Food Insecurity Associated with Attendance to Antenatal Care Among Pregnant Women: Findings from a Community-Based Cross-Sectional Study in Southern Ethiopia

Exploring the interplay between food security and antenatal care utilization among pregnant women in Southern Ethiopia: Insights from an institution-based cross-sectional study

Background

Ensuring the satisfaction of pregnant women with antenatal care is crucial for positive pregnancy outcomes and their engagement with emerging technologies and alternative care models. Maintaining high satisfaction during the antenatal period significantly impacts the well-being of both the expectant mother and the unborn child. Despite the recognized importance of antenatal care satisfaction, comprehensive information on satisfaction levels and influencing factors in the specific study area is lacking. Therefore, this study aims to assess antenatal care service satisfaction and associated factors among pregnant women in Arba Minch town, southern Ethiopia.

Methods

We conducted an institution-based cross-sectional study among 418 pregnant women from December 2022 to January 30, 2023, using a systematic sampling method. Data were collected using the Kobo Toolbox and analyzed with SPSS Version 26. The threshold for statistical significance was set at a p-value of less than 0.05.

Results

Out of 418 participants, 54.3% (95% CI=49.4-60.4) expressed satisfaction with antenatal care services. Factors significantly associated with women's satisfaction included: being unable to read and write (AOR=2.37; 95% CI: 1.97-3.80), being aged 25-29 years (AOR=3.20; 95% CI: 1.65-6.22), receiving antenatal care at a hospital (AOR=1.81; 95% CI: 1.05-3.12), having a previous history of antenatal visits (AOR=2.59; 95% CI: 1.26-5.30), a monthly income of 2500-5000 ETB (AOR=1.44; 95% CI: 1.21-3.94), waiting times of less than 30 min (AOR=2.59; 95% CI: 1.52-4.41), maintaining a positive attitude towards antenatal care (AOR=2.50; 95% CI: 1.05-3.65), and having a secure food source (AOR=2.06; 95% CI: 1.13-3.78).

Conclusion

Over 54% of participants were satisfied with antenatal care services. To improve satisfaction levels, recommended strategies include enhancing healthcare infrastructure, establishing maternity waiting areas, reducing waiting times, and expanding services to remote areas.

Household food insecurity and associated factors among postpartum women in southern Ethiopia: a community based cross sectional study

Approximately two billion individuals, or 26.4% of the global population, live in moderate- to severely food-insecure circumstances. It was discovered that not receiving all recommended antenatal care throughout one's pregnancy is one of the effects of household insecurity. The majority of women in Ethiopia, one of the most food-insecure countries in the world, with 10% of the population facing food poverty, devote more of their time to household duties, making food insecurity in the home the primary effect of poor prenatal care utilization. The main objective this study was to assess the status of household food insecurity among postpartum women at Arba Minch town, southern Ethiopia. A community-based cross-sectional study was conducted among 381 mothers who were enrolled from December 1, 2022, to January 30, 2023. The total sample size was allocated proportionately to the number of postpartum women living in each kebeles taking from the town registry of health extension workers for immunization. Thus, systematic sampling was applied. Kobo Toolbox was used for data collection and cleaning, which was then analyzed using the statistical package of Social Science Version 26 (SPSS). In this study, the prevalence of food insecurity was 30.2% (95% CI 25.5-34.5). The associated factors with household food-insecurity were maternal occupation (AOR = 0.5, 95% CI 0.27, 0.90), late antenatal care initiation (AOR = 3.5, 95% CI 2.13, 5.91), and low monthly income (AOR = 3.1, 95% CI 1.38, 6.93). Food insecurity among postpartum mothers in the study area is high. Families who are severely food insecure require quick assistance to lower poor maternal and neonate's outcomes. Furthermore, enhancing the occupation of mothers is crucial in reducing the morbidities and mortality of food insecure mothers, such as delayed prenatal care services, anemia, low birth weight, and stillbirth.

Prevalence and determinants of food insecurity among pregnant women in Nigeria: A multilevel mixed effects analysis

Food insecurity (FI) remains a key priority for sustainable development. Despite the well-known consequences of food insecurity on health and well-being, evidence regarding the burden and determinants of FI among pregnant women in Nigeria is limited. Framed by the social-ecological model, this study aimed to determine the prevalence of FI, and its associations with individual-/household-level and contextual-level factors among pregnant women in Nigeria. A cross-sectional study based on the Nigerian Multiple Indicator Cluster Survey (2021 Nigerian MICS6) was conducted among a sample of 3519 pregnant women aged 15-49 years. Several weighted multilevel multinomial logistic regression models were fitted to assess the association between individual-/household-s level and community-level characteristics with FI. We estimated and reported both fixed effects and random effects to measure the associations and variations, respectively. Results: The prevalence of FI among pregnant women in Nigeria was high, with nearly 75% of the participants reporting moderate to severe FI in the past 12 months (95% CI = 71.3%-75.8%) in 2021. There were also significant differences in all the experiences of food insecurity due to lack of money or resources, as measured by the Food Insecurity Experience Scale (FIES), except for feeling hungry but not eating because of lack of money or resources (p < 0.0001). Multivariate analysis revealed that higher parity, households with 5 or more members, household wealth index, urban residence, and community-level poverty were significantly associated with FI. Our study demonstrates a significantly high prevalence of FI among pregnant women in Nigeria in 2021. Given the negative consequences of FI on maternal and child health, implementing interventions to address FI during pregnancy remains critical to improving pregnancy outcomes.

