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Dietary diversity (DD) and associated factors among Lactating women (LW) in Pawie district, Northwest, Ethiopia, 2019: community-based cross-sectional study.

ABSTRACT: Background:Low Dietary Diversity (DD) result in severe problem among the vulnerable group in low-income countries (LICs), whose diets are predominantly starchy staples. Lactating Women (LW) from LICs are considered a nutritionally vulnerable group. It results in many consequences on the health and well-being of children, households, communities, and the nation. However, there is little empirical evidence on factors contributing to low DD among LW in Ethiopia and the proposed study site. Therefore, this study aimed at assessing the DD and associated factors among LW in Pawie district, Northwest Ethiopia. Methods:A Community-based cross-sectional study was conducted among 806 LW from March to May 2019 G.C. DD assessed using 24 h dietary recall methods with structured questionnaires.A mean dietary diversity score (DDS) was computed for ten food groups. Food insecurity measured using a 9-item Household Food Insecurity Access Scale (HFIAS). The multivariable logistic regression model was used to see the relevant associations. The variables which have a significant association with DD were identified based on AOR, P-value ≤ 0.05, and 95% Cl. Results:A total of 806 LW aged 15-49 years were interviewed with a response rate of 100%. About two-third of LW had low DD (<5 food groups). Fathers occupation being daily laborer [AOR = 1.82, 95% CI (.339, 9.784)], birth interval less than 24 months [AOR = 3.7, 95 % CI (1.743, 7.885)], family size greater than six members [AOR = 1.55, 95 % CI (1.046, 2.313)] and food insecurity [AOR = 2.23, 95 % CI (1.626, 3.066)] were more likely associated with the low DD among LW compared to their counterpart. Conclusion:The DD among LW was low. Low Dietary Diversity was statistically associated with low birth intervals, large family sizes, and food insecurity. Hence, attention should be paid to the identified factors of low DD of LW to improve their health, and that of their children as well as their family.

SUBMITTER: Mulatu S

PROVIDER: S-EPMC8645438 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundOptimal nutrition during lactation is essential for the well-being of the mother and the infant. Studies have shown that access to nutrient-rich foods during lactation is critical as minimal stores of nutrients can have adverse effects. This study aimed to investigate the diversity, composition, and nutrient adequacy of diets of lactating mothers in Southwest Ethiopia.MethodsA community-based cross-sectional survey was carried out in three districts of Jimma Zone, Southwest Ethiopia, in February 2014. A stratified multistage sampling technique was used to select 558 lactating mothers. Data were collected using a pre-tested and structured interviewer-administered questionnaire. Minimum dietary diversity for women (MDD-W) was computed from a single 24-h recall. A cut off value of 5 was used to classify the dietary diversity into achieving MDD-W or not. The proximate, mineral and anti-nutritional compositions of 12 commonly consumed foods were analysed using standard methods. Nutrient adequacy ratio (NAR) and Mean adequacy ratio (MAR) of these foods were estimated.ResultsThe mean (±SD) dietary diversity score (DDS) of the study participants was 3.73±1.03. Meeting MDD-W was positively associated with agricultural production diversity (P = 0.001) and educational level of the women (P = 0.04). Conversely, district of the study (P = 0.003) and place of residence (P = 0.019) were negatively associated with meeting MDD-W. The proximate composition (g/100g) of the sampled foods ranged between 24.8-65.6 for moisture, 7.6-19.8 for protein, 2.1-23.1 for crude fat, 2.0-27 for crude fibre, 1.0-21.2 for total ash, and 0.9-45.8 for total carbohydrate content. The calorific value ranged between 124.5-299.6 Kcal/100g. The mineral contents (mg/100g) ranged between 9.5-52.5 for iron, 2.2-4.2 for zinc, 42.6-318.2 for calcium, and 150.7-379.9 for phosphorus. The content of anti-nutritional factors (mg/100g) ranged between 11.1-178.9 for phytate and 3.7-315.9 for tannin. All the commonly consumed maternal foods were not sufficient to meet the energy, fat and protein requirements, (NAR<1). However, all diets provided adequate iron and most of the cereal-based foods provided adequate carbohydrate and minerals. The overall nutrient adequacy was below the cut-off point for all food types.ConclusionsThe diets of lactating mothers in Southwest Ethiopia lack diversity and nutrient adequacy. A community-based nutrition education program on the importance of diet diversity and nutrient intake during lactation based on a multi-sectoral approach is needed.

