deficiency (CED) among pregnant women. CED was expressed by the measurement of Mid Upper Arm Circumference (MUAC) showing value less than 23.5 cm.
AIM OF THE STUDY: This study aimed to identify the factors associated with chronic energy deficiency among pregnant women in rural area, Riau Province.
METHODOLOGY: A community- based cross sectional study was conducted among 130 samples of pregnant women in Sungai Sembilan Community Health Center in June 2020. Data was collected using structured and field-study questionnaires. Mid Upper Arm Circumference (MUAC) was measured by MUAC tape. Energy and protein intake were assessed using 24-hour food recall. Multiple logistic regression was employed to analyse factors associated with CED by using SPSS version 20.
RESULTS: The prevalence of CED among pregnant women was 64.9%. Age of mothers, food restriction, infection disease status, protein and energy intake were associated significantly with CED. Furthermore, energy intake and food restriction in pregnancy were risk factors of CED (AOR = 3.04, 95% CI: 1.1 – 8.3 and AOR = 6.73, 95% CI: 1.33 – 33.9, respectively). We found that proportion of energy intake below 80% RDA and mothers with food restriction were higher among CED group.
CONCLUSION: High prevalence of chronic energy deficiency (CED) was found among pregnant women. Hence, innovative intervention was required to overcome this problem.
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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] [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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Yismaw WS, Teklu TS. Nutritional practice of pregnant women in Buno Bedele zone, Ethiopia: a community based cross-sectional study. Reprod Health 2022; 19:84. [PMID: 35361230 PMCID: PMC8973800 DOI: 10.1186/s12978-022-01390-1] [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: 07/10/2021] [Accepted: 03/18/2022] [Indexed: 12/04/2022] Open
Abstract
Background Worthy health and welfare is part of the goals set by united nation. Dietary practice is visible activities or conducts of eating habit performed by a person. Poor maternal nutrition during pregnancy were associated with higher risk of having a preterm labour, low birth-weight, Intrauterine growth restrictions and facing threats to their own wellbeing and survival. Objective To assess the nutritional practice of pregnant women in Buno Bedele zone. Methods A community-based cross-sectional study design was deployed to conduct this study from November 1–30, 2019 in the Buno Bedele zone, Ethiopia. The study included 592 pregnant women and a proportional sample of the size of the population was allocated to each 32 kebeles. A structured interviewer administered pretested tool was utilized for data collection. Data entry was conducted using EPI-data version 3.4 and cleaned, edited and analyzed using the SPSS version 24.0. The data were presented in the form of text, frequencies, tables and figures while logistic regression was used to discover the association between dependent and independent variables. Result This study found that about 185 (31.2%) pregnant mothers had good dietary practice. The mothers’ educational status (AOR = 1.33, 95% CI 0.34, 2.08), income (AOR = 5.7, 95% CI, 5.1, 6.65), dietary knowledge (AOR = 3.03, 95% CI 1.98, 4.18) and pregnancy intervals (AOR = 4.16 95% CI 2.74, 6.49) were factors found to be affecting the nutritional practices of pregnant women. Conclusion and recommendation Only 31.2% of pregnant women had good dietary practice. This indicated that the majority of study participants had a poor dietary practice, which is a concern because having poor dietary practice contributes to maternal and neonatal mortality and morbidity. To increase their nutrition practices to have a healthy pregnancy. We need to focus on; nutrition education on basic nutrients, community mobilization on dietary practices using media, work on barriers, and advocating nutrition practice activities. Worthy health and welfare is part of the goals set by united nation. Dietary practice is visible activities or conducts of eating habit performed by a person. To have healthy and appropriate working of the body, eating balanced diet is very crucial. This study found that about 185 (31.2%) pregnant mothers had good dietary practice. The mothers’ educational status, income, dietary knowledge and pregnancy intervals were factors found to be affecting the nutritional practices of pregnant women. The finding indicated that the majority of study participants had a poor dietary practice, which is a concern because having poor dietary practice contributes to maternal and neonatal mortality and morbidity. To avert the problem this results healthy pregnancy. We need to focus on; nutrition education on basic nutrients, community mobilization on a diet using media, work on barriers and advocating nutrition practice.
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Affiliation(s)
- Worke Sisay Yismaw
- College of Public Health and Medical Sciences, Department of Nursing, Mettu University, Mettu, Ethiopia.
| | - Tigist Shayi Teklu
- College of Public Health and Medical Sciences, Department of Nursing, Mettu University, Mettu, Ethiopia
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Kamei A, Sato R, Thornton R. Effect of pregnancy tests on demand for family planning: evidence from a randomized controlled trial in Uganda. Reprod Health 2021; 18:231. [PMID: 34781969 PMCID: PMC8591838 DOI: 10.1186/s12978-021-01279-5] [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: 11/23/2020] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unmet need for family planning and unintended pregnancies are high in developing countries. Home pregnancy tests help women determine their pregnancy status earlier and the confirmation of a negative pregnancy status can facilitate the adoption of family planning. This study provides the first experimental evidence of the effect of access to pregnancy tests on women's demand for modern family planning. METHODS A randomized controlled trial was conducted among 810 women of reproductive age in northern Uganda. During a baseline survey, women were randomly allocated to either: (1) an offer to take a hCG urine pregnancy test during the survey (on-the-spot pregnancy test) (N = 170), (2) an offer of a home pregnancy test kit to be used at any time in the future (future-use pregnancy test) (N = 163), (3) offers of both on-the-spot and future-use pregnancy tests (N = 153), or (4) a control group (N = 324). Future-use pregnancy tests were offered either for free, or randomly assigned prices. Approximately 4 weeks after the baseline survey, a follow-up survey was conducted; modern contraception methods were made available at no charge at local community outreach centers. RESULTS When offered a free, on-the-spot pregnancy test, 62 percent of women accepted (N = 200). Almost all, 97 percent (N = 69), of women offered a free future-use pregnancy test strip, accepted it. Purchases of future-use pregnancy tests declined with price. The offer of either on-the-spot, future-use tests, or both, have no overall large or statistically significant effects on the take-up of modern family planning. CONCLUSION Demand for pregnancy tests is high and access to pregnancy tests has the potential to facilitate the demand for family planning. At the same time, more research is needed to understand underlying beliefs about pregnancy status and risk that guide behaviors ultimately important for maternal and neonatal health. Trial registration The study was pre-registered in July 2018 for AEA RCT registry (AEARCTR-0003187) and clinicaltrials.gov (NCT03975933). Registered 05 June 2019, https://clinicaltrials.gov/ct2/show/record/NCT03975933.
