This study was conducted to determine prevalence and factors associated with minimum dietary diversity among pregnant women attending ant natal care (ANC) in public health facilities. The overall proportion of the pregnant women who met minimum dietary diversity was 7.9% with 95%CI :( 5.2, 10.6%). The finding of this study was lower than studies conducted in Ethiopia and other countries. It is lower than the findings in studies undertaken in Bale Zone (43.8%), South East Ethiopia, Gojam (45%), Northern Ethiopia, Shashemane (25.4%), Ethiopia and Ghana (46.1%)[11, 14–16]. This might be due to the fact that the season when the study undertaken affected the study finding. Even though it is the harvesting season around the study area, most food products are starchy sources mainly barley, wheat, maize and teff. It might also be due to the new FAO 2016 guideline where the study tool was adapted, that recommends considering a pregnant woman achieved minimum dietary diversity if a pregnant woman consumes at least five out of ten food groups in the previous 24 hours.
Starchy staples were the most common food group eaten by respondents (99.5%). This might be due to more production of starchy foods in the study area and low purchasing power to access fruits and animal products from the market. It might also be due to lack of awareness on diversifying diets with low cost and effort among pregnant women and within the community where the women from. The finding is in line with the study done in Eastern Ethiopia and Kenya . However, the study conducted in Gojam, Northern Ethiopia  indicated that legumes, nuts, and seeds (85.5%) were the most commonly consumed food groups.
In this study maternal education was associated with achieving the minimum dietary diversity among pregnant mothers attending ante natal care. Women who have attended grade 9 and above in their education had 8.5 times more odds of getting minimum dietary diversity than those who were unable to read and write. The finding is similar with the study done in Shashemane, Ethiopia where pregnant women who had tertiary and secondary education had three times and two times more likely to achieve the adequate dietary diversity, respectively, as compared to those who had no formal education. It also agrees with studies conducted in Jille Tumuga, North eastern Ethiopia, East Gojam, North West Ethiopia and Kenya [11, 15, 17, 18]. This indicates as the education status of women increases the likelihood getting diverse diet increases. This might be that fact that as the more mothers educated the chance to get the nutrition information either by reading, learning or watching from different sources might be extended.
The frequency of the diet in the previous day prior to study is found to be a factor associated with minimum dietary diversity among pregnant women. In this study those who consumed food four and more times were 6.1 times more likely to practice minimum dietary diversity than their counterparts who received three and less times in the previous day. This might be the fact that as the frequency of the diet increases it provides the pregnant women an opportunity to get a diet from different food groups. It is a common habit in the study area that the pattern of eating foods depends on the specific time of the day. It is culture to practice cereal and grain sources with coffee in the morning and kocho (product of false banana) or enjera( bread made of teff or wheat) with cabbage or wot (stew made of bean or pea) in the mid day or night. If pregnant women get snack, it may add an access to get additional meal from different food groups. The finding is consistent with the studies done in Alemata Hosiptal, Northern Ethiopia and Finote selam town, North West Ethiopia [19, 20] where pregnant women those who got three and more meals per day had more odds of meeting minimum dietary diversity than their counterparts.
This study reports the finding which is inconsistent with other studies that marital status was associated with minimum dietary diversity. Mothers were currently married had 8 percent less odds of having minimum dietary diversity than those who were not in the marriage. This might be the fact that culturally and religiously common to women should give priority for their husbands and gusts in the house and there is a belief that tasty and delicious foods should given for them to show the respect from wives. Sample size may also affect the finding as most of the respondents were currently married and incomparable in proportion with those who were single, widowed or separated during the study.
This study has its own limitations. The nature of the study being a cross sectional study is difficult to ascertain the causation of the selected factors with minimum dietary diversity among pregnant women. Recall bias and social desirability might affect the study as the study was based on twenty four hour recall and there might be reporting socially acceptable and common diet during the interview. Seasonality may also affect the study as the access for different foods depends on harvesting season in the study area. Factors related with husbands and household food security were not studied and need to be considered in the future studies.