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Geremew H, Abdisa S, Zerihun E, Gizaw YK, Kassa Y, Gashu C, Simegn MB. Dietary diversity practice and its associated factors among pregnant women in Eastern Ethiopia: A community-based cross-sectional study. Food Sci Nutr 2024; 12:1965-1972. [PMID: 38455219 PMCID: PMC10916598 DOI: 10.1002/fsn3.3892] [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: 09/27/2023] [Revised: 11/18/2023] [Accepted: 11/21/2023] [Indexed: 03/09/2024] Open
Abstract
Micronutrient insufficiencies during pregnancy have a marked impact on the health of the woman and her offspring. Evidence about the dietary practice of pregnant women is limited in Ethiopia, particularly in drought-prone areas where food insecurity is widely seen. Therefore, this research aimed to assess the dietary diversity practice and associated factors among pregnant women in Chiro district, Eastern Ethiopia. We employed a community-based cross-sectional survey in Chiro district, Eastern Ethiopia. The data were collected from 417 randomly selected pregnant women using an interview-administered structured questionnaire. EpiData-3.1 and STATA-14 were used for data entry and analysis, respectively. The binary logistic regression analysis was deployed to assess the association between dietary diversity practice and predictor variables. Out of 420 calculated sample size, 417 pregnant women completed the survey giving a response rate of 99.3%. The overall prevalence of optimal dietary diversity was 38.4% (95% CI: 33.7%, 43.2%). Educational status (adjusted odds ratio [AOR]: 2.71, 95% CI: 1.08, 6.81), meal frequency (AOR: 1.91, 95% CI: 1.11, 3.28), home gardening (AOR: 4.21, 95% CI: 2.48, 7.16), and household food security (AOR: 0.23, 95% CI: 0.13, 0.40) were independent predictors of dietary diversity practice.This study found that a substantial proportion of pregnant women had suboptimal dietary diversity, indicating a fundamental micronutrient inadequacy. Educational status, meal frequency, home gardening practice, and household food security were independent determinants of dietary diversity practice. The findings suggest that promoting maternal education and home gardening practice, and controlling food insecurity might enhance optimal dietary diversity.
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Affiliation(s)
| | - Samuel Abdisa
- Department of Midwifery, College of Health ScienceOda Bultum UniversityChiroEthiopia
| | - Ebisa Zerihun
- Department of Nursing, College of Health ScienceOda Bultum UniversityChiroEthiopia
| | - Yitagesu Kifelew Gizaw
- Department of Statistics, College of Natural and Computational ScienceOda Bultum UniversityChiroEthiopia
| | - Yoseph Kassa
- Department of Statistics, College of Natural and Computational ScienceOda Bultum UniversityChiroEthiopia
| | - Chalachew Gashu
- Department of Statistics, College of Natural and Computational ScienceOda Bultum UniversityChiroEthiopia
| | - Mulat Belay Simegn
- Department of Public Health, College of Medicine and Health ScienceDebre Markos UniversityDebre MarkosEthiopia
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Tesfaye A, Gerbaba M, Tamiru D, Belachew T. Inadequate dietary diversity practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia: a community-based cross-sectional study. Sci Rep 2024; 14:2871. [PMID: 38311634 PMCID: PMC10838914 DOI: 10.1038/s41598-024-53467-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 01/31/2024] [Indexed: 02/06/2024] Open
Abstract
The aftermath of dietary modifications made during pregnancy has the most substantial effects on nutritional status and birth results, despite the important influence of nutritional reserves. Numerous studies have been conducted on dietary practices and their determinants among pregnant women; however, there is a gap in evidence among pregnant adolescents. Therefore, this study sought to close this gap by examining dietary practices and associated factors among pregnant adolescents in the West Arsi Zone, Central Ethiopia. This community-based cross-sectional study was conducted among 459 pregnant adolescents between February and March 2023. Cluster sampling was used for selecting pregnant adolescents. Structured questionnaires were used for data collection. The data were entered into the Kobo toolbox and exported to SPSS version 25 software for analysis. Dietary diversity was assessed using the 24-h dietary recall method. Binary and multivariable logistic regression analyses were used to identify independent predictors of dietary practices. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated to identify the factors associated with the outcome variables. A p value ≤ 0.05 indicated statistical significance. The prevalence of inadequate dietary practices among the pregnant adolescents was 78.4% (95% CI 74.3%, 82.8%), and a level of nutritional knowledge [AOR = 2.4, 95% CI (1.82-4.74]; an unfavorable attitude toward dietary diversity [AOR = 4.3, 95% CI 2.9-5.83]; a food insecurity status [AOR = 8.7, 95% CI 2.37-10.24]; and a low perceived severity of poor dietary practices [AOR = 4.7, 95% CI 3.26-5.47]. These factors were significantly associated with inadequate dietary practices among pregnant adolescents. The most frequently consumed foods were starchy foods (81.3%) and pulses (79%), and the least consumed foods were meat (2.8%) and fruits (3.48%). The magnitude of inadequate dietary practices was high, and it was significantly associated with educational, behavioral, and economic status. Nutritional interventions focused on communicating nutritional behavioral changes and strengthening sustainable income-generating strategies are recommended to improve the dietary practices of pregnant adolescents.
