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Zewude SB, Beshah MH, Ahunie MA, Arega DT, Addisu D. Undernutrition and associated factors among pregnant women in Ethiopia. A systematic review and meta-analysis. Front Nutr 2024; 11:1347851. [PMID: 38769991 PMCID: PMC11103006 DOI: 10.3389/fnut.2024.1347851] [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: 12/06/2023] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Background Maternal undernutrition is a major public health concern due to its association with mortality and overall disease burden for mothers and their children. Maternal nutrition determines pregnancy outcomes since reduced intake of nutrients influences gestational age length, placental function, and fetal growth during pregnancy. The complexity of the intergenerational aspects of maternal nutrition may also confound the design of interventions. Therefore, this research aimed to assess the prevalence of undernutrition and associated factors among pregnant women in Ethiopia. Methods We identified the literature from PubMed, EMBASE, Scopus, and CINAHL databases. Data were entered into Microsoft Excel and then exported to Stata version 17 statistical software for analysis. The I2 and Q-statistic values detect the level of heterogeneity, and meta regression was performed to investigate between-study heterogeneity using more than one moderator. JBI quality assessment tools were used to include relevant articles. Evidence of publication bias was indicated using the funnel plot and Egger's linear regression test. The effect size was expressed in the form of point estimates and an odds ratio of 95% CI in the fixed-effect model. Result In total, 19 studies fulfill the inclusion criteria. The pooled prevalence of undernutrition among pregnant women was 32% (95% CI 31.3-33.2 I2 = 97.5%, P < 0.0). Illiteracy (AOR = 3.6 95% CI; 2.3-5.6), rural residence (AOR = 2.6 95% CI; 1.2-3.5), a lack of prenatal dietary advice (AOR = 2.6 95% CI; 1.8-3.7), household food insecurity (AOR = 2.5 95% CI; 1.9-3.2), and low dietary diversity score (AOR = 3.7 95% CI; 2.2-5.9) appear to be significantly associated with undernutrition among pregnant women. Conclusion The review showed that the prevalence of undernutrition is still high among pregnant women. Illiteracy, rural residence, a lack of prenatal dietary advice, household food insecurity, and low dietary diversity score were significantly associated with undernutrition during pregnancy. Interventions should focus on educating the public and helping families access food or supplements they need through local markets, health systems, and community-based support, as undernutrition is caused by numerous interconnected causes. Systematic review registration https://www.crd.york.ac.uk/prospero/#myprospero, identifier: CRD42023417028.
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Affiliation(s)
- Shimeles Biru Zewude
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mekonen Haile Beshah
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Mengesha Assefa Ahunie
- Department of Social and Public Health, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dawit Tiruneh Arega
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Dagne Addisu
- Department of Midwifery, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Shenoy S, Sharma P, Rao A, Aparna N, Adenikinju D, Iloegbu C, Pateña J, Vieira D, Gyamfi J, Peprah E. Evidence-based interventions to reduce maternal malnutrition in low and middle-income countries: a systematic review. FRONTIERS IN HEALTH SERVICES 2023; 3:1155928. [PMID: 37954061 PMCID: PMC10634505 DOI: 10.3389/frhs.2023.1155928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 10/03/2023] [Indexed: 11/14/2023]
Abstract
Introduction Despite remarkable strides in global efforts to reduce maternal mortality, low-and middle-income countries (LMICs) continue to grapple with a disproportionate burden of maternal mortality, with malnutrition emerging as a significant contributing factor to this enduring challenge. Shockingly, malnourished women face a mortality risk that is twice as high as their well-nourished counterparts, and a staggering 95% of maternal deaths in 2020 occurred within LMICs. The critical importance of addressing maternal malnutrition in resource-constrained settings cannot be overstated, as compelling research studies have demonstrated that such efforts could potentially save thousands of lives. However, the landscape is marred by a scarcity of evidence-based interventions (EBIs) specifically tailored for pregnant individuals aimed at combatting maternal malnutrition and reducing mortality rates. It is against this backdrop that our study endeavors to dissect the feasibility, adoption, sustainability, and cost-effectiveness of EBIs designed to combat maternal malnutrition. Methods Our comprehensive search encompassed eight prominent databases covering the period from 2003 to 2022 in LMICs. We began our study with a comprehensive search across multiple databases, yielding a total of 149 studies. From this initial pool, we eliminated duplicate entries and the remaining studies underwent a thorough screening process resulting in the identification of 63 full-text articles that aligned with our predefined inclusion criteria. Results The meticulous full-text review left us with a core selection of six articles that shed light on interventions primarily centered around supplementation. They underscored a critical issue -the limited understanding of effective implementation in these countries, primarily attributed to inadequate monitoring and evaluation of interventions and insufficient training of healthcare professionals. Moreover, our findings emphasize the pivotal role of contextual factors, such as cultural nuances, public trust in healthcare, the prevalence of misinformation, and concerns regarding potential adverse effects of interventions, which profoundly influence the successful implementation of these programs. Discussion While the EBIs have shown promise in reducing maternal malnutrition, their true potential for feasibility, adoption, cost-effectiveness, and sustainability hinges on their integration into comprehensive programs addressing broader issues like food insecurity and the prevention of both communicable and non-communicable diseases.
