Assessment Of Nutritional Knowledge, Beliefs And Practices In Pregnant Women

Project and Seminar Material for Sociology

Assessment Of Nutritional Knowledge, Beliefs And Practices In Pregnant Women


Abstract


This study was carried out to examine the effect of nutritional knowledge on nutritional practice and belief among pregnant women in Oshodi/Isolo Local Government Area of Lagos State. The study focused on women attending the ante-natal clinic at five Health Centres in Lagos State. The subjects were made of women of various ages with different socio-cultural and economic levels. The descriptive research survey design was used to assess the opinions of selected respondents from five health centres in the Local Government under review.

A total of 200 (two hundred) pregnant women were selected as sample size of this study, which represented the entire population of the study. Three research questions were raised in the study, while three hypotheses were formulated and tested. The research questions were analysed using the simple percentage frequency counts, while the hypotheses were tested with the application of the independent t-test and Pearson Product Moment Correlational Coefficient at 0.05 level of significance.

At the end of the exercise, the results that emerged showed that: there is a significant effect of nutritional-knowledge on nutritional practice among pregnant women in Lagos State, there is a significant relationship between nutritional-knowledge and health vitality of the new born child in Lagos State, and there is a significant relationship between nutritional-knowledge and belief system among pregnant women in Lagos State. Based on the data analyses carried out and the conclusions thereafter, the following recommendations among others were made: every pregnant woman, should be aware of the importance of intake of good foods and drugs that are helpful to the unborn child and the mother and it is recommended that women who are pregnant should be exposed to the values inherent in good foods and effective drugs.


Chapter One


Introduction

Nutrition is a process of getting the right food for good health, growth and development. It is also the kind of food you eat and the way it affects your health. Good nutrition is vital for good health and it is one of the requirements to meet physiological changes and activity needs of different ages. Nutrition is the process of supplying and receiving nourishment; it is the science of food values (Advance Learners’ Dictionary, 1980).

Nutrition as the process of giving or getting the right kind of food for good health and growth (Krause, 2004).

The knowledge of nutrition by pregnant women is very important, as this will enable them to know the kind of food or drugs to take at any given time. The knowledge of nutrition enables pregnant women to be aware of the type of nutrition to be taken, helps pregnant women to identity and eat those foods that assist their unborn babies to be healthy (Uzor, 2006).

Believing in an intake of particular foods by pregnant women is very essential, because pregnant women who believe in taking certain foods and drugs not only remain healthy, but assist their unborn babies to be healthy. Pregnant women who believe in taking certain diets, deliver their babies strong and healthy (Siimon, 2000).

The practice of nutrition among pregnant women is equally important. This is because, it is one thing to have the knowledge of nutrition and or believe in intake of particular foods, it is very crucial and recommendable for pregnant mothers to form the regular habits of practicing eating good and healthy diets or foods as the benefits therefrom are great (Barnes, 1990).

The knowledge, believe and practices of food nutrition differ in different places. For instance, in India and any other developed countries of the world, pregnant women compulsorily develop the habit of practicing nutrition due to the kind of environment they are in. For instance, pregnant mothers in the developed world, are more exposed to better nutrition than those in the developing world (Lewis, 2001). They have the wherewithal to purchase and eat whatever diet they want.

In Nigeria, many women who are pregnant are not exposed to knowledge, belief and practice of nutrition. This is due to the level of education among Nigerian women. Most pregnant women in Nigeria are illiterate and dwell in the rural areas where information dissemination is difficult and therefore, most pregnant women in Nigeria do not practice nutrition (Onuoha, 2002). Not only being illiterates, they lack the wherewithal to purchase and at whatever diet they need due to poverty.

The practice and belief in nutrition among women who are pregnant in Lagos State, cannot be different from what is obtainable in Nigeria. Except that most pregnant women who dwell in the city of Lagos are aware of nutrition and its effect on health vitality of both mothers and their unborn babies. Most women who live in cities of Lagos State, have much information on nutrition and do develop positive belief and exhibits good practices of the intake of certain foods and drugs during their pregnancies (Nkemdirim, 2007).

Good food is a basic necessity for normal organ development and function, reproduction, growth and maintenance of optimum resistance to infection and ability to repair body damages (Banks, 1993).

Good nutrition is a fundamental part of a healthy life-style. It is very essential if you are planning to become pregnant. Both mother and father to be need to be healthy to provide strong genetic material for the child to be and a healthy womb to grow into it (Almond, 2000).

