Determinants Of Dietary Diversity And Nutritional Status Of Pregnant Women Attending Armed Forces Comprehensive Specialized Hospital Addis Ababa Ethiopia
The nutritional status of a woman during pregnancy is important as a suboptimal diet impactsrnnegatively on the health of the mother, the fetus and the newborn. There is limited knowledge inrnthe area of malnutrition and factors’ affecting it among pregnant women despite evidencernshowing that maternal nutrition has important direct and/or indirect consequences for all otherrnage. The objective of the study was to assess the determinants of dietary diversity and nutritionalrnstatus of pregnant women attending antenatal clinic at Armed Forces ComprehensivernSpecialized Hospital. The study was cross-sectional and conducted by using both quantitativernand qualitative methods. A multistage sampling procedure was employed to draw 320 samples,rnpregnant women. The women were selected in random through balloting among the first fivernpregnant women to arrive at the antenatal clinic and thereafter systematic sampling was usedrnand every fourth woman that arrived were sampled until the sample size is met. The data werernanalyzed by using a software STATA version 14. Descriptive statistics to determine the dietaryrndiversity and nutritional status were done and also to characterize the nutritional status. Thernstatistical model namely, logistic and ordered logistic regression was used for factors affectingrnthe dietary diversity and nutritional status. A P value of < 0.1 was considered statisticallyrnsignificant. According to the logistic model interpretation, negative relation implies that therndependent and independent variables are inversely related; while the positive association is thernoutcome and independent variable have direct relations. The findings of the descriptive analysisrnindicated that low dietary diversity was experienced by 61.56 percent of the respondents and thernrest of the study population was in a high dietary diversity. Based on Mid-upper armrncircumference cut-offs 0.31 percent were severely malnourished, while 3.44 percent werernmoderately malnourished and 96.25percent were well nourished. Findings from logisticrnregression revealed that income, meals that were eaten in the last 24 hours, and anemia havernpositively and significantly affects dietary diversity while not taking iron-fortified foods affectsrnnegatively. The results from the ordered logit model indicate that severe undernutrition isrndetermined by not taking micronutrient daily positively where ever income and cleaning utensilrnproperly impact negatively, although moderate undernutrition is associated with not takingrnmicronutrient daily positively and negatively with cleaning utensil properly. Though beingrnnourished is affected by not taking micronutrient daily negatively and positively by cleaningrnutensil properly. Whereas by World Health Organization hemoglobin cut-offs 2.50 percent,rn11.56 percent, and 85.94 percent were in severe anemia, moderate anemia, and normalrnhemoglobin level respectively. The results from the multinomial regression model reveal thatrnsevere anemia is negatively associated with dietary diversity. At the same time, moderate anemiarnis affected positively by not taking micronutrient daily and negatively by age, dietary diversityrnscore and morbidity status of the pregnant women. Similarly being in normal hemoglobin cut-offrnwas affected positively by age, dietary diversity and morbidity, negatively affected by not takingrnmicronutrient daily. Finally, the findings conclude that dietary diversity and nutritional statusrnwere very poor and socio-demographic, socio-economic, micronutrient supplementation,rnmorbidity, environmental factors, and dietary diversity influence the nutritional status ofrnpregnant women. It is recommended that promotion of dietary diversity and modification of dietsrnbe carried out through practical demonstrations in the community and health facilities and therernshould be income generation practices and entrepreneur encouragements should be practiced.