Abstract
Despite strong policy and program commitment, essential maternal nutrition services are not reaching enough women in many countries. This paper examined multifactorial determinants (personal, family, community, and health services) associated with maternal nutrition practices in Uttar Pradesh, India. Data were from a household survey of pregnant (n = 667) and recently delivered women (n = 1,835). Multivariable regression analyses were conducted to examine the determinants of four outcomes: consumption of diverse diets, consumption of iron folic acid (IFA) and calcium tablets, and weight monitoring during pregnancy. Population attributable risk analysis was used to estimate how much the outcomes can be improved under optimal program implementation. During pregnancy, women consumed 28 IFA and 8 calcium tablets, 18% consumed diverse diet, and 17% were weighed ≥3 times. Nutrition knowledge was associated with consumption of diverse diet (odds ratio [OR] = 2.2 times), IFA (2.3 times), calcium (11.7 times), and weight monitoring (1.3 times). Beliefs and self‐efficacy were associated with IFA (OR = 2.0) and calcium consumption (OR = 4.6). Family support and adequate health services were also associated with better nutrition practices. Under optimal program implementation, we estimate that 51% of women would have adequate diet diversity, an average consumption of 98 IFA, and 106 calcium tablets, and women would be weighed 4.9 times during pregnancy. Strengthening existing program operations and increasing demand for services has the potential to result in large improvements in maternal nutrition practices from current baseline levels but may not be sufficient to meet World Health Organization‐recommended levels without creating an enabling environment including improvements in education and income levels to support behaviour change.
Highlights
Maternal undernutrition has been a long‐standing public health concern globally due to its adverse consequences on mortality and morbidity burden for mothers and their children (Black et al, 2013)
Our study provides novel findings on the multiple determinants of specific maternal nutrition practices in Uttar Pradesh, India
The current situation is bleak, many of the key factors associated with maternal dietary diversity, iron folic acid (IFA)/calcium consumption, and weight gain monitoring are modifiable
Summary
Maternal undernutrition has been a long‐standing public health concern globally due to its adverse consequences on mortality and morbidity burden for mothers and their children (Black et al, 2013). Nearly 90% of PW in India were registered for health services, only half of them received at least four antenatal care (ANC) visits and only a third of them reported consuming IFA tablets for ≥100 days (Avula et al, 2018) This indicates a considerable gap in access to and utilization of existing maternal nutrition services and calls for special action toward improving program implementation and effectiveness. Uttar Pradesh, a densely populated state with high burden of undernutrition, lags behind India in maternal nutrition practices: 18% of pregnant women met recommendation of dietary diversity, women consumed 28 IFA and 8 calcium tablets, and they were weighed only 1.3 times during pregnancy. The findings can help identify key factors, which if strengthened, could markedly improve maternal nutrition practices and outcomes in the context of this program
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