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Affiliation(s)
- Shivani Shenoy
- Department of Global and Enviromental Health, NYU School of Global Public Health, New York, NY, United States
| | - Priyanka Sharma
- Department of Global and Enviromental Health, NYU School of Global Public Health, New York, NY, United States
| | - Aishwarya Rao
- Department of Global and Enviromental Health, NYU School of Global Public Health, New York, NY, United States
| | - Nusrat Aparna
- Department of Global and Enviromental Health, NYU School of Global Public Health, New York, NY, United States
| | - Deborah Adenikinju
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, New York, NY, United States
| | - Chukwuemeka Iloegbu
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, New York, NY, United States
| | - John Pateña
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, New York, NY, United States
| | - Dorice Vieira
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, New York, NY, United States
- NYU Health Sciences Library, NYU Grossman School of Medicine, New York, NY, United States
| | - Joyce Gyamfi
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, New York, NY, United States
| | - Emmanuel Peprah
- Global Health Program, Department of Social and Behavioral Sciences, ISEE Lab, NYU School of Global Public Health, New York, NY, United States
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Kushi EN, Belachew T, Tamiru D. The impacts of okra consumption on the nutritional status of pregnant women, west Ethiopia. Food Sci Nutr 2023; 11:5554-5564. [PMID: 37701227 PMCID: PMC10494605 DOI: 10.1002/fsn3.3512] [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: 01/12/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 09/14/2023] Open
Abstract
Food-insecurity and poor-quality diets remain a challenge for pregnant women. Consumption of okra has a great impact on improving the nutritional status of pregnant women. Okra plays a critical role in the prevention of malnutrition among pregnant women living in resource-limited settings. The evidence is scarce on the impacts of okra on mid-upper arm circumference (MUAC) measurement of pregnant women. A community-based cross-sectional study was employed among randomly selected 224 pregnant women from June 1 to July 30, 2020. An interviewer-administered questionnaire was used. The MUAC was measured by using an adult MUAC measuring tape. Data were entered into Epi-data version 3.1 and exported to SPSS version 25 for analysis by linear regression. The statistical significance of variables was declared at a p-value of .05, and unstandardized beta (β) coefficients along with a 95% confidence interval were computed. The proportion of pregnant women with low MUAC (≤22 cm) was 42.4%. In the multivariable linear regression model, hemoglobin concentration (β = 0.346, [95% CI: 0.153, 0.539], p = .001), food insecurity (β = -0.887, (95% CI: -1.441, -0.334), p = .002), daily consumption of okra (β = 1.269, [95% CI: 0.583, 1.956], p ≤ .001), and women working in NGO (β = 0.443, [95% CI: 0.256, 0.630], p ≤ .001) were significant variables. The prevalence of malnutrition among pregnant women (MUAC ≤ 22 cm) was 42.4%. Therefore, behavioral change communication interventions to promote okra consumption on regular basis were recommended.
