Knowledge and Perception on the Effect of Malnutrition Among Pregnant Women Attending Antenatal Clinic at Jericho Specialists and Jericho Nursing Home, Ibadan
Chapter One
General Objective
The study assessed the knowledge and perception of the effect of malnutrition among pregnant women attending the antenatal clinic in Jericho Specialists and Jericho Nursing home, Ibadan Oyo.
Specific Objectives
The study was guided by the following objectives;
- To identify the prevalence of malnutrition among pregnant women attending antenatal clinic in Jericho Specialists and Jericho Nursing home, Ibadan
- To determine the demographic factors causing malnutrition among pregnant women attending antenatal clinic in Jericho Specialists and Jericho Nursing home, Ibadan
- To find out the effect of maternal weight gain during pregnancy on birth weight.
- To determine the prevalence of anemia among pregnant women.
CHAPTER TWO
LITERATURE REVIEW
Introduction
In this chapter, literature related to the study is critically reviewed in-order to place linkage among the variables used in the research. This chapter is sectioned according to the major themes of the study. All the section therein is focused on the conceptual understanding of the knowledge and perception of the effect of malnutrition among pregnant women at Jericho Specialists and Jericho Nursing home.
Prevalence of Malnutrition among pregnant women.
Malnutrition is still a major health concern in both the developed and developing countries. Maternal mortality and morbidity, intra uterine growth retardation and low birth weight are commonly caused by poor nutrition and infections during pregnancy. This is evidenced about 5 to 20% of African women being malnourished (low BMI) as a result of chronic hunger. (Lartey A 2008).
In Bangladesh, India in three selected villages of Sirajganj, Kishoreganj and Tangail in July 2014, across section study was conducted where 56 pregnant and 46 postpartum women were recruited from community clinics by purposive sampling technique (Salim. F et al 2014). The study found out that, of the 56 subjects studied a significant number of 24 (23.5%) of the pregnant women were found to be underweight by calculating the BMI. Among the possible reasons that were stated was knowledge about malnutrition in pregnancy and lack of food in terms of types and amount and types to be taken during pregnancy.
Another cross sectional study done on a sample of 130 pregnant women in Algeria aged 19 – 45 years attending antenatal clinics discovered that 78.46% (more than half) of the 130 pregnant women were found to be malnourished (39.23% are overweight and 39.23% were obese) and only 21.54% had a healthy BMI. (S. Taleb; et al 2011). This was due to the sedentary lifestyle and poor dieting for example 8% of pregnant women in the study reported snacking all day.
According to other survey studies done on malnutrition in pregnant women in the Gulf region, it was discovered that overweight and obesity were the main problems in these women. It was estimated that 54 – 70% of pregnant women in this region were overweight or obese. In other words only 3 to 13% were found to be underweight hence a double burden of malnutrition. (Abdulrahman .M 2007).
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Some of the factors that was found to be associated with malnutrition included frequent child bearing and multiple pregnancies which causes several health and nutritional problems among pregnant women (Abdulrahman .M 2007). Statistics showed that the fertility rate of the gulf mothers is relatively high (ranging from 4.6 per 1000 women aged 15 -44 years in Bahrain to 7.1 in both Oman and Saudi Arabia).
In addition, unsound food habits during pregnancy which may affect the weight of the fetus. Few pregnant women consumed more fresh fruit during pregnancy and this affects their diet. In Kuwait, Prakash et al discovered that the intake of calcium, iron and vitamin C by pregnant mothers was below 75% of US recommended daily allowances (RDA), while among breastfeeding mothers, all nutrients (except protein) were below the RDA. Traditional beliefs was also found to another risk related to nutrition during pregnancy. For example, in some areas in the Gulf, mothers decrease their intake during pregnancy believing that extra food will cause an over large baby, while others believe that they should eat for two.
Majority of pregnant women believe that taking iron supplements may make the fetus big and results into difficult delivery or even abortion. Finally the other factor was lifestyle where by many pregnant mothers in the GCC are not employed and very few of them exercise. These factors contribute to malnutrition (overweight and obese).
Also sedentary lifestyle, having housemaids, cars, televisions, sophisticated home appliances decrease physical activity of women and together with taking fatty foods increase the weight of women during pregnancy.