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Affiliation(s)
| | - Ryoko Sato
- Harvard University, 677 Huntington Ave, Boston, MA, 02115, USA.
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Kyamwine IB, Namukose S, Wibabara Y, Bulage L, Kwesiga B, Ario AR, Harris JR. Patterns of wasting among pregnant and lactating women in Uganda, 2015-2018: analysis of Nutrition surveillance data. BMC Nutr 2021; 7:59. [PMID: 34645523 PMCID: PMC8515752 DOI: 10.1186/s40795-021-00464-w] [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: 02/05/2021] [Accepted: 08/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Maternal nutrition is closely linked to the survival and development of children during the first 1000 days of life. Maternal wasting, a measure of malnutrition, is measured using the mid-upper arm circumference. However, in 2019, the rate and distribution of wasting among pregnant and lactating women was not known. We described annual trends and distribution of wasting among pregnant and lactating women (PLW), Uganda, 2015-2018, to inform programming on targeted nutritional interventions. METHODS We analyzed nutrition surveillance data from the District Health Information System for all PLW from 2015 to 2018. We used the World Health Organization standard thresholds to determine wasting among PLW by year and region, drawing choropleth maps to demonstrate the geographic distribution of wasting among PLW. We used logistic regression to assess wasting trends. RESULTS During 2015-2018, 268,636 PLW were wasted (prevalence = 5.5%). Of the 15 regions of Uganda, Karamoja (prevalence = 21%) and Lango (prevalence = 17%) registered the highest prevalence while Toro (prevalence = 2.7%) and Kigezi (prevalence = 2.0%) registered the lowest prevalence. The national annual prevalence of wasting among PLW declined by 31% from 2015 to 2018 (OR = 0.69, p < 0.001). Regions in the north had increasing trends of wasting over the period [Lango (OR = 1.6, p < 0.001) and Acholi (OR = 1.2, p < 0.001)], as did regions in the east [(Bugisu (OR = 3.4, p < 0.001), Bukedi (OR = 1.4, p < 0.001), and Busoga (OR = 1.3, p < 0.001)]. The other 11 regions showed declines. CONCLUSION The trend of wasting among PLW nationally declined during the study period. Lango and Acholi regions, both of which were experiencing a nutrition state of emergency during this period, had both high and rising rates of wasting, as did the Karamoja region, which experienced the highest wasting rates. We recommended that the Ministry of Health increases its focus on nutrition monitoring for PLW and conduct an analysis to clearly identify the factors underlying malnutrition specific for PLW in these regions.
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Affiliation(s)
| | | | - Yvette Wibabara
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Lilian Bulage
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Benon Kwesiga
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Alex Riolexus Ario
- Uganda Public Health Fellowship Program, Ministry of Health, Kampala, Uganda
| | - Julie R Harris
- Workforce and Institute Development Branch, Division of Global Health Protection, Center for Global Health, US Centers for Disease Control and Prevention, Kampala, Uganda
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Hassan B, Rayis DA, Ahmed ABA, ALhabardi N, Adam I. Prevalence and associated factors of undernutrition among pregnant Sudanese women. Trans R Soc Trop Med Hyg 2021; 116:352-358. [PMID: 34415017 DOI: 10.1093/trstmh/trab128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/31/2021] [Accepted: 08/05/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Maternal undernutrition is a global health challenge, and it is associated with significant maternal and perinatal morbidity and mortality. This study aimed to assess the prevalence and the factors associated with undernutrition among pregnant women in Sudan. METHODS A cross-sectional study was carried out in Saad Abuelela Hospital in Khartoum, Sudan, from June to December 2019. Sociodemographic and obstetric characteristics were collected through a questionnaire. Mid-upper arm circumference was measured. Undernutrition was defined as a mid-upper arm circumference of <23 cm. Multiple logistic regression was used to assess the factors associated with maternal undernutrition. RESULTS Of 1801 pregnant women, 226 (12.5%) were undernourished. Multivariable analysis revealed that ≤2 antenatal care clinic visits (adjusted OR [AOR]=3.06, 95% CI 1.68 to 5.58) was associated with undernutrition. Age (AOR=0.90, 95% CI 0.87 to 0.94) and haemoglobin levels (AOR=0.81, 95% CI 0.67 to 0.97) were negatively associated with undernutrition. There was no association between parity, education, interpregnancy interval, occupation and maternal undernutrition. CONCLUSIONS Our findings indicated that 12.5% of the pregnant women in Khartoum were undernourished. More effort and action are need to improve the counselling and future inclusion of a supplemental food supply for undernourished pregnant women.
