Dietary Diversity Among Pregnant Women in Gurage Zone, South Central Ethiopia: Assessment Based on Longitudinal Repeated Measurement

Abstract

Purpose Dietary diversity is a key proxy indicator of nutrient adequacy; however, limited studies have been done on it among pregnant women in Ethiopia. The study aimed to examine the prevalence of sub-optimal dietary diversity and its associated factors among pregnant women in Gurage zone, South Central Ethiopia. Materials and Methods A mixed-method approach, a longitudinal study complemented with an exploratory qualitative study, was conducted. In the longitudinal study, a consecutively included sample of 668 pregnant women was followed in three rounds of survey. Dietary diversity was assessed using the minimum dietary diversity score for women (MDD-W) tool. The average of three dietary diversity scores was used to define overall diversity. Consuming less than 5 of 10 standard food groups was considered as suboptimal dietary diversity. Multivariable logistic regression analysis was used to identify predictors of suboptimal dietary diversity. Qualitative data were analysed using the thematic analysis method. Results During the 16 to 20, 28 to 29 and 36 to 37 weeks of gestation surveys, 75.0, 78.7 and 76.5% of the women had sub-optimal dietary diversity. In aggregate, 84.4% (95% CI: 81.6, 87.3) of the women had sub-optimal dietary diversity. Rural residents (AOR: 1.91, 95% CI: 1.01, 3.62), women with no formal education (AOR: 5.51, 95% CI: 1.96, 15.53) and from food insecure households (AOR: 2.44, 95% CI: 1.07, 5.59) had higher odds of suboptimal dietary diversity. Women with higher nutritional knowledge (AOR: 0.92, 95% CI: 0.87, 0.98) were less likely to have suboptimal dietary diversity. Food taboos, poor nutritional literacy and pregnancy complications were also reported as factors affecting dietary diversity. Conclusion Majority of pregnant women in the area had sub-optimal dietary diversity. Improving the socio-economic status and promoting nutrition knowledge may improve women’s dietary diversity.

Minimum Dietary Diversity and Associated Factors Among Pregnant Women Living in Arba Minch Health and Demographic Surveillance Sites, Southern Ethiopia, 2022

“…The possible agreement would be that a food-insecure pregnant woman might not have access to a variety of foods. This finding is similar to those reported in other areas, such as Raya Azebo, 35 West Gojam, 20 Gurage Zone studies, 46 and Mizan Aman hospital. 41 …”

“…The possible agreement would be that a food-insecure pregnant woman might not have access to a variety of foods. This finding is similar to those reported in other areas, such as Raya Azebo, 35 West Gojam, 20 Gurage Zone studies, 46 and Mizan Aman hospital. 41 Pregnant women who consumed more than 3 times within 24 h and those who had established an extra meal time were more likely to achieve MDD-W than their counterparts.…”

Magnitude and determinants of food insecurity among pregnant women in Nigeria: evidence from a nationwide cross-sectional survey

“…Pregnant women facing barriers to healthcare access were more likely to be food-insecure than those without healthcare access barriers. The role of barriers to accessing healthcare may be due to low antenatal care attendance [15,18], resulting in poor nutritional knowledge among pregnant women [13,15,16,19,21,[39][40][41]. In the current study, almost 53% of women with healthcare access barriers have nutrition education constraints, decreasing their awareness of the bene ts and readiness to adopt diversi ed dietary practices.…”

“…Foodinsecure pregnant women have low dietary diversity [8][9][10]. The magnitude of food insecurity among pregnant women was 41-84.4% in Ethiopia [7,8,[10][11][12][13][14][15][16][17][18][19], 53.1-80.1% in other African countries [1,20], and 30.2-51% globally [3,9,21,22]. Food insecurity among pregnant women has worsened because of increasing poverty and disruption of primary health services associated with the COVID-19 pandemic [23][24][25].…”

“…Published studies on the social determinants of food insecurity among pregnant women are growing. The ndings of these studies indicate that food insecurity and inadequate dietary diversity among pregnant women are associated with older age [19], being married [37] and unmarried [4], Christianity [37], residing in rural areas [8,10,11,13,21], low participation in household decision-making [21], low women empowerment [12], low education [1,3,8,9,[12][13][14][15][16][17][36][37][38][39], unemployment [36,37], low socioeconomic status [1,3,6,10,12,21,39], low income[8, 9, 13-15, 17, 18, 36, 37, 40], pregnant women from male headed households [17], high parity [1,17,37], large family size[8, 10,17], low antenatal care attendance [15,18], low frequency of listening to radio [11], mobile phone use [11], and poor nutritional knowledge [13,…”