A cross-sectional study (magnitude and determinants of malnutrition among pregnant women in eastern Ethiopia) done on 1731 pregnant women selected by a cluster random sampling method discovered that on average, 19.06% of respondents were malnourished, while 23.3% were underweight (body mass index < 19.8 kg m−2). Women in the 2nd and 3rd trimester had a 66% and almost two fold increased risk of malnutrition as compared to those in the 1st trimester, respectively. Women with improved eating habits had a 53% lower risk of malnutrition compared to those who never improved. The risk of malnutrition was 39% lower in subjects who got prenatal dietary advice than in those who never got one. Therefore, it was concluded that Malnutrition affects at least 1/5 women in the study, calling for priority attention (Haji Kedir 2014).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter presents the methodology that was used during the study. It highlights the research design, sample size determination and sampling technique, the data collection tools, data management and analysis procedure, as well as steps that will be taken to ensure validity and reliability during the study.
Study design
The study employed a cross-sectional research design to assess factors that contribute to maternal malnutrition during pregnancy. This design entailed collecting data to make inferences about a population of interest at one point in time.
Source of data
Primary data obtained from pregnant mothers attending ANC at Jericho Specialists and Jericho Nursing home.
Study area
The study was conducted in Jericho Specialists and Jericho Nursing home in Ibadan Oyo, in Nigeria’s central region. Ibadan Oyo gets its name Ibadan town, the main municipal, administrative and commercial center of the Oyo and the Oyo headquarters are located there. Jericho Specialists and Jericho Nursing home is a Oyo hospital that provides services for the sick or injured, especially those confined to bed. The hospital has a maternal and child health unit which is fully operational albeit the small space available for them. Services offered include general medical and surgical care, counseling and sensitization, family planning and antenatal care. According to the Jericho Specialists and Jericho Nursing home report of May 2021, a total of 1086 expectant women sought ANC services and the maternity unit has a total of 50 beds. Also a total of 393 births were recorded for the month of May 2021.
Population
Target population: This included all pregnant women in Ibadan Oyo.
Study population: This entailed pregnant women at ANC in Jericho Specialists and Jericho Nursing home who consented to participate in this study.
CHAPTER FOUR
DATA ANALYSIS AND RESULT PRESENTATION
Introduction
This chapter presents the results regarding the prevalence of malnutrition among pregnant women attending antenatal clinic in Jericho Specialists and Jericho Nursing home- Ibadan Oyo. It further presents the association of demographic factors, social economic factors and personal related factors and malnutrition.
CHAPTER FIVE
CONCLUSION AND RECOMMENDATIONS
Conclusion
This study was aimed to assess the knowledge and perception of the effect of malnutrition among pregnant women attending ANC in Jericho Specialists and Jericho Nursing home, Ibadan Oyo.
It found out that the prevalence of malnutrition was slightly high as 45.38% were malnourished. Of these, 19.41%, 15.82% and 10.15% were underweight, overweight and obese respectively.
Under social demographic factors, Malnutrition was associated with women aged more than 30 years and those with Christian faith.
In social economic factors it was found that monthly income of more than N100,000 was associated with malnutrition.
The personal related factors indicated that, lack of a balanced diet, parity more than 4 and having food taboos was also associated with malnutrition.
Recommendations
According to UDHS (2011), one of the millennium development goals was to eradicate Poverty and hunger. Nutrition should be a priority at national and regional levels as it is important for human and social-economic development in the country.
To the ministry of health.
The Ministry of Health together with other policy makers running the health sector should introduce feeding programmes in antenatal clinics and health centers. This may help done through provision of food subsidies to pregnant women.
There is need for conducting nutrition surveillance needs to be done continuously and special attention should be given to vulnerable groups such as the pregnant women and the children under 5 years.
The government should also strengthen its livelihood and economic empowerment programs to cater for women by providing opportunities for them to get more access to education, paid employment, assets such as land and credit facilities.
To Ibadan Oyo local government health department.
The Oyo should form Nutritional programmes which should be extended to the community. These programmes should teach the community about maternal nutrition.
The village health teams (VHTs) should also be strengthened to encourage all pregnant women seek ANC services
To Jericho Specialists and Jericho Nursing home staff.
Health workers should start providing counseling on dietary intake before and during pregnancy. This could be done through establishing nutrition education and efficient nutrition monitoring systems at all levels of antenatal care.
They should also emphasize the use of family planning, dangers of producing at an early or late age, benefits of attending ANC and taking the given routine drugs and also the implication of having many food taboos.
To the community members of Ibadan Oyo.
The VHTs in Ibadan community should encourage all pregnant women to attend ANC early in the first trimester as majority were found to be staring in 2nd and 3rd trimesters.
Local leaders should encourage people to do farming on top of the businesses in order to have food security in their homes.
Pregnant women should especially those who are employed and has a high social economic status should avoid taking sharks and fatty food as this was found to cause malnutrition in them.
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