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Affiliation(s)
- Bahaeldin Hassan
- College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Duria A Rayis
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan
| | - Abdel B A Ahmed
- College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - Nadiah ALhabardi
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
| | - Ishag Adam
- Department of Obstetrics and Gynecology, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, Kingdom of Saudi Arabia
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Gebremariam AD, Tiruneh SA, Engidaw MT, Tesfa D, Azanaw MM, Yitbarek GY, Asmare G. Development and Validation of a Clinical Prognostic Risk Score to Predict Early Neonatal Mortality, Ethiopia: A Receiver Operating Characteristic Curve Analysis. Clin Epidemiol 2021; 13:637-647. [PMID: 34366681 PMCID: PMC8336991 DOI: 10.2147/clep.s321763] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/12/2021] [Indexed: 01/27/2023] Open
Abstract
Background Early neonatal death is the death of a live-born baby within the first seven days of life, which is 73% of all postnatal deaths in the globe. This study aimed to develop and validate a prognostic clinical risk tool for the prediction of early neonatal death. Methods A prospective follow-up study was conducted among 393 neonates at Debre Tabor Referral hospital, Northwest Ethiopia. Multivariable logistic regression model was employed to identify potential prognostic determinants for early neonatal mortality. Area under receiver operating characteristics curve (AUROC) was used to check the model discrimination probability using ‘pROC’ R-package. Model calibration plot was checked using ‘givitiR’ R-package. Finally, a risk score prediction tool was developed for ease of applicability. Decision curve analysis was done for cost-benefit analysis and to check the clinical impact of the model. Results Overall, 15.27% (95% CI: 12.03–19.18) of neonates had the event of death during the follow-up period. Maternal undernutrition, antenatal follow-up less than four times, birth asphyxia, low birth weight, and not exclusive breastfeeding were the prognostic predictors of early neonatal mortality. The AUROC for the reduced model was 88.7% (95% CI: 83.8–93.6%), which had good discriminative probability. The AUROC of the simplified risk score algorithm was 87.8% (95% CI, 82.7–92.9%). The sensitivity and specificity of the risk score tool was 70% and 89%, respectively. The true prediction accuracy of the risk score tool to predict early neonatal mortality was 86%, and the false prediction probability was 13%. Conclusion We developed an early neonatal death prediction tool using easily available maternal and neonatal characteristics for resource-limited settings. This risk prediction using risk score is an easily applicable tool to identify neonates at a higher risk of having early neonatal mortality. This risk score tool would offer an opportunity to reduce early neonatal mortality, thus improving the overall early neonatal death in a resource-limited setting.
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Affiliation(s)
- Alemayehu Digssie Gebremariam
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sofonyas Abebaw Tiruneh
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melaku Tadege Engidaw
- Department of Public Health (Human Nutrition), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Desalegn Tesfa
- Department of Public Health (Reproductive Health), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Melkalem Mamuye Azanaw
- Department of Public Health (Epidemiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getachew Yideg Yitbarek
- Department of Biomedical Science (Medical Physiology), College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Asmare
- Department of Pediatrics and Child Health Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Gelebo DG, Gebremichael MA, Asale GA, Berbada DA. Prevalence of undernutrition and its associated factors among pregnant women in Konso district, southern Ethiopia: a community-based cross-sectional study. BMC Nutr 2021; 7:32. [PMID: 34247657 PMCID: PMC8273999 DOI: 10.1186/s40795-021-00437-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/04/2021] [Indexed: 01/31/2023] Open
Abstract
Background Undernutrition during pregnancy is an important public health problem. It is highly prevalent in Ethiopia but not sufficiently addressed yet. Hence, this study aimed to assess the prevalence of undernutrition and its associated factors among pregnant mothers in Konso district, Ethiopia. Methods Community-based cross-sectional study was conducted with a qualitative inquiry from December 2018 to January 2019. A multistage stratified sampling technique was used to select 527 subjects and quantitative data were collected from these subjects using a structured interviewer-administered questionnaire and additionally qualitative data were generated through two focus group discussions among purposely selected discussants. Mid upper arm circumference (MUAC) was measured by standard non-stretchable MUAC tape. Data were entered into Epi-data version3.1 and analyzed by SPSS version 21. In multivariable binary logistic regression, a statistically significant association was declared at p-value < 0.05 while thematic framework analysis was employed for the qualitative data. Results Among 501 participants, the overall prevalence of undernutrition (MUAC < 23 cm) was 43.1% (95% CI 38.7–47.5%). Household food security (AOR = 3.1; 95% CI: 2.1–4.6), low dietary diversity score (AOR = 4.9; 95% CI: 2.6–9.2), medium dietary diversity score (AOR = 2.3; 95% CI: 1.2–4.7), absence of latrine (AOR = 1.8; 95% CI: 1.2–2.6) and having family resource decision making by husband only (AOR = 1.7; 95% CI: 1.1–2.6) were significantly associated factors. Traditional believes to restrict food such as egg, milk, and milk products, avocado for women, weak nutrition education and malnutrition screening program, daily consumption of locally prepared alcoholic drink called “Cheka”, drought-prone nature of this setting, traditional way of farming practices and low socio-economic status were found to be barriers for women’s undernutrition. Conclusions The prevalence of undernutrition was found to be higher than previously reported findings. Household food security, dietary diversity, latrine availability, family resource decision making, food restrictions, weak maternal nutrition education, and malnutrition screening program, the practice of depending on a local alcoholic drink called “Cheka”, drought, traditional way of farming and low socio-economic status were identified factors. Hence, interventions targeting maternal nutrition education, hygiene, and sanitation promotion, household food insecurity improvement strategies should be implemented to improve the nutritional status of pregnant women.
