Nutritional Knowledge and Dietary Practices of Pregnant Women Receiving Nutrition Education While Attending Antenatal Care at Mbagathi Hospital Nairobi County Kenya

Abstract

Nutritioneducationisoneoftheimportantcomponentsofantenatalcare.Itisawidelyused strategy to improve nutritional knowledge of pregnant women seeking ante natal care more so in governmentrunhealthcarefacilities. A lot of studies to assess the level of nutritional knowledge on pregnant women attending antenatal care in government health facilities have been done but little data exists on the antenatal care situation at Mbagathi hospital given that it’s one of the key government run level five hospital facility in Nairobi County that serves a population of about 3.1 million urban dwellers. The broad objective of this study was to determine the nutritional knowledge and dietary practices of pregnant women receiving nutrition education while attending antenatal care at Mbagathi hospital Nairobi county. The study used a descriptive cross-sectional study design for collection and analysis of data and. Total of 195 pregnant women receiving nutrition education while attending antenatal care in Mbagathi hospital Antenatal clinic were recruited into the study through systematic sampling. The study, using a semi structured questionnaire, assessed the level of nutritional knowledge and dietary practices of attendees of ante natal clinic. Anthropometric measurement of the Middle-upper arm Circumference (MUAC) was used to assess the nutrition status of the women. The study used Statistical Package for the Social Sciences (SPSS) version 20 software for data entry and analysis. Descriptive statistics (mean, median, frequency and standard deviation) described the background characteristics of the study sample while inferential statistics, (P-Value of <0.05 at 95% confidence interval), were employed to determine associations and relationships between two or more variables. Majority (69%) of the participants were within the age category of between 21- 30 years and the mean age was 27 (±=5.38) years. Over three quarters (79%) were married while 21% were not. Slightly below half of the women, 43%, had attained secondary education 17% had primary education while 9% had University education. Slightly over a third (35%) were housewives, 31% self-employed and 12% were salaried workers. The mean household size was 3.18 (±=1.47) Over 50% of the respondents were in their third trimester of pregnancy, 34% in the second and 7% in the first trimester. Only 39% had made between three and four antenatal visits, with the mean number of visits was 3.7. Nearly all (94%) participants had blood pressure readings taken, 71% had a concurrent illness (colds and flus, urinary tract infections, Malaria), 8% had a diagnosis of High Blood Pressure, 4% had gestational diabetes while 2% had iron deficiency anemia. On assessment of nutritional knowledge, 84% displayed adequate levels of nutrition knowledge with regards to aspects of nutrition during pregnancy like variety of foods; amount of food during pregnancy; energy sources; micronutrient supplement for pregnant women, necessity for supplementation and duration; micronutrients, iron and calcium and consequences of deficiency during pregnancy while 13% had poor knowledge score. The level of nutritional knowledge was strongly associated with the number of antenatal care visits attended (p=0.03), nutrition status (p=0.018) and the mean dietary diversity score (p=0.03) of the participants. Assessment of dietary diversity showed that having consumed at least five food groups, 63% met the minimum dietary diversity score for women. There was a significant association between household size and dietary diversity score (p=0.033). Majority (65%) of pregnant women from household sizes of 1 to 4 members displayed adequate dietary diversity. However, there was no association between dietary diversity with education status, marital status, occupation and level of income. Nutrition status was assessed by taking the reading of the middle upper arm circumference (MUAC) using an adult MUAC tape. The respondents had MUAC measurement of ranging from 22.8cm to over 30cm, with 62% of the pregnant women had normal nutritional status with a MUAC reading of between 22.8-30.7cm, 27% of the women were obese with a MUAC readings of >30cm while 11% with MUAC reading of <22 cm were underweight...