DIETARY
PRACTICE
AND
ASSOCIATED
FACTORS
AMONG
PREGNANT WOMEN IN JIMMA TOWN HEALTH CENTERS, JIMMA,
SOUTH WEST ETHIOPIA
BY: DURETI KEBEDE
A RESEARCH THESIS SUBMITTED TO JIMMA UNIVERSITY, INSTITUTE OF
HEALTH, AND COLLAGE OF HEALTH SCIENCE, SCHOOL OF MIDWIFERY, IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE BACHELOR OF
MIDWIFERY.
SEP, 2022
JIMMA, ETHIOPIA
I
JIMMA
UNIVERSITY,
INSTITUTE
OF
HEALTH,
COLLAGE OF HEALTH SCIENCE, SCHOOL OF MIDWIFERY
DIETARY
PRACTICE
AND
ASSOCIATED
FACTORS
AMONG
PREGNANT WOMEN IN JIMMA TOWN HEALTH CENTERS, JIMMA,
SOUTH WEST ETHIOPIA
BY: Dureti Kebede
ADVISOR: _Enyew Melkamu
SEP, 2022
JIMMA, ETHIOPIA
II
Contents
ABSTRACT............................................................................................................................................. V
Acknowledgements ................................................................................................................................. VI
Lists of abbreviations ............................................................................................................................ VII
CHAPTER ONE: INTRODUCTION ....................................................................................................... 1
1.1 BACKGROUND ............................................................................................................................ 1
1.2 Statement of the problem ................................................................................................................ 3
1.3 Significance of the study ................................................................................................................. 4
CHAPTER TWO: LITERATURE REVIEW ........................................................................................... 5
CHAPTER THREE; OBJECTIVES ......................................................................................................... 8
3.1 General Objective ........................................................................................................................... 8
3.2 Specific Objective ........................................................................................................................... 8
CHAPTER FOUR: METHODS AND MATERIALS .............................................................................. 9
4.1 Study area............................................................................ Ошибка! Закладка не определена.
4.2 Study period .................................................................................................................................... 9
4.3 Study design .................................................................................................................................... 9
4.4 Population ........................................................................... Ошибка! Закладка не определена.
4.5. Inclusion and exclusion criteria ......................................... Ошибка! Закладка не определена.
4.6. Sample size and sampling techniques .......................................................................................... 10
4.7. Sampling technique ............................................................ Ошибка! Закладка не определена.
4.8. Data collection tool and procedures ............................................................................................. 10
4. 9. Study variables .................................................................. Ошибка! Закладка не определена.
4.10. Operational definition and measurements................... Ошибка! Закладка не определена.
4.11. Ethical consideration ........................................................ Ошибка! Закладка не определена.
4.12. Dissemination plan........................................................... Ошибка! Закладка не определена.
5. Result ........................................................................................ Ошибка! Закладка не определена.
Table 1: Socio-demographic characteristics of the participants ............................................................. 13
III
Table 2: Knowledge of the participants on dietary practice ................................................................... 15
Table 3: Dietary practice of pregnant mothers........................................................................................ 15
5.1. Discussion ........................................................................................................................................ 25
5.2. Conclusions ...................................................................................................................................... 25
5.3. Recommednations ............................................................................................................................ 26
6. REFERENCES ......................................................................... Ошибка! Закладка не определена.
Annex: - Questionnaire ................................................................. Ошибка! Закладка не определена.
IV
ABSTRACT
Background: Nutrition is a fundamental pillar of human life, health and development
throughout the entire life span. The nutrition requirement varies with respect of age, gender and
physiologic change like pregnancy. Pregnancy is a critical life in women’s life when the
expectant mother needs optimal nutrients to support the developing fetus. The diet of a woman
before and during pregnancy has immense influence on the course of pregnancy and health of a
child both after delivery and in the future. Lack of dietary knowledge and the knowledge about
consequences of malnutrition among future mothers may result in a lot of dietary indiscretion,
which in turn can cause deficiency or excess of energy and particular nutrients, as well as
abnormal course of pregnancy. Hence, for keeping a proper diet during pregnancy a woman must
not only know the healthy eating guidelines, but also realize how a diet influences the course of
pregnancy and child's health.
Objectives: The aim of this study is to assess the dietary practice and associated factors among
pregnant women visiting ANC follow up at Jimma town health centers, 2022.
Methods: An institutional based cross sectional study was conducted from March 10- 30, 2022
among 239 pregnant women attending ANC clinics in health centers of Jimma town. Convenient
non probability sampling procedure was used to select the study participants. The data was
collected using semi- structured questionnaire. The association between explanatory variables
and dietary practices was determined by carrying out chi square test using SPSS software. Pvalues of <0.05 was considered as statistically significant.
Result:
Conclusion:
Keywords: Nutrition, Practice, Pregnancy, Jimma
V
Acknowledgements
First and for most thanks to the Almighty GOD who is my power and strength. I would like to
express my deepest and heartfelt gratitude to my advisor Mr.Eneyew for his continuous guidance
and unreserved support throughout my work. I would like to thank Jimma University for
providing me this opportunity to maintain & continue my academic pursuits. I also thank the
university, particularly college of public health & medical science and CBE office for providing
me materials needed for this research paper.