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Affiliation(s)
| | - Mathewos Alemu Gebremichael
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
| | - Gistane Ayele Asale
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dessalegn Ajema Berbada
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Corley AG. Linking armed conflict to malnutrition during pregnancy, breastfeeding, and childhood. GLOBAL FOOD SECURITY 2021; 29:100531. [PMID: 33884257 PMCID: PMC8054973 DOI: 10.1016/j.gfs.2021.100531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
BACKGROUND Women in LMICs are important agricultural actors; however, these same women, and with their children, suffer high rates of acute malnutrition during armed conflicts. METHODS AND FINDINGS A review was undertaken of peer-reviewed literature to describe how armed conflict drives acute malnutrition in pregnant and breastfeeding women and their children. Armed conflict factors driving malnutrition were conceptualized as belonging to one of eight overarching drivers. CONCLUSION Future research must examine the effect of specific drivers on acute malnutrition in order to improve predictive models; emphasize inclusion of pregnant and breastfeeding participants in studies; elucidate the role of peacekeepers in mitigating the risk of acute malnutrition; explore how to support breastfeeding women living in armed conflict situations; and explore how displaced populations affect host communities' food systems.
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23
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Barcus GC, Papathakis PC, Schaffner A, Chimera B. Nutrition Screening, Reported Dietary Intake, Hospital Foods, and Malnutrition in Critical Care Patients in Malawi. Nutrients 2021; 13:nu13041170. [PMID: 33916149 PMCID: PMC8066941 DOI: 10.3390/nu13041170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022] Open
Abstract
In low-income countries there are few data on hospital malnutrition. Reduced food intake combined with nutrient-poor foods served in hospitals contribute to nutritional risk. This study investigated whether reported dietary intake and disease state of hospitalized adults in critical care units was related to malnutrition determined by mid-upper arm circumference (MUAC). Adult in-patients (n = 126) in tuberculosis, burn, oncology, and intensive care units in two public tertiary hospitals in Malawi were screened for nutritional status using MUAC and a question on current dietary intake. The hospital menu was reviewed; portion sizes were weighed. The prevalence of moderate and severe malnutrition was 62%. Patients with organ-related diseases and infectious diseases had the highest rates of reduced reported dietary intake, 71.4% and 57.9%, respectively; however, there was no association between reported dietary intake and MUAC. In those unable to eat, however, the rate of severe malnutrition was 50%. The menu consisted of porridge and thickened corn-based starch with fried cabbage; protein foods were provided twice weekly. There was a nutrient gap of 250 calories and 13 gm protein daily. The findings support the need for increasing dietetic/nutrition services to prevent and treat malnutrition in hospitals using simple screening tools.
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Affiliation(s)
- Grace C. Barcus
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Peggy C. Papathakis
- Department of Food Science and Nutrition, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
- Queen Elizabeth Central Hospital, P.O. Box 95, Blantyre, Malawi;
- Correspondence:
| | - Andrew Schaffner
- Department of Statistics, California Polytechnic State University, San Luis Obispo, CA 93407, USA;
| | - Bernadette Chimera
- Queen Elizabeth Central Hospital, P.O. Box 95, Blantyre, Malawi;
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Chichiri, Blantyre, Malawi
- Kamuzu Central Hospital, Area 33 Mzimba Street, P.O. Box 106, Lilongwe, Malawi
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24
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Badiane A, Diouf A, Sylla PMDD, Cissé NS, Idohou-Dossou N, Dramaix M, Wade S, Donnen P. Body composition and determinant factors among mother-child pairs (6-8 months) in rural areas of Senegal. MATERNAL AND CHILD NUTRITION 2021; 17:e13174. [PMID: 33719201 PMCID: PMC8189237 DOI: 10.1111/mcn.13174] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/03/2021] [Accepted: 02/09/2021] [Indexed: 11/30/2022]
Abstract
This cross-sectional study was conducted to determine the association between selected characteristics and body composition of mothers and children in early life. This study included 213 mother-child pairs 6 to 8 months involving in the cohort study of the Research and Development Project conducted in Kaffrine district. The main outcomes were fat-free mass (FFM) and body fat (BF), measured using deuterium dilution method and anthropometry. Independent variables were sociodemographic, dietary diversity and health characteristics. Descriptive, correlation, bivariate and multiple regression analyses were conducted. According to body mass index (BMI), 23% of mothers were underweight, 12% were overweight/obese and 11% had excess BF. Four per cent of children were below -2 weight-for-length z-score (WLZ), 10% were below -2 length-for-age z-score (LAZ) and 40% had excess BF. Maternal FFM was positively correlated with child FFM (r = 0.25, P = 0.002). Similarly, mothers' BMI, FFM and BF were significantly and positively correlated with children's LAZ. Stepwise regression showed an increased association between minimum dietary diversity (MDD) and WLZ score, FFM and BF of children. Among mothers, being employee and doing reproductive health care were determinants of higher BMI, FFM and BF. This study found a strong association between maternal and child body composition in early life. Adequate diet is the main determinant of children nutritional status. Among the mothers, having a job and doing primary health care seem to be beneficial for the nutritional status. Improvement of women's empowerment, quality of health care and dietary diversity could have a positive impact on maternal and child nutrition.