Nutritional beliefs of pregnant women mean traditional beliefs regarding harmful and beneficial foods for women during pregnancy. There are also beliefs regarding the optimal amount of food to be taken during pregnancy for a successful reproductive out come. These beliefs may or may not conform to the modern biomedical notions about the proper type and amount of food needed by pregnant women to safeguard maternal nutrition, adequate growth of foetus and safe delivery (Allport, 1999). For instance, “An economy and political weekly published, September 10 2004”, revealed that in India, the food taken by a large section of pregnant women is deficient in caloric content, protein, and other nutrients(a leading cause of maternal and child mortality) (Monde, 2001).

Three well known reasons for low nutritional status of pregnant women in India are wide spread poverty; discrimination against women and female children in household food distribution and health care; and lack or poor quality of antenatal care (Alpha, 1998).

Whether or not the beliefs and practice regarding food during pregnancy are significant additional reasons for the low nutritional status of pregnant and undesirable reproductive outcome in India is an important question which has been hardly addressed by scholars (Bruce, 1999).

The practices about food during pregnancy by women are generally by choice (Bruke, 1991). For instance, the concept of hot and cold food are quite wide spread in India and many other countries, but the underlining criteria for classifying food as “hot” or “cold” are often not clear.

A balance of hot and cold is necessary for body wellbeing and since pregnancy generates a state of hotness, it is desirable to bring a balance by cold foods (Mathew and Benjamin 1999; Nichter and Nichter 1989).

Generally, adequate nutrition in pregnant women is one of the most crucial components of healthy society. Many of the chronic, on going problems that women experience in health, employment and productivity can be alleviated if they receive adequate nutrition through out their life cycle (Edward, 1996).

Poor nutrition in pregnant women creates a self-perpetuating cycle. Infants born with low birth weight or presenting with retarded growth are at risk for higher-than-average rate of morbidity and mortality during infancy and childhood (Betty, 1999). The need for balance diet during pregnancy to meet the nutritional needs foetus and mother (Betty, 1999).

On the other hand reported that various types of nutrients needed during pregnancy for physical and mental wellbeing of pregnant women, the developing foetus and the placenta includes protein, carbohydrate, fats vitamins, minerals, roughages or fibers and water(Zinger 1999). Krause laid an emphasis on the body condition resulting from the utilization of essential nutrients available to the body as body nutritional status (Krause, 2001).

The pregnant woman during the last trimester needs small but frequent needs rather than several large ones at a time, she needs high energy diet for labour and lactation, the requirements for food differs from those of non-pregnant women (Krause, 2001).

During this period also, all dietary essentials must be increased proportionally in order to supply the additional demands of the mother and the developing foetus. When there is nutritional inadequacy, the mother immune system reduces, thereby exposing her to various illnesses, intrauterine death may occur, pregnancy may be threatened and the woman may loose her life. Poor nutrition during this period may result in foetal abnormalities plus brain damages and low birth weight (Osareren, 1996).

Nutritional status of the pregnant woman must be maintained prior to conception, especially the adolescent girl. Health education of the mother at antenatal, postnatal and child welfare clinic should be emphasized according to (Nzeribe, 2003). Demonstration with local food should be used by midwives to highlight on the preparation, quantity and combinations required to get a balance diet. This will help prevent and reduce complications due to malnutrition.


1.1 Background of the Study

This study was carried out on the assessment of nutritional knowledge beliefs and practices of pregnant women and their effect on their nutritional status. The study focused on pregnant women. The subjects were made up of women of various ages with different social- culture and economic levels. Energy given food items (starches) were considered good most often, while easily available protective (vegetable and fruits) and body building food items (proteins) were infrequently mentioned or avoided for cultural, religious and health reasons. Nearly three quarter of the women did not gain enough to meet the commended weekly weight gain 24.6% lost weight (Nwosu, 1990).

Traditional beliefs rather than the more frequently cited reasons of poverty and non-availability of foods are seen as major factors limiting the quality of diet among respondents (Osondu, 1994).

The importance of nutrition, its knowledge and practices by a pregnant mothers cannot be overemphasized. This is because, the awareness of diet, the belief in it and the practices of eating well during pregnancy help a pregnant woman not only to deliver a healthy baby, but to be healthy herself (Uzor, 2000).

