Across Africa, malnutrition and food insecurity remain significant challenges and are particularly pronounced in Central and Eastern Africa (1). Ethiopia has significant nutritional problems that pose substantial risks to public health. The 2016 Ethiopian Demographic and Health Survey revealed that malnutrition was highly prevalent among children under the age of five, with 38% being stunted, 24% being underweight, and 10% being wasted; 20% of women of reproductive age were thin, while 8% were overweight or obese, all of which is indicative of a complex landscape of nutrition-related challenges (2).
A key contributor to nutritional inadequacy in Ethiopia is low diet quality, especially among vulnerable groups such as women and children. Diet quality refers to a balanced diet that provides enough energy and essential nutrients (3). A standard measure of diet quality is dietary diversity, the number of food groups consumed over a given period of time. (4) (5).
only 7% of Ethiopian women eat the minimum recommended number of food groups (6). The most commonly consumed food groups are grains (61%), roots and tubers (3.9%), fruits (9.9%), and legumes and nuts (8.4%). The least consumed food groups are eggs (0.3%), dairy products (5%), fleshy foods (1.5%), and oils and fats (1.5%) (7).
The quality of diets in Ethiopia are shaped by various factors that influence people’s food choices and intake. Among these, socioeconomic status is a significant determinant, with wealthier households with larger landholdings being better able to afford and access a diverse range of foods (8). In previous studies, women's empowerment, education level, and occupational status were found to be critical in determining household dietary quality, as women tend to be the primary caregivers and decision-makers regarding household food choices (9).
Dietary quality can be influenced by family size and household food production, which can affect the availability and accessibility of food within the household (8, 10). Nutritional knowledge is an essential determinant of diet quality, as individuals who know the nutritional value of various foods are better equipped to make informed dietary choices that support good health (10–12).
Over the past three decades, nutritional status in Ethiopia has steadily improved, albeit at a slow pace. Since 2008, the Ethiopian government has undertaken several nutritional initiatives, including the National Nutrition Strategy and National Nutrition Program parts One and Two, the Seqota Declaration, and the Food and Nutrition Policy (13–17). Recently, nutrition-specific and nutrition-sensitive programs have been implemented. The malnutrition reduction approach focuses mainly on immediate causes, called nutrition-specific interventions. These address the determinants of foetal and child nutritional development, including vitamin A and zinc supplementation, exclusive breastfeeding, dietary diversity promotion, and food fortification (18). Nutrition-sensitive programs address adequate maternal, household, and community caregiving resources, access to health services, and a safe and hygienic environment, while also incorporating specific nutritional goals and actions(19). Different sectors, such as agriculture, education, and industry, have been involved in mainstreaming nutrition into their priority activities.
Exploring the dynamics of the food system and its contributions to diet quality and related gaps is vital to understanding the complex issues of food and nutritional security. It is also crucial to consider the diverse socioeconomic backgrounds and contexts in which people consume food to design effective nutritional interventions. Therefore, comprehensive research into various aspects of the food system is necessary to uncover the underlying factors influencing dietary quality. Several studies have discussed the factors influencing diet quality in general but little research has been conducted into the specific topic of KAP and kitchen characteristics and their impact on dietary quality. Therefore, this research investigates how nutrition-related knowledge, attitudes, practices, and kitchen characteristics influence women’s dietary quality at the national level. This understanding can, in turn, help in the design of effective interventions to improve women’s dietary quality and reduce the burden of diet-related diseases.