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Affiliation(s)
- Abdou Badiane
- Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Adama Diouf
- Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Papa M D D Sylla
- Laboratoire de Botanique et Biodiversité, Département de Biologie Végétale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Ndeye S Cissé
- Laboratoire de Recherche sur les Transformations Economiques et Sociales, Institut Fondamental d'Afrique Noire, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Nicole Idohou-Dossou
- Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Michèle Dramaix
- Centre de Recherche Politiques et systèmes de Santé - Santé Internationale, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Salimata Wade
- Laboratoire de Recherche en Nutrition et Alimentation Humaine (LARNAH), Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Philippe Donnen
- Centre de Recherche Politiques et systèmes de Santé - Santé Internationale, Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
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Zewdie S, Fage SG, Tura AK, Weldegebreal F. Undernutrition among Pregnant Women in Rural Communities in Southern Ethiopia. Int J Womens Health 2021; 13:73-79. [PMID: 33447094 PMCID: PMC7802823 DOI: 10.2147/ijwh.s285132] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/05/2020] [Indexed: 12/13/2022] Open
Abstract
Background Maternal undernutrition rates in Ethiopia are among the highest in the world. In addition, a huge inequity exists within the country, with pregnant women in rural communities being at increased risk. This study assessed the prevalence of undernutrition and its associated factors among pregnant women in a rural community in southern Ethiopia. Methods A community-based cross-sectional study was conducted among 376 randomly selected pregnant women. Data were collected through face-to-face interview followed by mid–upper arm circumference measurement. Household food insecurity and minimum dietary diversity for women were assessed. Data were entered into EpiData 3.1 and exported to SPSS 20 for analysis. Logistic regression models were fitted to check associations between independent variables and undernutrition. Statistical significance was set at p<0.05. Results The prevalence of undernutrition was 41.2% (95% CI 36.3%–46.3%). Unintended pregnancy (AOR 2.06, 95% CI 1.27–3.36) and not participating in Wome's Health Development Army meetings (AOR 3.64, 95% CI 1.51–8.77) were independent predictors of undernutrition. However, minimum dietary diversity for women of five or more food groups (AOR 0.24, 95% CI 0.07–0.82), having at least one antenatal care visit (AOR 0.46, 95% CI 0.27–0.78), age at first pregnancy ≥20 years (AOR 0.39, 95% CI 0.21–0.76), and being from food-secure households (AOR 0.26, 95% CI 0.16–0.43) were independent protective factors against undernutrition. Conclusion Undernutrition among pregnant women was highly prevalent in the study area. Interventions aiming to reduce undernutrition should focus on discouraging teenage and unintended pregnancy, reducing household food insecurity, and promoting antenatal care visits and encouraging consumption of diversified diets by women. Strengthening the existing network of the Women’s Health Development Army seems to be very important.
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Affiliation(s)
- Solomon Zewdie
- Goro Dola Woreda Health Office, Guji Zone, Oromia Regional State, Goro Dola, Ethiopia
| | - Sagni Girma Fage
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, 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, the Netherlands
| | - Fitsum Weldegebreal
- College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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26
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Muze M, Yesse M, Kedir S, Mustefa A. Prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte zone, Southern Ethiopia. BMC Pregnancy Childbirth 2020; 20:707. [PMID: 33213406 PMCID: PMC7678074 DOI: 10.1186/s12884-020-03404-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/10/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Maternal undernutrition is highly prevalent in underdeveloped countries. Hence, this study was intended to determine the prevalence and associated factors of undernutrition among pregnant women visiting ANC clinics in Silte Zone. METHOD Facility-based cross-sectional study was conducted from July to January 2019. Systematic random sampling technique was used to select 422 study participants from 11 randomly selected health facilities. Data was collected by using a structured-interviewer administered questionnaire. Mid upper arm circumference (MUAC) was measured by standard non stretchable MUAC tape. Data was entered into a computer using Epi data 3.1 and edited, cleaned, and analyzed using SPSS version 20. Both bivariate and multiple logistic regression analyses were employed to identify factors associated with maternal undernutrition. RESULT In this study, the overall prevalence of undernutrition among study subjects was 21.8%. Age greater than 31 years of women (AOR = 0.15; 95% CI: 0.03, 0.93), Birth intervals > 2 years (AOR = 0.18; 95% CI: 0.04, 0.76), good nutritional knowledge (AOR = 0.34; 95% CI: 0.17, 0.67), and having no dietary change as a result of current pregnancy AOR = 6.02; 95% CI: 2.99, 12.14) were significantly associated with undernutrition. CONCLUSIONS The prevalence of undernutrition among pregnant women was 21.8%. Current estimate is lower than previously reported in the study area but higher than reported in developed country. Age of women, Birth intervals, and Dietary change as a result of current pregnancy and Nutrition knowledge were important risk factors/ predictors of undernutrition (MUAC < 23 cm). Interventions targeting maternal nutrition education and child spacing with giving special emphasis to adolescent pregnant women are recommended.
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Affiliation(s)
- Mohammed Muze
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia.
| | - Mubarek Yesse
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Shemsu Kedir
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia
| | - Abdilmejid Mustefa
- Department of Nursing, Collage of Medicine and Health Science, Werabe University, Werabe, Ethiopia
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Prevalence of Undernutrition and Associated Factors among Pregnant Women in a Public General Hospital, Tigray, Northern Ethiopia: A Cross-Sectional Study Design. J Nutr Metab 2020; 2020:2736536. [PMID: 33083055 PMCID: PMC7563058 DOI: 10.1155/2020/2736536] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/11/2020] [Accepted: 09/25/2020] [Indexed: 11/24/2022] Open
Abstract
Background Undernutrition is a global health problem, particularly in pregnant women. Despite the limited studies performed in different parts of Ethiopia, the information about the prevalence of undernutrition of pregnant women in the current study area is not documented. Therefore, this study aimed to assess the prevalence of undernutrition and associated factors in pregnant women. Methods An institution-based cross-sectional study design was conducted in the Tigray region from August 01 to December 30, 2018. Study subjects were selected by systematic sampling technique from the respective hospitals. An interviewer-administered questionnaire was used to collect the data. Data were cleaned and entered using Epi-Data version 3.1 and then exported to statistical package for social science (SPSS) version 23.0 for analysis. Multivariate analyses were carried out, and adjusted odds ratios (AORs) with 95% CI and significance level (p value) <0.05 were considered. Results Out of the total 844 selected pregnant women, 840 participated in the study, yielding a response rate of 99.5%; of this, respondent's undernutrition prevalence was found to be 40.6% with 95% confidence interval (38.93% and 42.27%). Agriculture as occupation (AOR = 2.6, 95% CI: 1.5, 4.5), women who wanted the pregnancy (AOR = 0.25, 95% CI: 0.14, 0.448), no history malaria during pregnancy (AOR = 0.291, 95%: (0.152, 0.555)), coffee intake during pregnancy (AOR = 1.6, 95% CI: 1.04, 2.69), and hemoglobin < 11 g/dl (AOR = 4.9, 95% CI: 3.09, 7.8) were the factors that were significantly associated with undernutrition, p value (<0.05). Conclusion In this study, occupation, history of having malaria during pregnancy, wanted type pregnancy, coffee intake during pregnancy, and hemoglobin < 11 g/dl were factors significantly associated with undernutrition in pregnant mothers. So, healthcare providers, policymakers, and other stakeholders should give special focus on these factors.