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Affiliation(s)
- Adane Tesfaye
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Department of Nutrition, School of Public Health, College of Medicine and Health Sciences, Dilla University, Dilla, Ethiopia.
| | - Mulusew Gerbaba
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Tefera Belachew
- Department of Nutrition and Dietetics, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Etea TD, Yalew AW, Sisay MM. Mediating effects of women's empowerment on dietary diversity during pregnancy in Central West Ethiopia: A structural equation modelling. Glob Health Action 2023; 16:2290303. [PMID: 38126365 PMCID: PMC10763841 DOI: 10.1080/16549716.2023.2290303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/28/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Considerable proportions of pregnant women consume inadequately diversified diets in Ethiopia. On the other hand, women's empowerment is identified as a means of achieving maternal nutrition improvement. However, evidence on the relationship between multiple dimensions of women's empowerment and dietary diversity during pregnancy is limited in Ethiopia. OBJECTIVE This study aimed to assess the mediating effects of women's empowerment in the pathway between women's education and dietary diversity during pregnancy in West Shewa zone, Ethiopia. METHODS A health facility-based cross-sectional study was conducted among 1,383 pregnant women in 2021. Dietary diversity was measured using the minimum dietary diversity for women (MDD-W) tool. Exploratory and confirmatory factor analyses were employed to identify and validate women's empowerment dimensions. Structural equation modelling (SEM) was used to examine the pathways linking pregnant women's education and empowerment to dietary diversity during pregnancy. RESULTS From the latent dimensions of women's empowerment produced by factor analyses, pregnant women's education was directly associated with household decision-making power, psychological and time dimensions. In turn, household decision-making power, psychological and time dimensions were associated with dietary diversity during pregnancy. The direct relationship between pregnant women's education and dietary diversity was insignificant, but the total indirect effect and total effect were significant. Household decision-making power, psychological and time dimensions were significant mediators in the relationship between pregnant women's education and dietary diversity. However, economic dimension was related to neither pregnant women's education nor dietary diversity. CONCLUSION This study highlights pregnant women with better education are more likely to be empowered in household decision-making, psychological and time dimensions; and those empowered pregnant women are more likely to consume more diverse diets, suggesting women's access to higher education could have a positive indirect effect on consumption of more diverse diets during pregnancy by empowering women in the study area.