A woman eats during pregnancy greatly affects both herself and her growing child. According to them, the fetus depends on the mother for an adequate prenatal diet, since so much demands are made on the woman’s system, there is the need for her to be well nourished (Bhatia, Katiya and Agarwaal, 1990). Researchers have carried out a study on the effect of knowledge of nutrition and its practices on health vitality of the unborn child (Mundi, Allport and Allport, 1991). Their finding showed that good diet is helpful for the formation, growth and development of the fetus. Not only that, the knowledge and practices of nutrition, the belief in eating the correct diet by pregnant mothers to delivery of babies who are not only healthy, but weigh normally.

Having the knowledge of nutrition or diet and believing in the same are one thing, but practicalizing what one knows and believes is another and most important for the pregnant woman (Uzomah, 2007).Knowledge of certain foods and drugs and belief in them, will cause pregnant women to practice their intakes (Amaonye, 2000). For instance, for pregnant women to take foods rich in vitamin and protein such as: meat, milk, fish, eggs, liver, kidney, beans, vegetables, fruits, bread, and should take folic acid and fergon tablets for healthy babies to be formed and delivered without problems (Barnes, 2001).

Globally speaking, women who are pregnant should be aware of the intake of foods and drugs that promote health vitality in both the unborn child and the mother (World Health Organisation (WHO), 1979). In Nigeria, awareness has been created on the kind of foods pregnant mothers should take for them to be healthy and maintain balance. Also, in Lagos State, a sensitization mechanism has been put in place for the promotion of nutritional knowledge, beliefs and practices among pregnant women. This has helped most pregnant women to be aware of certain food-intakes and drugs that give them the necessary health vitality in pregnancy (Nkwor, 2001).


1.2 Statement of Problem

In our society, there is strong attachment to beliefs and cultural norms even among the educated ones. While we agree that some of these beliefs and the practices are good, the others may not be so good. Recorded advances in medicine and medical services not withstanding, majority of the pregnant women seem to prefer taking instruction on nutrition and antenatal healthcare from traditional birth attendants. This diverse information have effect on the health of pregnant women thus the need to carry out this study on effect of nutritional knowledge, beliefs and practices among pregnant women.

Understanding what they eat and what they forbid or abhor will enable the health worker structure a balance diet for them in line with available local food stuffs. Also, finding a means of spreading health talk on nutrition during pregnancy.


1.3 Objectives

  1. Assess the nutritional knowledge of pregnant women in Oshodi\Isolo Local Government Area. Lagos.
  2. Assess the nutritional beliefs of pregnant women in Oshodi\Isolo Local Government Area. Lagos.
  3. Determine the nutritional practices of pregnant women in Oshodi\Isolo Local Government Area using Mid upper arm circumference (MUAC) and haemoglobin(Hb).
  4. Establish the relationship between maternal demographic factors on nutritional beliefs and nutrition status among pregnant women in Oshodi\Isolo Local Government Area.
  5. Assess the relationship between socio economic factors on nutritional beliefs and nutrition status among pregnant women in Oshodi\Isolo Local Government Area.

1.4 Research Hypotheses

  • HO 1: There is no significant association between demographic factors, nutritional beliefs and nutritional practices of pregnant women in Oshodi\Isolo Local Government Area.
  • HO 2: There is no significant relationship between socio economic factors, nutritional beliefs, nutritional practices among pregnant women in Oshodi\Isolo Local Government Area.

1.5 Significance of the Study

The significant of this study to the pregnant women is for them to be more informed and enlightened on the importance of balanced diet during pregnancy, which will result in a healthy mother and child, as well as dispelling some rumors, superstition and old wives tale about nutrition in pregnancy.

Findings from this study will help health workers to identify the areas of concentration during antenatal health education/ health talk.

The findings will also contribute toward the improvement of the nutritional knowledge and practices of pregnant women, promote their well-being and prevent complications which may endanger their lives during delivery as a result of poor nutrition. Such complications like anemia, abortion, sepsis, bleeding, post-partum shock and eventually maternal death.

To correct any wrong beliefs and practices of pregnant women attending these centers and beyond. To make intelligent suggestions that would improve their nutrition and health status.

This study is also important to the nation because its findings could assist in mortality and mortality and morbidity rate among women as well as number of hospitalized ones.