Project description:ObjectivesThis study aims to assess the prevalence of undernutrition and factors associated with it among khat-chewer and non-chewer lactating women at Chiro district, west Hararghe zone, eastern Ethiopia.MethodsA community-based comparative cross-sectional study was conducted among 446 (223 khat chewers and 223 non-chewers) randomly selected lactating women who have children aged 6 and 23 months. Data were collected through face-to-face interviews using structured questionnaires followed by weight and height measurements to calculate and categorize nutritional status based on body mass index (kg/m2). Data were entered into EpiData version 3.1 and analyzed using STATA version 14.2. A binary logistic regression model was fitted to check the association between independent variables and undernutrition. The level of statistical significance was declared at a p-value less than 0.05.ResultsThe overall prevalence of undernutrition among lactating women was 30.7% (95% confidence interval = 26.6, 35.2). Undernutrition was significantly higher among khat chewers, 39.0% (95% confidence interval = 32.8, 45.6) than non-chewers, 22.4% (95% confidence interval = 17.4, 28.4), (χ2 (degree of freedom) = 14.4231, p < 0.0001). Chewing daily (adjusted odds ratio = 3.14, 95% confidence interval = 1.08, 9.15), reducing number of meals after chewing (adjusted odds ratio = 3.45, 95% confidence interval = 1.29, 9.20), and unavailability of latrine (adjusted odds ratio = 2.98, 95% confidence interval = 1.02, 8.75) were significantly associated with undernutrition among khat-chewer lactating women. Furthermore, age at first pregnancy (<18 years) (adjusted odds ratio = 3.17, 95% confidence interval = 1.17, 8.60), not taking any additional meals (adjusted odds ratio = 3.41, 95% confidence interval = 1.08, 10.7), and hand washing after toilet use (adjusted odds ratio = 6.10, 95% confidence interval = 2.51, 14.8) were significantly associated with undernutrition among non-chewer lactating women.ConclusionThe overall prevalence of undernutrition is higher than previous studies and is alarming among khat-chewer lactating mothers. Thus, nutritional and public health interventions should target khat-chewer lactating mothers particularly focusing on daily chewer either to improve their dietary practice during and after chewing or to stop khat chewing if possible, in order to reduce the effect of khat on food absorption. Besides, improving latrine coverage and use, and prevention of early pregnancy are of paramount importance in reducing undernutrition among lactating mothers.

Project description:Background:Dietary diversity (DD) is among the core infant and young child feeding (IYCF) indicators. However, in many developing countries, meeting the minimum standards of DD is challenging and information concerning its determinants is limited. Objective:To assess the level and predictors of DD among children aged 6-23 months in rural communities of Aleta Wondo district, Sidama zone, Southern Ethiopia. Method:A community-based cross-sectional study was conducted in rural Aleta Wondo in February 2016. Multistage sampling was employed to recruit 502 children aged 6-23 months. DD was assessed by asking the mother whether the index child had received food from the standard seven food groups in the previous day, without setting minimum intake restrictions. Ultimately, the dietary diversity score (DDS) was rated on a 7-point scale, and it was modeled using linear regression analysis. The outputs are presented using adjusted regression coefficients (?). Results:Only 12.0% (95% confidence interval: 9.0-15.0%) of the children met the minimum recommended DD, receiving from four or more from seven food groups. The analysis identified eleven significant predictors of DDS. As the maternal knowledge of IYCF increases by a unit, DDS raised by 0.21 units (p = 0.004). Unit increment in the husband's involvement in the IYCF score was linked with 0.32 units improvement in DDS (p = 0.016). One unit change in the ordinal category of household food insecurity was associated with 0.13 reduction in DDS (p = 0.001). Similarly, household wealth index (??=?0.54, p = 0.041), father's literacy (??=?0.48, p = 0.002), ownership of home garden (??=?0.38, p = 0.01), mother's participation in cooking demonstrations (??=?0.19, p = 0.036), and child age in months (??=?0.04, p = 0.001) were all positively associated with DDS. Furthermore, receiving IYCF information via mass media (??=?0.04, p = 0.001) and during antenatal (??=?0.91, p = 0.022) and postnatal checkups (??=?0.21, p = 0.043) were positive predictors of DDS. Conclusions:Promoting the socioeconomic status of the community, strengthening of home gardening, involving husbands in IYCF, and enhancing maternal knowledge of IYCF may advance DD.