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Affiliation(s)
| | - Tefera Belachew
- Departments of Nutrition and DieteticsJimma UniversityJimmaEthiopia
| | - Dessalegn Tamiru
- Departments of Nutrition and DieteticsJimma UniversityJimmaEthiopia
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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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Factors associated with undernutrition among pregnant women in Haramaya district, Eastern Ethiopia: A community-based study. PLoS One 2023; 18:e0282641. [PMID: 36893154 PMCID: PMC9997975 DOI: 10.1371/journal.pone.0282641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 02/20/2023] [Indexed: 03/10/2023] Open
Abstract
INTRODUCTION Although undernutrition in pregnancy has continued to get global attention as pregnancy is considered a critical period in the life cycle owed to increase the metabolic and physiological demands, evidence is scarce on undernutrition and associated factors among pregnant women in eastern Ethiopia. Therefore, this study assessed the undernutrition and associated factors among pregnant women in Haramaya district, Eastern Ethiopia. METHODS A community-based cross-sectional study was conducted among randomly selected pregnant women in Haramaya district, eastern Ethiopia. Data were collected through face-to-face interviews, anthropometric measurement, and hemoglobin analysis by trained research assistants. An adjusted Prevalence ratio (aPR), and a 95% confidence interval (CI), were used to report associations. Poisson regression analysis model with a robust variance estimate identified variables associated with undernutrition. Data were double entered using Epi-data 3.1 and cleaned, coded, checked for missing and outliers, and analyzed using Stata 14 (College Station, Texas 77845 USA. Finally, the p-value <0.05 was the cut-off point for the significant association. RESULTS A total of 448 pregnant women with a mean age of 25.68 (± 5.16) were included in the study. The prevalence of undernutrition among pregnant women was 47.9% (95% CI: 43%-53%). From the analysis, the undernutrition was more likely higher among respondents who had five or more family members (APR = 1.19; 95% CI = 1.02-1.40), lower dietary diversity (APR = 1.58; 95% CI = 1.13-2.21) and those who were anemic (APR = 4.27; 95% CI = 3.17-5.76). CONCLUSION Nearly half of the pregnant women in study area were undernourished. High prevalence was found among women who had large family sizes, low dietary diversity and anemia during pregnancy. Improving dietary diversity, strengthening family planning services and giving special attention to pregnant women, supplementation of iron and folic acid, and early detection and treatment of anemia is essential to improve the high burden of undernutrition and the adverse effect on pregnant women and the fetus.
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Wakwoya EB, Belachew T, Girma T. Determinants of nutritional status among pregnant women in East Shoa zone, Central Ethiopia. Front Nutr 2022; 9:958591. [PMID: 36590215 PMCID: PMC9797973 DOI: 10.3389/fnut.2022.958591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Background Undernutrition is an insufficient intake of energy and nutrients to meet an individual's needs to maintain good health. Undernutrition during pregnancy severely affects the health of mothers and her baby. Globally it contributes directly or indirectly to 3.5 million maternal deaths annually. This study aimed to determine the level of undernutrition and identify factors associated with undernutrition among pregnant women attending public health facilities in the East Shoa Zone, Central Ethiopia. Methods Institution-based cross-sectional study was conducted among 472 randomly selected pregnant women from June to August 2021. Sociodemographic, obstetrics, and knowledge related data were collected using a structured interviewer-administered questionnaire, and maternal nutritional status was measured using the Mid Upper Arm Circumference (MUAC). The collected data were entered to EPI-info version 3.5.4 and then exported to SPSS for windows version 26.0 software for analysis. Multivariable regression analysis was fitted to identify determinants of undernutrition. An adjusted odds ratio with 95% confidence intervals and a p-value < 0.05 was considered a statistically significant. Results The prevalence of undernutrition among pregnant women was 13.9% [95% CI: 11.0-17.4]. On multivariable logistic regression model after adjusting background variables, wealth (AOR: 4.9, 95% CI 1.34-18.20), women's decision making power (AOR: 3.31, 95% CI 1.18-7.79), and nutritional counseling (AOR: 3.53, 95% CI 1.29-9.60) were independently associated with nutritional status of pregnant women. Conclusion Findings indicated that significant number of pregnant women in the study were undernourished. Higher wealth index, nutritional counseling, and women's decision-making power were inversely associated with undernutrition. The findings imply the need for economic empowerment of women, enhancing decision-making ability of women and routine and consistent nutritional counseling to decrease undernutrition among pregnant women.