Water insecurity, food insecurity and social capital associated with a group-led microfinance programme in semi-rural Kenya

ABSTRACTSocial capital predicts many positive health outcomes, including food and water access and sufficiency. Hence, increasing social capital has emerged as one potential strategy to improve food and water security. In this study, we investigate whether social capital generated through participation in a community-based microlending programme based in semi-rural Kenya is associated with water and food insecurity, and explore the interconnectedness of water and food insecurity through mediation analysis. Randomly-selected women participants of the community-based programme (n = 400) were interviewed in June 2018 and again in June 2019. Survey measures included water insecurity, food insecurity and an index of social capital constructs, namely group cohesion, trust, expectations of mutual support, sense of belonging and frequency of attendance in the programme. Random effects linear regression showed that an increase the social capital index was associated with lower water and food insecurity. The mediation analysis indicated that the association between social capital and food insecurity was completely mediated by water insecurity. This study demonstrates the need for further investigation into how social capital-generating programmes can contribute to systems approaches for collaborative food and water security programmes, especially among rural communities in low- and middle-income countries.

Effects of the COVID-19 pandemic on antenatal care utilisation in Kenya: a cross-sectional study

OBJECTIVE

The aim of this study was to assess the effects of COVID-19 on antenatal care (ANC) utilisation in Kenya, including women's reports of COVID-related barriers to ANC and correlates at the individual and household levels.

DESIGN

Cross-sectional study.

SETTING

Six public and private health facilities and associated catchment areas in Nairobi and Kiambu Counties in Kenya.

PARTICIPANTS

Data were collected from 1729 women, including 1189 women who delivered in healthcare facilities before the COVID-19 pandemic (from September 2019-January 2020) and 540 women who delivered during the pandemic (from July through November 2020). Women who delivered during COVID-19 were sampled from the same catchment areas as the original sample of women who delivered before to compare ANC utilisation.

PRIMARY AND SECONDARY OUTCOME MEASURES

Timing of ANC initiation, number of ANC visits and adequate ANC utilisation were primary outcome measures. Among only women who delivered during COVID-19 only, we explored women's reports of the pandemic having affected their ability to access or attend ANC as a secondary outcome of interest.

RESULTS

Women who delivered during COVID-19 had significantly higher odds of delayed ANC initiation (ie, beginning ANC during the second vs first trimester) than women who delivered before (aOR 1.72, 95% CI 1.24 to 2.37), although no significant differences were detected in the odds of attending 4-7 or ≥8 ANC visits versus <4 ANC visits, respectively (aOR 1.12, 95% CI 0.86 to 1.44 and aOR 1.46, 95% CI 0.74 to 2.86). Nearly half (n=255/540; 47%) of women who delivered during COVID-19 reported that the pandemic affected their ability to access ANC.

CONCLUSIONS

Strategies are needed to mitigate disruptions to ANC among pregnant women during pandemics and other public health, environmental, or political emergencies.

Level of food consumption score and associated factors among pregnant women at SHEGAW MOTTA hospital, Northwest Ethiopia

Background

Several studies conducted to access the status of household food insecurity in Ethiopia show that the nutrition problem is still highly prevalent especially in pregnant women and children. This study was conducted in 2018 main harvesting season with the principal objective to assess the level of food consumption score and associated factors among pregnant women attending antenatal service at Shegaw Motta Hospital.

Methods

Institution based cross-sectional study was conducted among pregnant women attending antenatal care service at Shegaw Motta Hospital, East Gojjam Zone, Northwest Ethiopia. Primary data of 422 pregnant women were collected using interviewer administered structured questionnaire and a systematic random sampling technique was used to select study participants. The standardized World Food Program eight food groups English version questionnaire was translated to the local Amharic language and used along with the Ethiopian food composition table. The collected data were subjected to descriptive statistics and analyzed with SPSS software.

Results

From the total of 422 pregnant women, 1.9% (95% CI: 0.7–3.3) of the respondents food consumption score were poor, 16.6% (95% CI: 13.0–20.4) were borderline and the remaining 81.5% (95% CI: 77.5–85.1) had acceptable food consumption score. Residence, being rural or urban [AOR = 4.594;95%CI: 1.871–11.283, P = 0.001], religion status, being an Orthodox [AOR = 0.073;95% CI: 0.021–0.254, P < 0.0001], were factors associated with food consumption score.

Conclusions

Food consumption score among pregnant women seems to be highly unacceptable. Residence and religion were factors associated with food consumption score. Therefore, appropriate nutrition education should be given.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10366-y.