What factors are associated with maternal undernutrition in eastern zone of Tigray, Ethiopia? Evidence for nutritional well-being of lactating mothers

Abstract

Background Maternal undernutrition is a pervasive health problem among Ethiopian mothers. This study aims at identifying the level of maternal undernutrition and its associated factors in Kilte Awaleo-Health and Demographic Surveillance Site (KA-HDSS), Tigray region, Ethiopia. Methods Nutritional status of 2260 lactating mothers was evaluated using the mid-upper-arm circumference (MUAC). Data from the vital events and verbal autopsy databases were linked to the survey and baseline recensus data to investigate the association of adult mortality from chronic causes of death (CoD) on maternal undernutrition. We employed a generalized log-binomial model to estimate the independent effects of the fitted covariates. Results The overall prevalence of maternal undernutrition based on MUAC < 23 cm was 38% (95% CI: 36.1, 40.1%). Recent occurrence of household morbidity (adjusted prevalence ratio (adjPR) = 1.49; 95%CI: 1.22, 1.81) was associated with increased risk of maternal undernutrition. In addition, there was a 28% higher risk (adjPR = 1.28; 95%CI: 0.98, 1.67) of maternal undernutrition for those mothers who lived in households with history of adult mortality from chronic diseases. Especially, its association with severe maternal undernutrition was strong (adjusted OR = 3.27; 95%CI: 1.48, 7.22). In contrast, good maternal health-seeking practice (adjPR = 0.86; 95%CI: 0.77, 0.96) and production of diverse food crops (adjPR = 0.72; 95%CI: 0.64, 0.81) were associated with a lower risk of maternal undernutrition. Relative to mothers with low scores of housing and environmental factors index (HAEFI), those with medium and higher scores of HAEFI had 0.81 (adjPR = 0.81; 95%CI: 0.69, 0.95) and 0.82 (adjPR = 0.82; 95%CI: 0.72, 0.95) times lower risk of maternal undernutrition, respectively. Conclusions Efforts to ameliorate maternal undernutrition need to consider the influence of the rising epidemiology of adult mortality from chronic diseases. Our data clearly indicate the need for channeling the integrated intervention power of nutrition-sensitive development programs with that of nutrition-specific sectoral services.

Dietary habits, diversity, and predictors among pregnant women attending primary health care centers for antenatal care in Lagos, Nigeria

“…The situation is critical in Ethiopia with a prevalence rate of 38%. [ 3 ] The prevalence of overweight and obesity has been rising in all regions, together reaching more than 70% in the Americas and the Caribbean and more than 40% in Africa with economic development, nutritional shifts, and cultural factors often cited as drivers. [ 4 ]…”

“…In Nigeria, 32% of children younger than five years are stunted, 3.5% are severely wasted, 20.2% are underweight. [ 3 ] More than a third of child deaths and 11% of the total disease burden worldwide are due to maternal and child undernutrition. [ 3 ] Maternal undernutrition increases the probability of poor pregnancy outcomes and contributes to at least a fifth of maternal death globally.…”

“…[ 3 ] More than a third of child deaths and 11% of the total disease burden worldwide are due to maternal and child undernutrition. [ 3 ] Maternal undernutrition increases the probability of poor pregnancy outcomes and contributes to at least a fifth of maternal death globally. [ 9 ] According to World Food Program, approximately half of all pregnant women in developing countries are anemic which causes about 110,000 deaths during childbirth each year.…”

“…Widespread global micronutrient deficiencies (MNDs) and their consequences exist with pregnant women and under 5-year-old children at the highest risk. [ 3 12 13 14 ] Consequences of maternal and child undernutrition were responsible for 2·2 million deaths and 21% of disability-adjusted life-years (DALYs) for children younger than 5 years. [ 3 ] Studies in Nigeria have shown spina bifida to constitute about 72.7% of neural tube defects diagnosed in pregnant women, perinatal mortality of 81.8%, and low birth weight (mostly due to maternal malnutrition) accounting for almost 30% of all births.…”

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

“…Additionally, there are dietary supplementation programs for undernourished mothers and other indirect health services [13]. Despite the availability of these interventions in the community, their utilization by lactating mothers was reportedly low [16,17]. While factors such as inadequate access to food, socio-cultural and religious influences, selling of food products, and poor access to WASH hindered program utilization in many low-income countries, evidence regarding the potential barriers to access such services in Ethiopia and specifically the Tigray region, is not understood well.…”