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Kushi EN, Belachew T, Tamiru D. Antenatal care follow-up was significantly associated with a higher probability of high dietary diversity score among pregnant women in okra-producing areas of western Ethiopia: proportional odds model. Food Nutr Res 2023; 67:9608. [PMID: 37533449 PMCID: PMC10392863 DOI: 10.29219/fnr.v67.9608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/31/2023] [Accepted: 06/12/2023] [Indexed: 08/04/2023] Open
Abstract
Background Dietary diversity is important for pregnant women since it has been associated with nutrient adequacy. It is very crucial to ensure optimal fetal health and development. There is no evidence at the community level on the magnitude of dietary diversity and its predictors among pregnant women in okra-producing areas of western Ethiopia. Objective This study aimed to assess the level of dietary diversity and its associated factors among pregnant women. Design A community-based cross-sectional study was employed among randomly selected 224 pregnant women in western Ethiopia. An interviewer-administered questionnaire was used to collect the data. The qualitative open 24-h recall was used to assess the level of dietary diversity. Ordinal logistic regression analyses were used by SPSS version 25. An adjusted proportional odds ratio along with a 95% confidence interval [CI] was computed to measure the strengths of the association at a P ≤ 0.05. Result This study revealed that more than one-fourth, 64 (28.6%), of the respondents were found to have high dietary diversity scores. Antenatal Care [ANC] visits (Adjusted Odds Ratio [AOR] = 2.10, [95% CI: 1.13, 3.90], P = 0.01), changing food intake (AOR = 2.97, [95% CI: 1.16, 3.67], P = 0.002), and being food secure household (AOR = 2.63, [95% CI: 1.38, 5.00], P = 0.003) were significantly associated with a higher probability of having high dietary diversity score. However, lack of formal education (AOR = 0.34, [95% CI: 0.61, 0.89]) was inversely associated with the probability of having high dietary diversity. Conclusion More than half of pregnant women in western Ethiopia were found to have low dietary diversity. Therefore, ANC follow-up, dietary modification, and promotion of frequent use of wild edible plants (okra) to maintain household food security were very crucial.
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Affiliation(s)
- Efrem Negash Kushi
- Department of Public Health, College of Health and Medical Science, Mettu University, Mettu, Ethiopia
| | - Tefera Belachew
- Departments of Nutrition and Dietetics, Public Health Institute, Jimma University, Jimma, Ethiopia
| | - Dessalegn Tamiru
- Departments of Nutrition and Dietetics, Public Health Institute, Jimma University, Jimma, Ethiopia
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Workneh F, Tsegaye S, Amanuel H, Eglovitch M, Shifraw T, Shiferie F, Tadesse AW, Worku A, Isanaka S, Lee ACC, Berhane Y. Dietary Perspectives and Practices during Pregnancy in Rural Amhara Region of Ethiopia: An Exploratory Qualitative Study. Curr Dev Nutr 2023; 7:100079. [PMID: 37250386 PMCID: PMC10209480 DOI: 10.1016/j.cdnut.2023.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 05/31/2023] Open
Abstract
Background Nutrition during pregnancy has lifelong impacts on the mother and fetus. In Ethiopia, nearly a third of pregnant women experience undernutrition. When designing nutrition interventions during pregnancy, it is important to understand existing dietary perspectives and practices in local communities. Objectives To explore the processes that shape dietary perspectives and practices during pregnancy in rural West Gojjam and South Gondar Zones of the Amhara region in Ethiopia. Methods From October to November 2018, we conducted 40 in-depth interviews with pregnant women (n = 16), family members (n = 12), and healthcare providers (n = 12) using a semistructured interview guide. Interviews were conducted in Amharic, transcribed in Amharic, and translated into English. We used a thematic analysis approach to organize data per the predefined topic areas and identify emerging themes, as well as barriers and enablers to healthy nutrition during pregnancy. Results Pregnant women and their family members recognized the benefits of a diversified diet to promote the health of the mother and the fetus. However, participants reported low dietary diversity because of limited access to nutritious foods and particular perspectives on food restrictions during pregnancy. The common practice of religious fasting also limited pregnant women's dietary intake. Women reported restricting their food intake in later pregnancy because of loss of appetite, as well as concerns about having a large infant, which might complicate delivery. Intake of locally made alcoholic drinks (Tella) was reported among pregnant women because participants thought it had low levels of alcohol that would not harm the fetus. Conclusions Although participants understood the importance of a healthy and diverse diet in pregnancy, we identified several barriers and perspectives regarding nutrition during pregnancy. Low income and lack of access to diverse foods, particularly in certain seasons, religious fasting, intentional food restrictions to limit the size of the infant, and alcohol use were commonly reported. Locally appropriate counseling and interventions should be developed, with an emphasis on increasing access to and consumption of diverse foods. Curr Dev Nutr 2023;x:xx.