VI
Lists of abbreviations
ACOG- American College of Obstetrics and Gynecology
ANC – Antenatal care
CBE-Community Based Education
EC-Ethiopian calendar
FAO- Food and Agriculture organization
HCG-Human Chorionic Gonadotrophic hormone
IM – Institute of Medicine
JUSH – Jimma University Specialized Hospital
MCH – Maternal and Child Health
OL-obstructed labor
SNNP – Southern Nations, Nationality and People
UNICEF – United Nations International Children Educational Fund
USAID-United State Agency for International Development
WHO – World Health Organizations
VII
CHAPTER ONE: INTRODUCTION
1.1 BACKGROUND
Pregnancy is a critical period in the lifecycle during which additional nutrients are required to
meet the metabolic and physiological demands as well as the increased requirements of the
growing fetus(1). A well balanced diet is a basic component of good health at all times,
especially for pregnant women. Pregnant women require varied diets and increased nutrient
intake to cope with the extra needs during pregnancy. For healthy pregnancy, the mother’s
diet needs to be balanced and nutritious, involving the right balance of proteins,
carbohydrates and fats and consuming a wide variety of vegetables and fruits(2). Dietary
practices play a significant role in determining the long-term health status of both the
expectant mother and the growing fetus. Improper dietary practices of pregnant women have
apparently led to increased rates of poor birth outcomes(3). Appropriate dietary practice
plays a vital role in reducing some of the health risks associated with pregnancy such as risk
of fetal and infant mortality, intrauterine growth retardation, low birth weight and premature
births, decreased birth defects, cretinism, poor brain development and risk of infection.
In most developing countries, maternal under nutrition during pregnancy is persistent and an
important contributor to morbidity, mortality, and poor birth outcomes(4). Poor nutritional
status is common in developing countries, often resulting in pregnancy complications and
poor obstetric outcomes. Pregnant women in Sub-Saharan Africa (SSA) are at particular
nutritional risk as a result of poverty, food insecurity, political and economic instabilities,
frequent infections, frequent pregnancies and bad dietary practices like restriction of
important food groups during pregnancy due to various forms of taboos, misconceptions, and
cultural beliefs towards certain foods exist in various countries and hinder the pregnant
women from consuming diversified/nutritionally rich food groups(5, 6).
Diets of pregnant women in low and middle-income countries (LMICs) are monotonous, low
quality and predominantly plant-based with little consumption of micronutrient-dense
animal-source foods, fruits, and vegetables (7, 8). Studies have shown that there is a strong
positive relationship between the nutritional status of a pregnant woman, the growth and
development of the fetus(9), the birth outcomes (10), and childhood morbidity and
mortality(11). Pregnant women who eat a balanced diet have fewer complications during
pregnancy and labor, and they are more likely to deliver live, normal, and healthier
babies(12). On the other hand, pregnant women’s poor nutritional status results in adverse
birth outcomes like low birth weight, preterm delivery and intrauterine growth retardation.
1
The consequences of micronutrient malnutrition affect not only the health and survival of
women but also their children (13).
The use of dietary supplements and fortified foods should be encouraged for pregnant women
to ensure adequate supply of nutrients for both mother and fetus(14).To alleviate nutritionrelated health problem, Ethiopian government implemented different intervention programs
such as linking with maternal continuum care, micro-nutrients supplementation to pregnant
mothers, implementing packages of Health Extension Program and nutrition education like
dietary diversification and minimum acceptable diet(15). Dietary diversity refers to an
increase in the variety of foods across and within food groups consumed by each woman over
a given reference period which can promote good health and physical and mental
development of women(16). It is a qualitative measure of food consumption, used as a proxy
of micronutrient adequacy at an individual level(17). Low dietary diversity is one of the most
important causes of micronutrient deficiencies, also leading to macronutrient shortages (18).
Minimum acceptable diet is a composite of women fed with a minimum dietary diversity and
a minimum meal frequency.
Caloric intake should increase by approximately 300 kcal/day during pregnancy. This value
is derived from an estimate of 80,000 kcal needed to support a full-term pregnancy and
accounts not only for increased maternal and fetal metabolism but for fetal and placental
growth. Dividing the gross energy cost by the mean pregnancy duration (250 days after the
first month) yields the 300 kcal/day estimate for the entire pregnancy(19, 20). However,
energy requirements are generally the same as non-pregnant women in the first trimester and
then increase in the second trimester, estimated at 340 kcal and 452 kcal per day in the
second and third trimesters, respectively. Furthermore, energy requirements vary significantly
depending on a woman’s age, BMI, and activity level. Caloric intake should therefore be
individualized based on these factors(19). Pregnant women need 1000- 1,300 milligrams of
calcium, 27 milligrams Iron, 220 micrograms Iodine, (750-770 micrograms Vitamin A , 8085 milligrams Vitamin C and 600 international units of Vitamin D (21, 22).
