FACTORS INFLUENCING DIETARY INTAKE OF PREGNANT WOMEN ATTENDING ANTENATAL CLINIC AT PRIMARY HEALTHCARE CENTRES IN ILE-IFE, NIGERIA

Abstract

Adequate and proper Maternal Nutrition (MN) during pregnancy is essential for Maternal and Child Health (MCH). Inadequate Dietary Intake (DI) during pregnancy, however, is a major proximate determinant of poor MCH in Nigeria. Information on factors influencing DI among Pregnant Women (PW) has potential benefits in designing strategies for addressing poor MN. This study was therefore designed to determine factors influencing DI among PW attending Antenatal Clinic in Ile-Ife, Nigeria. In this cross-sectional study, total sampling procedure was used to recruit 530 consenting PW visiting all the 35 Primary Health Care Centres in Ile-Ife. An interviewer-administered semi-structured questionnaire was used to collect data. The instrument included a 30-point knowledge of DI scale, questions on dietary practices and factors influencing DI. Knowledge scores of ≤10, ≥10 -20 and >20 were rated as poor, fair and good respectively. Six Focus Group Discussion (FGD) sessions were conducted to complement the quantitative data. Quantitative data were analysed using descriptive statistics, Chi-square and logistic regression tests at p=0.05 while qualitative data were subjected to content analysis. Age of respondents was 27.0±5.3 years, 90.8%.were married, 44.5% had tertiary education, 75.0% were Christians, 23 .5% were unemployed, 11.1 % earned above #50,000 monthly and 4.6% had no monthly income. Knowledge score was 23.6±4.2, and 75.5%, 21.5% and 3.0% had good, fair and poor knowledge respectively. Knowledge of DI was significantly related to older age and high level of education. Respondents that earned more than N50,000 had good knowledge of DI. Identified factors that influenced DI were cultural taboos (36.5%), restriction (25.6%), beliefs relating to negative health effect (13.7%), taste (12.1%) and religious beliefs (12.1 %). Major foods avoided for cultural reasons were protein and vitamins rich foods such as snail (97.5%), wallnut (84.0%), snake(77.7%), Crasscephalum crepidoides(52.0%) and pumpkin (48.0%). Major foods avoided based on religious beliefs were pork(87.4%), dog (76.9%) and snake (66.5%). Respondents with primary education were more likely to avoid food based on cultural taboos compared with those who have tertiary education (OR: 4.2, Cl: 1.1-15.5). Odds of avoiding foods due to cultural taboos were higher among those that earned above N50,000 compared with those that had no monthly income (OR: 11.1, Cl: 1.9-64.1). Significant predictor of avoidance of food based on religious beliefs was low level of education (OR: 1.6, CI: 1.3-2.9). Unemployed respondents were more likely to avoid food due to dislike for taste (OR: 4.1, Cl: 1.8-9.4) while those without formal education were less likely to avoid food due to taste (OR: 0.2, Cl: 0.1-1.3). The FGD revealed that reasons for restriction of food were mainly because of fear of adverse effects the foods might have on PW or the unborn child. Cultural taboos and food restriction were major factors influencing dietary intake among the pregnant women and were more pronounced among women with low education and low monthly income. Appropriate dietary alternatives through nutrition education interventions are required to address the phenomenon.