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Abera SF, Kantelhardt EJ, Bezabih AM, Tsadik M, Lauvai J, Ejeta G, Wienke A, Frank J, Scherbaum V. What factors are associated with maternal undernutrition in eastern zone of Tigray, Ethiopia? Evidence for nutritional well-being of lactating mothers. BMC Public Health 2020; 20:1214. [PMID: 32770979 PMCID: PMC7414570 DOI: 10.1186/s12889-020-09313-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 07/29/2020] [Indexed: 12/20/2022] Open
Abstract
Background Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia. Methods Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates. Results The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively. Conclusions Efforts to ameliorate maternal undernutrition need to consider the influence of the rising epidemiology of adult mortality from chronic diseases. Our data clearly indicate the need for channeling the integrated intervention power of nutrition-sensitive development programs with that of nutrition-specific sectoral services.
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Affiliation(s)
- Semaw Ferede Abera
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany. .,Food Security Center, University of Hohenheim, Stuttgart, Germany. .,School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia. .,Kilte Awlaelo - Health and Demographic Surveillance Site, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
| | - Eva Johanna Kantelhardt
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University, Halle, Germany.,Department of Gynaecology, Faculty of Medicine, Martin-Luther-University, Halle, Germany
| | - Afework Mulugeta Bezabih
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.,Kilte Awlaelo - Health and Demographic Surveillance Site, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Mache Tsadik
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.,Kilte Awlaelo - Health and Demographic Surveillance Site, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Judith Lauvai
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany
| | - Gebisa Ejeta
- Department of Agronomy, Purdue University, West Lafayette, IN, USA
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Faculty of Medicine, Martin-Luther-University, Halle, Germany
| | - Jan Frank
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
| | - Veronika Scherbaum
- Institute of Nutritional Sciences, University of Hohenheim, Stuttgart, Germany.,Food Security Center, University of Hohenheim, Stuttgart, Germany
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Undernutrition and Associated Factors among Lactating Women: Community-Based Cross-Sectional Study in Moyale District, Borena Zone, Southern Ethiopia. ADVANCES IN PUBLIC HEALTH 2020. [DOI: 10.1155/2020/4367145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Undernutrition is one of the most widespread public health problems that affect both developed and developing countries. In Ethiopia, it is one of the factors leading to unacceptable high morbidity and mortality among women. However, little is documented on undernutrition among lactating women particularly in such a purely pastoral community. Therefore, this study was designed to assess prevalence of undernutrition and its associated factors among lactating women living in pastoral community of Moyale District, Borena Zone, Southern Ethiopia, 2018. Methods. A community-based cross-sectional study was conducted. Data were collected from a random sampled 545 lactating women using structured interviewer-administered questionnaire. Height and weight measurements of the study participants were also taken to compute body mass index. Data were entered in to Epi info version 7 and then exported to SPSS version 21 software for analysis. Descriptive statistics like frequency, mean, and percentage were computed to describe characteristics of the sample. Multivariable analysis was carried out, association between independent and dependent variables were measured using adjusted odds ratios, and its 95% confidence interval and P value below 0.05 were considered statistically significant. Results. This study showed that prevalence of undernutrition among lactating women was 17.7%. Dietary diversity (AOR = 2.49, 95% CI: 1.43–4.36), monthly income (AOR = 5.22, 95% CI: 1.40–19.40), extra meal taking (AOR = 2.76, 95% CI: 1.43–5.29, delivery place (AOR = 2.65, 95% CI: 1.24–5.65), and household food insecurity (AOR = 6.57, 95% CI: 3.50–12.34) were independent variables showing statistically significant association with undernutrition of lactating women. Conclusion and recommendations. The study revealed that magnitude of undernutrition among lactating women was high. Dietary diversity, monthly income, extra meal, delivery place, and household food insecurity were found to be predictor of undernutrition. Finally, we recommend that governmental and nongovernmental organizations should organize timely interventions targeting lactating women.
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Bari A, Sultana N, Mehreen S, Sadaqat N, Imran I, Javed R. Patterns of maternal nutritional status based on mid upper arm circumference. Pak J Med Sci 2020; 36:382-386. [PMID: 32292438 PMCID: PMC7150405 DOI: 10.12669/pjms.36.3.1331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 12/02/2019] [Accepted: 12/18/2019] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To determine the patterns of maternal nutrition status by using mid upper arm circumference (MUAC) and to examine the association of maternal nutritional status with the nutritional status of malnourished children under two years of age. METHODS Descriptive study conducted at the Department of Pediatric Medicine of the Children's Hospital, Lahore from January 2017 to March 2018. A total of 227 mother accompanying their children admitted for nutritional rehabilitation were included. Demographics of participants along with MUAC of every mother was taken. Data analysis was done by SPSS 22. RESULTS Mean maternal age was 28.29±5.30 years and mean age of children was 9.22 ± 6.05 months. Mean maternal MUAC was 25.53±3.63 cm. Normal nutrition was present in only 70 (31%), 35 (15.4%) had moderate to severe under nutrition and 68 (30%) were overweight and 17 (7.5%) were obese. Maternal illiteracy was common 150 (66%) and 203 (89%) belong to poor social class. Majority 150 (75%) children had <-3SD WHZ score. Only 42 (18.5%) children were exclusively breast fed. Maternal malnutrition was significantly associated with severity of child's undernutrition (p=0.045) and low rates of exclusive breast feeding practices (p=0.049). CONCLUSION Malnutrition, in the form of both under nutrition and obesity is prevalent in mothers of malnourished children belonging to lower social class. Maternal illiteracy and low income are the major contributor in maternal malnutrition which in turn has an impact on child nutrition and breast feeding practices.
