Barriers to utilize nutrition interventions among lactating women in rural communities of Tigray, northern Ethiopia: An exploratory study

Abstract

Background While lactation is a physiological process requiring high energy demand to fulfill the nutrient requirements of the mother and the breastfeeding child, many factors affecting maternal nutrient intake can lead to nutritional deficits. Previous studies in Ethiopia have reported the prevalence of maternal and child undernutrition and related complications. However, qualitative studies exploring potential barriers to utilizing available nutrition interventions are limited. This study, therefore, sought to qualitatively explore barriers hindering the uptake of nutrition services among lactating mothers from rural communities in Tigray, northern Ethiopia. Methods We conducted 6 in-depth interviews, 70 key informant interviews, and 13 focus group discussions among purposively selected community groups, experts, and lactating mothers between November- 2017 and January- 2018. Audio records of all interviews and focus group discussions were transcribed verbatim (word-to-word) and translated into English. Then, translated data were analyzed thematically using qualitative data analysis software Atlas ti-version 7.4. Results The participants in this study perceived that lactating mothers in their study area are not properly utilizing available and recommended nutrition interventions, and as a result, their nutrient intake was reported as inadequate. Participants identified inadequate accessibility and availability of foods, feeding practices, cultural and religious influences, focus on agricultural production and productivity, barriers related to health services and poor access to water, sanitation and hygiene as major barriers hindering the uptake of nutrition interventions by lactating women in Tigray, northern Ethiopia. Conclusion The uptake of nutrition intervention services was low among lactating mothers and was hindered by multiple socio-cultural and health service related factors requiring problem-specific interventions at community, health facility, and administrative levels to improve the nutritional status of lactating mothers in the study area.

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“…This finding revealed that the odds of optimal nutrition and health practices among pregnant women who traveled 30-60 minutes and greater than 60 minutes to get care from health institution were less likely as compared to pregnant women who travel less than 30 minutes. This finding is consistent with the study done in Tigray, Ethiopia, that mothers reported the unavailability of health facilities close to their locality was a key barrier to utilizing available services from health institution [43]. This has an implication that pregnant women are forced to either travel long distances to get health services or otherwise don't access the service given at health institution including nutrition and/or health related issues.…”

Assessment of nutrient adequacy and associated factors among lactating women of rural Bangladesh using observed intake: Findings from Bangladesh Integrated Household Survey 2018–2019

“…Poor hygiene and repeated infections also play an important role in the mother's micronutrient status (Henjum et al, 2015 ). Moreover, poor nutrition knowledge, cultural taboos, and gender inequity in the intrahousehold food distribution aggravate poor nutrient intake and maternal malnutrition (Beyene et al, 2021 ). A study recently showed that factors such as age, marital status, educational level, and monthly household income affected the overall diet quality of reproductive‐age women of rural Bangladesh (Akter et al, 2021 ).…”

Qualitative assessment of programmatic constraints in delivery of effective interventions for improving maternal nutrition in Bangladesh

“…Even in high-income countries, low- and middle-income families could not ensure nutritious foods for pregnant women 15 16. A study in Ethiopia stated that the poor economic status of the family was the leading barrier to provide healthy food consumption 17. Another study in Ethiopia showed that around 40% of the pregnant women had low dietary diversity 18.…”