Project description:Information on micronutrient adequacy of diets of rural Indonesian lactating women is lacking, despite their high nutrient requirements. This is of concern because deficits in micronutrient intakes may compromise the health of both mothers and infants. This study aimed to assess micronutrient adequacy and dietary diversity (DD) among rural lactating women and explore relationships between micronutrient adequacy, DD, and intakes of energy and food groups consumed. We measured in-home 12-h weighed food records and 12-h recalls over three non-consecutive days from 121 exclusively breastfeeding women at 2-5 months postpartum. Next, we calculated intakes of energy and 11 micronutrients and estimated probability of adequacy (PA) for usual intakes of 11 micronutrients for each women taking into account national fortification of wheat flour with thiamin, riboflavin, folate, zinc, and iron. We assessed DD from nine food groups consumed. Energy and macronutrient balance were within recommended ranges, yet population prevalence of adequacy was less than 50% for niacin, vitamins B6 and C, and less than 60% for calcium, vitamin B12 and vitamin A, all micronutrients not targeted by the national wheat flour fortification program. In contrast, population prevalence of adequacy for the fortified micronutrients was at least 60%, with iron and zinc attaining 79% and 97%, respectively. Overall mean population prevalence of micronutrient adequacy was 57% and mean (±SD) DD score was 4.3±1.2. Mean PAs, a composite measure based on individual PAs over 11 micronutrients, were strongly correlated with energy intakes and with DD scores. In the multivariate models with maternal education and wealth index as covariates, organ meats were the most important determinant of mean PA after controlling for energy intake. In conclusion, despite wheat flour fortification, lactating mothers remained at risk of multiple micronutrient inadequacies. Increasing intakes of animal source foods including organ meats, and fruits and vegetables should be considered.

Project description:BackgroundVitamin A deficiency is known for its adverse health consequences, such as blindness, growth retardation and death. To curb the problem, Ethiopia has implemented various public health measures although little has been done to examine the deficiency among pregnant and lactating women. As a result, this study assessed the prevalence of Vitamin A deficiency and associated factors among pregnant and lactating women in Lay Armachiho district, northwest Ethiopia.MethodsA community-based cross-sectional study was conducted on pregnant and lactating women in Lay Arimachiho district, northwest Ethiopia, using the multistage systematic sampling technique to select participants. The binary logistic regression model was fitted to test the effect of exposure variables, and the Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) and p-value < 0.05 were computed to identify the significance and the strength of the associations of variables with Vitamin A deficiency.ResultsThe study revealed that 13.7% of the pregnant and lactating women had night blindness and 0.4% had also Bitot's Spot. Over 35 years of age of mothers (AOR = 2.74; 95%CI: 1.15,7.43), less than USD 22.7 household monthly income (AOR = 8.9; 95%CI: 4.54,21.73), and poor hand washing practices after toilets (AOR = 8.87; 95% CI: 4.43,18.68) were positively associated with VAD, while mothers' access to the media (AOR = 0.20; 95%CI:0.07, 0.59), formal education (AOR = 0.09; 95% CI: 0.03, 0.41), over 18 years of age at first marriage (AOR = 0.19; 95%CI: 0.08,0.36), and no fasting (AOR = 0.14; 95%CI: 0.04,0.46) were negatively associated.ConclusionsMaternal Vitamin A deficiency was the major public health problem in Lay Armachiho district. Over 35 years of age of mothers, less than USD 22.7 household monthly income and poor hand washing practices after toilets were high risks for VAD, while mothers' access to the media, formal education, over 18 years at first marriage, and no fasting were low risks. Therefore, community awareness about the risk of early marriage, poor hand hygiene practices after toilets, and fasting during pregnancy and lactating period were essential. Organizations working on maternal health need to focus on mothers with low incomes in order to reduce their deficiency in Vitamin A.

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Dietary diversity (DD) and associated factors among Lactating women (LW) in Pawie district, Northwest, Ethiopia, 2019: community-based cross-sectional study.

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