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Affiliation(s)
- Attia Bari
- Dr. Attia Bari, (DCH, MCPS, FCPS, MHPE), Associate Professor, Department of Pediatric Medicine, The Children’s Hospital and The ICH, Lahore, Pakistan
| | - Nighat Sultana
- Dr. Nighat Sultana, (FCPS), Assistant Professor, Department of Pediatric Medicine, The Children’s Hospital and The ICH, Lahore, Pakistan
| | - Sana Mehreen
- Dr. Sana Mehreen, (FCPS), Senior Registrar, Department of Pediatric Medicine, The Children’s Hospital and The ICH, Lahore, Pakistan
| | - Nadia Sadaqat
- Dr. Nadia Sadaqat, (FCPS), Senior Registrar, Department of Pediatric Medicine, The Children’s Hospital and The ICH, Lahore, Pakistan
| | - Izza Imran
- Dr. Izza Imran, (FCPS), Senior Registrar, Department of Pediatric Medicine, The Children’s Hospital and The ICH, Lahore, Pakistan
| | - Rashida Javed
- Miss. Rashida Javed, (MSc Nutrition), Department of Pediatric Medicine, The Children’s Hospital and The ICH, Lahore, Pakistan
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Ouédraogo CT, Wessells KR, Young RR, Faye MT, Hess SY. Prevalence and determinants of gestational weight gain among pregnant women in Niger. MATERNAL & CHILD NUTRITION 2020; 16:e12887. [PMID: 31568674 PMCID: PMC7038899 DOI: 10.1111/mcn.12887] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/12/2019] [Accepted: 08/20/2019] [Indexed: 01/18/2023]
Abstract
Low gestational weight gain (GWG) and low mid-upper arm circumference (MUAC) are associated with adverse pregnancy outcomes. We aimed to assess the prevalence and determinants of low GWG and low MUAC among pregnant women in rural Zinder, Niger. A community-based survey was conducted among 1,384 pregnant women in the catchment areas of 18 integrated health centers in the region of Zinder, Niger. Weight and MUAC were measured during an in-home visit and again 1 month later, when haemoglobin concentration and micronutrient status were also assessed. The prevalence of low GWG was defined based on the 2009 United States Institute of Medicine (U.S. IOM) guidelines (<0.35 kg/week) and less than the third centile of the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standards. Factors associated with GWG and MUAC were identified using logistic regression models adjusting for season, village, and gestational age. The median (interquartile range) age was 25.0 (20.7, 30.0) years, and 16.4% were ≤19 years. The prevalence of low GWG were 62.9% and 27.5% according to 2009 IOM and less than the third INTERGROWTH-21st centile, respectively; 24.9% had low MUAC. Higher α-1-acid glycoprotein (OR = 1.7, 95% CI [1.1, 2.8]) and C-reactive protein (OR = 1.2, 95% CI [1.02, 1.50]) increased the odds of low GWG. Adolescents (OR = 2.7, 95% CI [1.8, 4.0]), housewives (OR = 1.97, 95% CI [1.36, 2.86]), and those who reported recent food assistance (OR = 1.80, 95% CI [1.04, 3.11]) had higher odds of low MUAC. Prevalence of low GWG and low MUAC was high among pregnant women. Determinants of GWG and MUAC included socio-economic, demographic, and biological factors, although only markers of inflammation were consistent predictors across different definitions of low GWG.
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Affiliation(s)
- Césaire T. Ouédraogo
- Program in International and Community Nutrition, Department of NutritionUniversity of CaliforniaDavisCaliforniaUSA
| | - K. Ryan Wessells
- Program in International and Community Nutrition, Department of NutritionUniversity of CaliforniaDavisCaliforniaUSA
| | - Rebecca R. Young
- Program in International and Community Nutrition, Department of NutritionUniversity of CaliforniaDavisCaliforniaUSA
| | | | - Sonja Y. Hess
- Program in International and Community Nutrition, Department of NutritionUniversity of CaliforniaDavisCaliforniaUSA
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Motadi SA, Matsea Z, Mogane PH, Masidwali P, Makwarela M, Mushaphi L. Assessment of Nutritional Status and Dietary Intake of Pregnant Women in Rural Area of Vhembe District, Limpopo Province. Ecol Food Nutr 2019; 59:229-242. [PMID: 31766889 DOI: 10.1080/03670244.2019.1690999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Poor consumption of balanced diet could result in poor weight gain during pregnancy increasing the risk of premature delivery, low birth weight, and birth defects. To assess the nutritional status and dietary intake of pregnant women in rural areas of Vhembe district. A cross-sectional descriptive study was carried out among 240pregnant women who were selected conveniently from 16 clinics in Vhembe District. An interviewer-administered questionnaire was used for data collection. Anthropometric measurements were measured following standard techniques. Data on dietary intake were collected using Food Frequency Questionnaire (FFQ). Permission and clearance were obtained and participant's rights were respected. Majority (78%) had secondary educational level while 19.5% had tertiary educational level. The mean energy and carbohydrate intake was 2248 Kcal and 372.1 g, respectively. Prevalence of underweight, overweight and obese using BMI was 16.3%, 24.2%, and 8.7% respectively. Dietary intake of the study participants showed that the intake of energy, fats, carbohydrates and vitamin C met the Recommended Dietary Allowance (RDA) values. The mean intake of protein was 30.2 ± 18.2 g. However, micronutrients like zinc, iron, magnesium, calcium including Vitamin A, B1 and B2 did not meet the RDA values in the current study. Despite government's programs to ensure adequate consumption of micronutrients and proper weight gain during pregnancy, malnutrition and insufficient consumption of micronutrients remains a major public health problem in South Africa. Improving nutritional status during pregnancy should follow an integrated approach tackling both malnutrition and micronutrient deficiencies at the same time considering the behavioral approach which will improve child survival and maternal health.
