Food Consumption, Dietary Diversity and Associated Factors in Pregnant Women Receiving Ante-Natal Care in East Gojjam Zone, Amhara, Ethiopia

Abstract

Introduction: Dietary Diversity Score (DDS) and Food Consumption Score (FCS) are indices developed to indicate micronutrient deficiency and food inadequacy. This study assessed the association between socio-economic-demographic, environmental, anthropometric and risky behavioral factors with DDS and FCS. Although these indices are significantly applicable in low-income countries set up, limited studies have been conducted on the effect of these factors on DDS and FCS. Materials and Methods: An institutional-based cross-sectional study was conducted on 423 pregnant women of<17 weeks gestation from randomly selected health institutions in five Woredas that are located in the local administration of Amhara Regional State from June 2019 to October 2019. Weekly and daily nutritional reports were collected using food frequency questionnaires. In addition, the Mid Upper Arm Circumference (MUAC) of each participant was also recorded using a “MUAC tape”. Moreover, Wealth Index (WI) was developed and categorized using principal component analysis. Bivariate and multivariable logistic regression were calculated between DDS and/or FCS and their associated factors. Results and Discussion: The prevalence of low DDS and FCS were 53.2 and 19.7%, respectively. Attainment of education up to junior school level (AOR of 0.260 (0.096, 0.709); P<0.009), low FCG (0.008 (0.001, 0.058); P<0.0001), alcohol (0.307 (0.145, 0.651); P<0.002) and frequent coffee consumption (0.393 (0.177, 0.874); P<0.022) were found to be significant risks for low DDS. Whereas, sharing toilets with other households and low DDS were associated with low FCS with AOR of=0.396 (0.174, 0.901); P<0.027 and 0.008 (0.001, 0.06) P<0.0001, respectively. In addition, the poorest WI quintile reduced the probability of the DDS by 53.9% while an increased MUAC will put the participant in the adequate or high DDS group by 11%. Conclusion and Recommendation: Low level of education, low FCS, poorest WI, low MUAC, alcohol and frequent coffee consumption were found to contribute to the reduction in DDS. A low FCS was associated with the use of a shared toilet between households as well as low DDS. Therefore, aggressive promotion of women’s education, provision of health education about the use of diversified or fortified food and supplementation of micronutrients, ceasing alcohol and coffee consumption is recommended. Moreover, policies on fostering plant and animal food production and consumption would be of high priority. In addition, the fortification of food with essential amino acids and micronutrients, and supplementation of MMN should be encouraged until sufficient production and diversification of the consumed food are attained.