Abstract
BackgroundAntenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. A cross sectional study was conducted in Pregnant Women (PW) and mothers who had delivered in the past three months; Recently Delivered Women (RDW) in urban slums of North-east district of Delhi, India, to explore ANC utilization, dietary practices and nutritional outcomes.MethodsA household survey was conducted in three urban slums to identify PW and RDW. Socio-economic and demographic profile, various components of ANC received including nutrition counselling, dietary intake and nutritional outcomes based on anthropometric indices and anaemia status were assessed. Socio-demographic characteristics, nutrient intake and nutritional status were compared between those who availed ANC versus those who did not using logistic regression. Descriptive summary for services and counselling received; dietary and nutrient intake during ANC were presented.ResultsAlmost 80% (274 out of 344) women received some form of ANC but the package was inadequate. Determinants for non-utilization of ANC were poverty, literacy, migration, duration of stay in the locality and high parity. Counselling on nutrition was reported by a fourth of the population. Nutrient intake showed suboptimal consumption of protein and micronutrients like iron, calcium, vitamin A, vitamin C, thiamine, riboflavin niacin, zinc and vitamin B12 by more than half of women. A high prevalence of anaemia among PW (85%) and RDW (97.1%) was observed. There was no difference in micronutrient intake and anaemia prevalence among women who received ANC versus who did not.ConclusionsPregnant women living in urban poor settlements have poor nutritional status. This may be improved by strengthening the nutrition counselling component of ANC which was inadequate in the ANC package received. Empowering community based health workers in providing effective nutrition counselling should be explored given the overburdened public health system.
Highlights
Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns
During the formative phase of the project, a situational analysis was conducted and in this paper we present the findings on the availability and utilization of ANC services with a special focus on counselling, explore factors associated with ANC utilization and describe the nutrient adequacy of the diet consumed by the pregnant and recently delivered women along with their nutritional assessment
From a total population of 32,034, we identified 406 selfdeclared pregnant women and 200 mothers who had given birth in past three months
Summary
Antenatal Care (ANC) is one of the crucial factors in ensuring healthy outcomes in women and newborns. Nutrition education and counselling is an integral part of ANC that influences maternal and child health outcomes. Antenatal Care (ANC) is the key entry point for pregnant women to receive a broad range of health promotion and prevention services. Nutrition education and counselling is a widely used strategy to improve the nutritional status of women during pregnancy that significantly influences foetal, infant and maternal health outcomes. Systematic reviews on impact of antenatal dietary advice, nutrition education and counselling with or without nutrition supplementation report improved dietary intake and weight gain in mothers, reduced risk of anaemia and preterm delivery, increased head circumference and birth weight [2,5,6]. In spite of its known merits, Information, Education and Communication (IEC) during ANC along with nutrition and diet education is reported to be poorly executed and ANC is considered as a missed opportunity for IEC [7]
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