Determinants of Household Dietary Diversity and Nutritional Status of Women in Reproductive Age Group: The Case of Addis Ababa City, Ethiopia
Hassen, Zinet Nezir
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Food consumption and dietary habits are influenced by many factors. Women knowledge on basic nutrition has paramount importance in influencing household food choice and consumption. So far a range of factors affecting Household Dietary Diversity (HDD) have been identified in many assessments in Ethiopia. However, the association between women nutrition knowledge, HDD and nutrition status is less studied particularly in urban Ethiopia. This study is therefore aimed at assessing the relationship of women nutrition knowledge and HDD and its implication on the nutritional status of women in the reproductive age group. A cross-sectional study was carried out in two sub-cities of Addis Ababa, Ethiopia in July 2011. Data was collected from 273 households that were selected using multistage sampling. Structured questionnaires were used to collect household information on demographic, socioeconomic, nutrition knowledge and household dietary diversity. Anthropometric data was collected from all respondent women in reproductive age group and level of malnutrition was established using Body Mass Index (BMI) reference value recommended by World Health Organisation (WHO). Total number of people in the visited Households (HHs) was 1,131 with an average household (HH) size of 4.1. Majority (64.1 percent) of the HHs were headed by male and the mean age of the respondent's was 33.71. On av~rage, about half of the surveyed HHs income was spent in food. Among the three income tertiles, HHs in the lowest income tertile spend 62.2 percent (Cl, 52.43 -71.89) of their income on food compared to 37.95 percent (CI, 32.05 - 43. 85) in the highest tertile . .The average food expenditure between the various income groups was significantly different at P <0.0001. On a 100 point scale, the average score of overall nutritional knowledge of respondents was 22 ± 16.2 with most (85 percent) of respondents scored low «35 percent). Only 5.9 percent of the HHs were found to have low Dietary Diversity Score (DDS) while the rest 60.4 and 33.7 percent of HHs had medium and high DDS respectively. Chronic Energy Deficiency (CED) was found in 6.6 percent of the women while the majority (65.9 percent) had normal BMI. Household DDS was significantly associated with HH asset (P<O.Ol), net per capita income (P<0.05) and HH food security (p <0.05) while women's nutritional knowledge show no significant relationship with HDD. Marital status and per capita expenditure showed significant association with women's nutritional status. Widowed women were more likely to be malnourished than married or single women P<O.05, (OR 2.4; 95% CI 1. 2..6, 3.47) while the risk of under nutrition decreased when per capita expenditure increases P< 0.01 (OR 0.993 CI -0.005, 1.991). Overall nutrition knowledge of women in the study area is very low. Over 70 percent of HHs reported of eating from five and above food groups, however less than a quarter of the households consumed animal based protein and fruits in the past 24 hour. CED is identified in 6.6% of the assessed women and no significant association is observed between CED, HDD and nutrition knowledge. Although levels of nutrition knowledge do not show any association with HDD or nutritional status of women in this study, the prevailing low level of nutrition knowledge requires awareness raising interventions. Income and household wealth appear to be the main determinants of HDD. Hence, in addition to the efforts of improving the knowledge base, government and policy makers should also focus towards improving household income to ensure adequate access to diversified food.