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Affiliation(s)
| | | | | | - Phumuzo Masidwali
- Department of Nutrition, University of Venda , Thohoyandou, South Africa
| | - Masindi Makwarela
- Department of Nutrition, University of Venda , Thohoyandou, South Africa
| | - Lindelani Mushaphi
- Department of Nutrition, University of Venda , Thohoyandou, South Africa
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Desyibelew HD, Dadi AF. Burden and determinants of malnutrition among pregnant women in Africa: A systematic review and meta-analysis. PLoS One 2019; 14:e0221712. [PMID: 31490956 PMCID: PMC6730925 DOI: 10.1371/journal.pone.0221712] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 08/13/2019] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Malnutrition in pregnancy remains unacceptably high across all regions of Africa though promising progresses have been made globally. Primary studies might not be sufficient to portrait a comprehensive picture of malnutrition during pregnancy and its main risk factors. Therefore, we intended to review the burden of malnutrition, for this specific review implies to protein energy malnutrition, during pregnancy in Africa to present its magnitude and determinant factors. METHODS We did a systematic review of observational studies published from January 1/2008 to January 31/2018. The CINAHL(EBSCO), MEDLINE (via Ovid), Emcare, PubMed databases and Google scholar were searched. Articles quality was assessed using the Newcastle-Ottawa Scale and studies with fair to good quality were included. We pooled malnutrition prevalence and an odds ratio estimates for risk factors after checking for heterogeneity and publication bias. This review has been registered in Prospero with a protocol number CRD42018114949. RESULT 23 studies involving 20,672 pregnant women were included. Using a random effect model, the overall pooled prevalence of malnutrition among pregnant women in Africa was 23.5% (95%CI: 17.72-29.32; I2 = 98.5%). Based on the current review pooled odds ratio finding; rural residency (POR = 2.6%; 95%CI: 1.48-4.65; I2 = 0%), low educational status of partners (POR = 1.7%; 95%CI: 1.19-2.53; I2 = 54.8%), multiple pregnancy (POR = 2.15%; 95%CI: 1.27-3.64; I2 = 0%) and poor nutritional indicators (POR = 2.03%; 95%CI: 1.72-2.4, I2 = 0%) were positively determine maternal malnutrition. On contrary, better household economic status (POR = 0.47%; 95%CI: 0.36-0.62; I2 = 24.2%) negatively determine maternal malnutrition. CONCLUSION A significant number of the pregnant population in Africa are suffering of malnutrition, above 10% of the standard acceptable malnutrition rate. Thus, efforts should be renewed to ensure a proper and widespread implementation of programs that would address issues identified in the current review to reduce the burden of malnutrition.
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Affiliation(s)
- Hanna Demelash Desyibelew
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- College of Medicine and Public Health, School of Public Health, Flinders University, Bedford Park, Australia
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Dadi AF, Desyibelew HD. Undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. PLoS One 2019; 14:e0215305. [PMID: 31009475 PMCID: PMC6476509 DOI: 10.1371/journal.pone.0215305] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Regardless of significant gains and signs of progress in the last decades, maternal undernutrition remains a major public health concern in Ethiopia. Supporting the progress of interventions being taken in the country with evidence might be important to keep the sustainability of the government effort. We aimed at determining the extent of undernutrition and its associated factors among pregnant mothers in Gondar town, Northwest Ethiopia. METHOD A community-based cross-sectional study was conducted by including 940 selected pregnant mothers through a cluster sampling. A face-to-face interview was administered to pregnant mothers at a household level. We collected data using an Online Data collection kit (ODK) and the collected data was directly downloaded from the Google Cloud platform and finally imported to Stata 14 for further analysis. A multivariable logistic regression model was fitted to identify factors associated with undernutrition. A crude and adjusted odds ratio with their 95% confidence interval was calculated to declare the association and its significance. Model fitness was assured through the Hosmer and Lemeshow goodness of fit test and model classification accuracy. RESULT 14.4% (95%CI: 12.3-16.7) of pregnant mothers were undernourished. After adjusting for the main covariates; as the age of the pregnant mothers increases the odds of being undernourished decreases by 10% (AOR: 0.90; 95%CI: 0.87-0.95) and having a poor marital condition (AOR: 2.18; 95%CI: 1.03-4.59) increased the odds of undernutrition. The risk of undernutrition was also decreased by 43% among those pregnant mothers who consumed coffee sometimes (AOR: 0.57; 95%CI: 0.36-0.89) as compared to daily consumers. CONCLUSION A significant proportion of pregnant mother were undernourished. Integration of nutritional interventions with maternity health services would be highly important to improve the nutritional status of the mothers. It is also important to counsel pregnant mothers about a consequence of frequent coffee drinking during their pregnancy.
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Affiliation(s)
- Abel Fekadu Dadi
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hanna Demelash Desyibelew
- Department of Public Health Nutrition, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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