Dietary Diversity Practice and its Influencing Factors Among Pregnant Women in Afar Region of Ethiopia: A Cross-sectional Study Design Supplemented by Qualitative Study.

DOI: https://doi.org/10.21203/rs.3.rs-1080595/v1

Abstract

Background: Women in low-income countries are frequently malnourished when they become pregnant, and the demands of pregnancy can exacerbate nutritional deficiencies, particularly micronutrient deficiencies, with serious health effects on the fetus. Antenatal nutritional supplements can help to improve birth outcomes and maternal health. As a result, determining the magnitude of dietary diversity and its influencing factors among pregnant women in the pastoral region of Afar, where no study has been conducted, is an essential in order to establish an intervention program in the region. 

Method: A mixed study comprising 241 pregnant women and six focus group discussions was conducted from October 1 to November 10, 2018. Participants in the quantitative study were selected by a systematic sampling method, whereas those in the focus group discussions were chosen by using purposive sampling method. The data was collected using pretested questionnaires administered via face-to-face interviews. The relationship between dietary diversity practice and its affecting factors was investigated using logistic regression analysis. The strength of the association was determined by odds ratio with a 95 % confidence interval. Thematic framework was used to analyse the qualitative data.

Results: Seventy-three percent of pregnant women had poor dietary diversity. Dietary diversity was higher in younger pregnant women who were under the age of 20 years (AOR=5.8; at 95% CI: 1.6-13.5) and aged between 21-25 years (AOR=3.9; at 95 percent CI:1.1-12.2) than in older pregnant women with over the age of 30 years. Those participants with a high average family income (above 4500 birr) had a good dietary diversity when compared to those with family income less than 1500 birr (AOR=0.1:95% 39 CI;0.02-0.7) and between 1500-3000 birr (AOR=0.05:95% CI;0.01-0.2). Pregnant women who had one antenatal care visit practiced less dietary diversity than those who had four or more (AOR=0.18: 95 percent CI; 0.04-0.8). Protein-rich foods (meat and eggs), semisolid foods (porridge and cereal soup), milk, fruit (banana) and vegetable (cabbage) 43 were the most commonly avoided foods by pregnant women. These meals were commonly avoided since they produced large babies and were attached to the fetus's body.

Conclusion: The majority of study participants had a poor dietary diversity. Pregnant women with a low family income and only one prenatal care visit were less likely than those with a high family income and four or more antenatal care visits to practice dietary diversity, respectively. Most pregnant women avoided high-protein diets, semi-solid foods, milk, vegetable and fruit. Due to the presumptions of producing large fetus and attached to the fetus's body, these foods were avoided.

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