Demographic characteristics of participants
Majority of the respondents 171(46.3%) were aged 18-25 years followed by 121 (32.8%) who were aged 25-32 years. The study found that majority of the respondent 199(53.9%) lived in town. Majority of the participants of this study were married 206(55.8%) followed by 89(24.1%) widowed. Summary in Table 2.
Further on computation the study found a strong indirect relationship between marital status and the level of hemoglobin among pregnant women living in Isiolo County. Living with a husband significantly reduced the chances of the pregnant mother having lower hemoglobin level (anemia). (χ2 (1, N=369) = 27.116, p=0.018, r=5.56). The study revealed that majority of the respondents lived with their extended families 199(53.9%) compared to 170 (46.1%) who lived with nuclear families. There was no significant association between who the pregnant mother lived with and occurrence of anemia in pregnancy.
The study found that, 92(24.9%) participants had never attended school while majority 179(48.5%) had a primary school level of education. Interestingly, the study also revealed a strong negative correlation between level of education of the pregnant mother and their Hemoglobin level. As the level of education increased, the chances of having anemia in pregnancy significantly reduced at χ2 (3, N=369) = 17.55, p<0.001, r=9.95).
Relationship between cultural beliefs and taboos and prevalence of anaemia among pregnant women
In most cases, the food taboos are implemented by mothers who do not have the facts about the taboos. Lack or low levels of nutritional knowledge and nutritional requirements in pregnancy imposes risk both to the fetus and the pregnant mother. The current study revealed that in Isiolo County, there were food taboos stipulated on certain foods during pregnancy like not eating chicken eggs and fish from the lake. Majority of the mothers (71.5%, n=264) practiced the taboos and this was attributed to lack of nutritional knowledge in pregnancy. This clearly indicated that food taboos stipulated were ignorantly put into place therefore affecting the pregnant women and the wellbeing of the fetus.
It was evident from the participants that the food taboos had negative impact on pregnant mothers, this was supported by 81% (n=299) mothers who agreed that the taboos contributed to maternal anemia in pregnancy since the nutritional foods needed in pregnancy were prohibited. This implied that cultural taboos imposed by the community prevented the pregnant mothers from exercising their right of choice on foods they consume during pregnancy hence increasing prevalence of anaemia. Cultural taboos were therefore considered to be significantly contributing to prevalence of anemia in pregnancy at (χ2 (4, N=369) = 27.126, p<0.001, r=0.31).
It was also noted that majority of the mothers (51.8%, n=191) hailed from poverty-stricken areas and had low literacy levels. This implied that despite having the will to take a balanced diet, the mothers couldn’t afford the different food choices and they lacked the nutritional knowledge on which food to consume when pregnant. This was a clear indication that high poverty level contributes to anaemia prevalence in Isiolo County. The study results revealed a significant positive relationship between food taboos and beliefs practiced in Isiolo County and prevalence of anaemia among pregnant women (r=0.651, f=67.85, p=0.01). Summary in Table 3
Discussion of the results
Anaemia is a reduction in the red cell mass in the blood resulting in a drop in oxygen supply to meet the metabolic needs of the body is a challenge to pregnant women in Kenya especially in Isiolo County. This study sought to assess the food taboos and beliefs during pregnancy and their contribution on anaemia among pregnant women in Isiolo County.
The study examined demographic characteristics of the participants and how they were associated with anaemia in pregnancy. Interestingly marital status was a significant determinant on the health of the pregnant women. Married women were most likely to get some assistance are from their husbands including financial support and provision of a balanced diet during the time when they needed the help the most. Living with a husband was found to reduce chances of low hemoglobin level (anemia) to a significant percentage. This finding is consistent with that of Mohammed et al in Ethiopia in the year 2019 who found that concerned spouses supported their wives to adhere to the right diet during pregnancy despite the cultural beliefs held. However, almost a fifth of the study participants (18.2%) avoided one or more food items due to extensive pregnancy related food taboos and myths . The main reasons for the non-adherence were mainly traditionally held beliefs and misconceptions. The study concluded that a significant relationship exists between pregnancy and anaemia though other factors apart from pregnancy still explained the risk of anaemia.
Diverse cultural practices restricting the consumption of foods high in iron could affect the haemoglobin level of women during pregnancy. Cultural taboos and beliefs practiced to a large extent were found to influence diet selection during pregnancy in the current study. These findings concurred with those of Patil et al in the rural community of Pondicherry in the year 2010 who found that foods such as Green chili pepper, organ meat, fish, eggs and dark green leafy vegetables were the most avoided food items, with the reasons for the avoidance being largely traditionally held myths and misinformation . Further Zerfu et al did a study on anemia in pregnancy in Ethiopia in (2016) and found that women avoided some foods during pregnancy due taboos and beliefs that one would gain weight. Some food restrictions are based on decency and aesthetics .
In Kalenjin community–Kenya, moboriet consumption is believed by some people to make a woman defecate during birth. Sugary foods are also believed to be key encourager of saliva over production to the baby. This is a clear indication that some taboos and beliefs about certain diet and foods may hinder consumption of the right diet during pregnancy hence leading to anaemia. The mothers involved in focus group discussion indicated that food taboos concerning pregnant mothers should be scrapped off since they interfere with intake of best foods that boost hemoglobin level. It was indicated that pregnant women were positive and ready to accept the change. However, several women in another group were off the opinion that
“Cultural taboos and beliefs are important in societal set up. The old people have a reason of ignoring some of these foods. Our grandparents never ate these foods and we are healthy, they never died. Traditional methods have been used since time in memorial and the community existed using this rules and taboos”.
This finding was found to be consistent with that of Mohammed et al and Zerfu et al studies respectively in their studies [11, 12] which indicated that majority of pregnant mothers believed the beliefs were of help to them.