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Affiliation(s)
- Firehiwot Workneh
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sitota Tsegaye
- Department of Nutrition and Behavioral Sciences, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Hanna Amanuel
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Michelle Eglovitch
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Tigest Shifraw
- Department of Reproductive Health and Population, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Fisseha Shiferie
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Amare W. Tadesse
- Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alemayehu Worku
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
| | - Sheila Isanaka
- Departments of Nutrition and Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Anne CC Lee
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Yemane Berhane
- Department of Epidemiology and Biostatistics, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
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Mesfin BA, Argaw AT, Getahun Negash F, Emiru DA, Aserese AD, Matebe GY. Minimum Dietary Diversity and Associated Factors Among Pregnant Women Living in Arba Minch Health and Demographic Surveillance Sites, Southern Ethiopia, 2022. Health Serv Res Manag Epidemiol 2023; 10:23333928231166671. [PMID: 37122558 PMCID: PMC10134103 DOI: 10.1177/23333928231166671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 05/02/2023] Open
Abstract
Background Worldwide 1.2 billion women suffer from micronutrient deficiency. Feeding diversified foods during pregnancy prevents pregnancy complications such as severe anemia, low birth weight, and birth defects. However, the status of minimum dietary diversity and associated factors among pregnant women were not explored in the study area; therefore, this study was conducted at the Arba Minch Health and Demographic Surveillance Sites (AMHDSS). Method A community-based cross-sectional study was conducted from December 19, 2021, to October 30, 2022, on randomly selected 635 pregnant women. The data were collected through face-to-face interviews, and measurements of mid-upper arm circumference using a tablet; then exported to Statistical Package for Social Sciences version 25. Descriptive statistics were used to describe the characteristics of the study participants and presented by text, figures, and tables. Binary logistic regression was used to determine factors associated with pregnant women MDD-W. Independent variables with a P-value < .05 were considered as associated factors. Findings 98.2% of the pregnant women responded to this survey, more than half, (53.3%) of them achieved MDD-W, and 24.2% of the pregnant women were undernourished. The MDD-W was associated with household food security (AOR = 0.55, CI: .36, .83), meal frequency, (AOR = 1.62, CI: 1.1, 2.5), house ownership (AOR = 0.52, CI: .29, .9), ownership of banana farms (AOR = 1.7, CI: 1.02, 2.8), antenatal follow-up (ANC) (AOR = 1.9, CI: 1.1, 3.3), and occupational status (AOR = 6, CI: 2.1, 17.6). Conclusion The MDD-W outcome in this study was higher than that in other studies. The MDD-W is associated with, ANC follow-up, meal frequency, living in a food-secured household, ownership of a house, and pregnant women's merchant occupation. For optimal pregnancy outcomes; the AMHDSS and stakeholders might need to work in collaboration to increase ANC coverage and meal frequency for pregnant women. In addition, micronutrient supplementation, and increasing the availability/production capacity of food-insecure households are expected.
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Affiliation(s)
- Bezawit Afework Mesfin
- Department of Midwifery, Arba Minch University College of Medicine and Health Sciences, Arba Minch, Ethiopia
- Bezawit Afework Mesfin, Department of Midwifery, Arba Minch University College of Medicine and Health Sciences, Arba Minch, P.O. Box 21, Ethiopia.
| | - Abinet Teshome Argaw
- Department of Biomedical Sciences, Arba Minch University College of Medicine and Health Sciences, Arba Minch, Ethiopia
| | - Firdawek Getahun Negash
- Department of Epidemiology, Arba Minch University College of Medicine and Health Sciences School of Public Health, Arba Minch, Ethiopia
| | - Dagninet Alelign Emiru
- Department of Medical Laboratory Science, Arba Minch University College of Medicine and Health Sciences, Arba Minch, Ethiopia
| | - Adisalem Damtei Aserese
- School of Public Health Department of Human Nutrition, Arba Minch University College of Medicine and Health Sciences School of Public Health, Arba Minch, Ethiopia
| | - Girum Yihun Matebe
- Department of Health Economics, Addis Ababa University College of Health Sciences, School of Public Health, Arba Minch, Ethiopia
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