1.6 Scope of the Study

The study examined assessment of nutritional knowledge, beliefs and practices of pregnant women and their effect of their nutritional status in Lagos State. Despite the fact that there are many hospitals and health centers for pregnant women in Lagos, the scope of this study is limited to Oshodi/Isolo health centre in Lagos state only.


1.7 Limitations

The under listed constraints limitations to the study:

Time

The period within which the study id to be carried out is too short for a detailed research.

Finance

The researcher is also faced with financial constraints and could not meet the need for future studies.


1.8 Research Method

A descriptive design employing a questionnaire with a convenience sample of women from child bearing age, including interview as necessary.


1.9 Operational Definition of Terms

The following terms were operationally defined:

Nutrition:

This is the way of taking in food substances into the body in order for the body to function.

Pregnant Women:

This means women of age 18 years and above carrying baby inside their womb, which lasts for 9 months.

Knowledge:

Information that someone knows about something.

Beliefs:

This is what one has in mind as regards to things. Example – Food and its substances

Practices:

Things you do as regards to eating. The type of food you eat in real practices.

Food Substances:

These are different type of food we eat. E.g. Yam, Beans, Vegetable etc.

Feotus:

This means an unborn baby. That is baby still inside the mothers’ womb.

Superstition:

This means negative belief against something.

Culture:

This means practice of a particular group of people.


Chapter Five


Summary, Conclusions and Recommendations

5.1 Summary

Nutritional beliefs of the pregnant women was good although low was reported by six percent of the respondents. DDS was negatively related with parity and gestation though not significantly. There were significant differences between groups which were observed for DDS based on marital status. Nutritional beliefs was found to be better with better socio economic as influenced by the occupation of the father in which post hoc tests indicated significant statistical differences in the MUAC reading of the pregnant women. There was a positive significant correlation between ownership of assets and DDS as DDS increased with the increase in the assets owned.

Nutritional practices of the pregnant women was poor and as such there is need to scale up interventions geared towards addressing nutrition status among pregnant women. MUAC findings were negatively correlated with gestation in weeks and this shows that the nutrition status deteriorated with advancement of pregnancy. Age and parity were found to be predictors of the MUAC reading of the pregnant women. Nutritional practices based on MUAC was positively correlated with ownership of assets and therefore those respondents who owned more assets were more likely to have a better nutrition status.

Household food insecurity based on the coping strategies being employed was minimal and thus this may not be a factor in this study. Mainly insurance coping strategies were employed. Culture may still be influencing the nutrition status as shown by Hb reading though it was not a major factor currently influencing nutritional beliefs as there was no significant relationship found.


5.2 Conclusions

The mean DDS indicated that nutritional beliefs among the pregnant women was good as majority had high and medium nutritional beliefs based on the FAO categorization. The MUAC data indicated that three out of ever are malnourished while the rest have a good nutrition status however; based on dietary intake, the nutrient requirements for both the macronutrients and the micro nutrients for the pregnant women were not being met. Requirements for energy, carbohydrates, protein; and micronutrients of interest- iron and Vitamin C were below the RDAs for majority of the women.

There were significant relationships between the nutrition status of the pregnant women and other factors. The MUAC measurements increased with increase in age of the pregnant women and also with increase in the number of assets. There is an indication that the nutrition status is better with a higher socio-economic status. Significant negative correlations were found for MUAC reading and gestation in weeks. Based on Hb concentrations, negative relationships were found with parity and gestation of the pregnant women. It can therefore be concluded that socio demographic, socio economic, morbidity and cultural factors influence nutritional beliefs and also the nutritional practices of pregnant women.


5.3 Recommendations

Promotion of nutritional beliefs and modification of diets through practical demonstrations in the community by community health workers which are considered as level one and the MCH clinics in all the health facilities with an aim to improve the nutritional beliefs and thus the dietary quality of the pregnant women. There is need for screening for malnutrition in pregnancy as part of the nutrition services mothers receive in the antenatal clinic so as to identify any nutritional risks in time for correction.

5.3.1 Recommendations for Practice

There is need to create awareness in the community and especially among the women of reproductive age on the problem of high prevalence malnutrition and anaemia with a focus on early prevention of the two. The high rates of anaemia may be reduced by diversification of diets through diet modifications and use of locally available foods. There is need to promote behavioural changes among pregnant women with regard to intake of certain foods such as eggs and avocado which are nutritious but are not eaten for fear of birth complications through increase in knowledge about healthy foods in pregnancy. This can be done through promotion of community nutrition education and awareness programmes.


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