Determinants of Dietary Diversity and Nutritional Status of Pregnant Women Attending Armed Forces Comprehensive Specialized Hospital, Addis Ababa, Ethiopia
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Date
2019-06
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Addis Ababa University
Abstract
The nutritional status of a woman during pregnancy is important as a suboptimal diet impacts
negatively on the health of the mother, the fetus and the newborn. There is limited knowledge in
the area of malnutrition and factors’ affecting it among pregnant women despite evidence
showing that maternal nutrition has important direct and/or indirect consequences for all other
age. The objective of the study was to assess the determinants of dietary diversity and nutritional
status of pregnant women attending antenatal clinic at Armed Forces Comprehensive
Specialized Hospital. The study was cross-sectional and conducted by using both quantitative
and qualitative methods. A multistage sampling procedure was employed to draw 320 samples,
pregnant women. The women were selected in random through balloting among the first five
pregnant women to arrive at the antenatal clinic and thereafter systematic sampling was used
and every fourth woman that arrived were sampled until the sample size is met. The data were
analyzed by using a software STATA version 14. Descriptive statistics to determine the dietary
diversity and nutritional status were done and also to characterize the nutritional status. The
statistical model namely, logistic and ordered logistic regression was used for factors affecting
the dietary diversity and nutritional status. A P value of < 0.1 was considered statistically
significant. According to the logistic model interpretation, negative relation implies that the
dependent and independent variables are inversely related; while the positive association is the
outcome and independent variable have direct relations. The findings of the descriptive analysis
indicated that low dietary diversity was experienced by 61.56 percent of the respondents and the
rest of the study population was in a high dietary diversity. Based on Mid-upper arm
circumference cut-offs 0.31 percent were severely malnourished, while 3.44 percent were
moderately malnourished and 96.25percent were well nourished. Findings from logistic
regression revealed that income, meals that were eaten in the last 24 hours, and anemia have
positively and significantly affects dietary diversity while not taking iron-fortified foods affects
negatively. The results from the ordered logit model indicate that severe undernutrition is
determined by not taking micronutrient daily positively where ever income and cleaning utensil
properly impact negatively, although moderate undernutrition is associated with not taking
micronutrient daily positively and negatively with cleaning utensil properly. Though being
nourished is affected by not taking micronutrient daily negatively and positively by cleaning
utensil properly. Whereas by World Health Organization hemoglobin cut-offs 2.50 percent,
11.56 percent, and 85.94 percent were in severe anemia, moderate anemia, and normal
hemoglobin level respectively. The results from the multinomial regression model reveal that
severe anemia is negatively associated with dietary diversity. At the same time, moderate anemia
is affected positively by not taking micronutrient daily and negatively by age, dietary diversity
score and morbidity status of the pregnant women. Similarly being in normal hemoglobin cut-off
was affected positively by age, dietary diversity and morbidity, negatively affected by not taking
micronutrient daily. Finally, the findings conclude that dietary diversity and nutritional status
were very poor and socio-demographic, socio-economic, micronutrient supplementation,
morbidity, environmental factors, and dietary diversity influence the nutritional status of
pregnant women. It is recommended that promotion of dietary diversity and modification of diets
be carried out through practical demonstrations in the community and health facilities and there
should be income generation practices and entrepreneur encouragements should be practiced.
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Keywords
Antenatal clinic, under nutrition, anemia, hemoglobin, Mid-upper arm circumference