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Affiliation(s)
- Ermias Bekele Wakwoya
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia,*Correspondence: Ermias Bekele Wakwoya
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia,Department of Pediatrics and Child Health, Jimma University, Jimma, Ethiopia
| | - Tsinuel Girma
- Department of Nutrition and Dietetics, Jimma University, Jimma, Ethiopia
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Kebede TB, Mengesha S, Lindtjorn B, Engebretsen IMS. Anaemia, anthropometric undernutrition and associated factors among mothers with children younger than 2 years of age in the rural Dale district, southern Ethiopia: A community‐based study. MATERNAL & CHILD NUTRITION 2022; 18:e13423. [PMID: 36006033 PMCID: PMC9480945 DOI: 10.1111/mcn.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/23/2022] [Accepted: 07/29/2022] [Indexed: 11/27/2022]
Abstract
Mothers in resource‐poor settings are affected by different forms of undernutrition. However, the nutritional status of mothers in rural areas, particularly after delivery, is not well documented. This study assessed haemoglobin levels and body mass index (BMI) of mothers with children below 2 years of age in a rural district of southern Ethiopia. Factors associated with low haemoglobin levels and low BMI were analysed. A community‐based cross‐sectional study was conducted among 931 mother‐child pairs. Structured and standard questionnaires were used to collect data on background information, 24 h dietary recalls, and household food insecurity. Anthropometric and haemoglobin level assessments were performed. Anaemia was defined as haemoglobin levels below 12.0 g/dl, and anthropometric undernutrition was defined as a BMI <18.5 kg/m2. Multilevel linear regression was used to determine associations. Out of 931 mothers, 12.8% were anaemic and 12.6% had a BMI <18.5 kg/m2. The prevalence of minimum dietary diversity was 37.8%. The majority (78.5%) of the households were food insecure. Weight (β 0.02; 95% CI: 0.003−0.03), dietary diversity (β 0.08; 95% CI: 0.03−0.12) and secondary school attendance (β 0.34; 95% CI: 0.08−0.59) were associated with the mothers' haemoglobin level. Dietary diversity (β 0.08; 95% CI: 0.01−0.16) and household's wealth (β 0.6; 95% CI: 0.27−0.94) were associated with the mothers' BMI. Findings suggest that education and community‐based nutrition interventions must be strengthened to ensure household food security. Implementation of the national food‐based strategies should be considered, to improve the dietary diversity and nutritional status of mothers. Anaemia and underweight were less prevalent among mothers with young children in the rural Dale district, southern Ethiopia, than the national report of the Ethiopian Demographic and Health Survey in 2016. Dietary diversity is positively associated with haemoglobin level and body mass index among mothers with children younger than 2 years of age. The existing nutrition interventions such as the Productive Safety Net Programme need strengthening, to improve the sustained food access to rural households. Planing and implementing community‐based small‐scale activities, such as school gardening, and fish and poultry farming, to ensure the availability and affordability of nutritious foods.
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Affiliation(s)
- Tsigereda B. Kebede
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
| | - Selamawit Mengesha
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Sidama Regional Health Bureau Sidama region Hawassa Ethiopia
| | - Bernt Lindtjorn
- College of Medicine and Health Sciences Hawassa University Hawassa Ethiopia
- Centre for International Health University of Bergen Bergen Norway
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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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Tilahun AG, Fufa DA, Taddesse RD. Undernutrition and its associated factors among pregnant women at the public hospitals of Bench-Sheko and Kaffa zone, southwest Ethiopia. Heliyon 2022; 8:e09380. [PMID: 35592665 PMCID: PMC9111893 DOI: 10.1016/j.heliyon.2022.e09380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/05/2021] [Accepted: 04/28/2022] [Indexed: 12/02/2022] Open
Abstract
Background Undernutrition in pregnant women, expressed as low mid-upper arm circumference, is responsible for maternal mortality and morbidity, adverse birth outcomes, subsequent childhood malnutrition, and mortality. As a result, the purpose of this study was to determine the prevalence of maternal undernutrition and associated factors during pregnancy in public hospitals in the Bench-Sheko and Kaffa zones of southwest Ethiopia. Methods A facility-based cross-sectional study design was employed among 566 women who received antenatal care from March-May 2021 at the public hospitals of the Bench-Sheko and Kaffa zones, Southwest Ethiopia. A systematic random sampling technique was used to select the research unit. Undernutrition was measured by mid-upper arm circumference. The data were entered into Epi- Data version 3.1 and then exported to Statistical Package for Social Science (SPSS) version 21 software for analysis. Multivariate logistic regression models were constructed using variables with a P-value <0.25 in bivariate logistic regression analysis. Finally, in multivariate logistic regression analysis, the variable with a (P-value < 0.05) is considered statistically significant. Results A total of 566 pregnant women participated in our study with a response rate of 98.3%. The overall prevalence of undernutrition among pregnant women was 42.4% (95% CI: 38.3, 46.5). In multivariate logistic regression, the age of mothers between 16-24 years old (AOR = 3.9, 95% CI: 1.60, 9.70), household food insecurity (AOR = 1.81, 95% CI: 1.04, 3.15), and poor dietary knowledge (AOR = 3.25, 95% CI: 1.94, 5.47) were the factors significantly associated with undernutrition among pregnant women. Conclusion According to this study finding, the prevalence of undernutrition was very much high in the study area, which was significantly associated with the age groups of 16-24 years older women, poor dietary knowledge, and household food insecurity. Therefore, the strategies and programs targeted towards reducing and preventing undernutrition among pregnant mothers should be made at all levels to improve their nutritional status, and also health information, nutrition counseling, and food assistant should be provided.
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Affiliation(s)
- Abel Girma Tilahun
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Dinaol Abdissa Fufa
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Rahel Dereje Taddesse
- School of Public Health, College of Medicine and Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia
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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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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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