2
1.2 Statement of the problem
Globally about 303,000 mothers died from pregnancy and childbirth related causes in 2015
and majority (99%) of the deaths occurred in developing countries, with sub-Saharan Africa
alone accounting for roughly 66%. But the target is to reduce the global maternal mortality
ratio to less than 70 per 100,000 live births at 2030 (23, 24). Ethiopia is also one of the subSaharan country with high Maternal mortality rate 412 deaths per 100,000 live births and
child mortality rate 67 per 1000 live birth(25). Women tend not to report for care until the
second trimester, thus the initial critical period
of the first 1000 days are frequently
missed(26). This presents a major limitation to ensuring adequate uptake of interventions for
a reasonable duration, even though factors like nutritional status are crucial from the time of
conception for placentation, organogenesis, prevention of congenital birth defects, and fetal
growth.
Many of women became pregnant each year, most of them in developing countries suffer
from ongoing nutritional deficiency, repeated infections and the long term causalities
consequences of under nutrition during their own child hood. Many women suffer from a
combination of chronic protein energy deficiency, poor weight gain, pregnancy anemia and
other micronutrients deficiency as well as infections like HIV and malaria. These along with
inadequate dietary practice contribute to high rate of maternal morbidity, mortality and poor
birth outcomes.
Adequate nutrient intake during pregnancy was found to reduce the risk for low birth weight
(19%), small-for gestational-age births (8%), preterm birth by 16%, and infant mortality by
15% in those highly adhered to the regimen. In underweight women, multiple micronutrient
supplementation initiation before 20 weeks’ gestation decreased the risk of preterm birth by
11% (27, 28). Antenatal healthy diet initiation in pregnancy and high adherence to multiple
micronutrients supplements also provided greater overall benefits (10, 29). However, the
burden of nutritional deficiency among pregnant women is still high especially in n subSaharan Africa (30-32). For instance, findings from Ethiopia also showed that 60.7% of
pregnant women had history of poor dietary practices (33).
A number of negative health consequences occur as a result of poor dietary practice during
pregnancy. For instance, despite the global target is to reduce anaemia in women of
reproductive age by 50% by 2025 (34), it affects 29% of pregnant women (35). Worldwide,
more than a third of women are estimated to have folic acid deficiency(36). Also, in Ethiopia,
about 31.8% of pregnant women were anaemic(37), 31.8% were malnourished (38) and one
3
in every three women had folic acid deficiency (39). Evidence showed that in low- and
middle-income countries, anaemia contributes to 18% of perinatal mortality, 19% of preterm
births and 12% of low birth weight(40). In addition, a number adverse maternal and child
health outcomes including miscarriage, preterm, low birth weight, still birth, congenital
anomalies, impaired fetal growth, learning impairment and behavioral problems of the
offspring as well as poorer pregnancy weight gain, maternal and child mortalities occur as a
result poor dietary practices during pregnancy(41). Indeed, the nutrient intake of pregnant
women has various consequences on the health and wellbeing of children, households,
communities and the nation at large, particularly in sub-Saharan Africa, where it is a great
determinant of survival and quality of life for the off-spring (30). Furthermore, on top of
health impacts, it leads to reduction in women’s productivity, and has economic, and
psychosocial impacts(42). Failure to address maternal nutrition during pregnancy leads to
permanent impairment, and might also affect future generations (43)(44, 45). These can be
due to inadequate dietary intake, limited diet diversity (vegetables and fruits), and changing
lifestyles(46, 47). A malnourished mother will give birth to a malnourished child, then to a
malnourished teenager, then to a malnourished pregnant woman, and so the cycle continues.
Different policies, programs and strategies such as minimum acceptable diet, dietary
diversity, micronutrient supplementation, nutritional counseling has been implemented in in
different countries of the world in order to improve dietary practice during pregnancy(46, 48,
49). In addition, pregnant women should also eat foods rich in macro and micro nutrients
such as brown rice, red meat, liver, poultry, egg yolk, legume, dark-green leafy vegetables,
citrus fruits, beans, and peas (50). However, the world especially the developing countries
have been far from achieving the plan to improve or ending all forms of malnutrition (51, 52).
There were some evidences on the nutritional status of pregnant women (53-56). Different
studies showed that prevalence of poor dietary practice during pregnancy were high in
Ethiopia(57, 58). However, pregnant women’s dietary practice in the study area were under
researched. Therefore, the current study aimed to assess dietary practice and associated
factors among pregnant women attending public health facilities of Jimma zone, 2022
1.3 Significance of the study
Information obtained from this study will help to evaluate knowledge and dietary practice of
pregnant women who will have ANC visit at Jimma town public health centers. It may also
4
serves health professionals and health institutions to design appropriate intervention which
contribute in the reduction of maternal and infant morbidity and mortality rate due to
malnutrition related to inadequate intake of nutrients during the pregnancy and its
complications. It informs experts to promote dietary practices by educating people. Findings
from this study will potentially serve rethinking about maternal nutrition at policy, program
and management levels. Furthermore, it will also makes an important empirical contribution
to the growing body of literature.
CHAPTER TWO: LITERATURE REVIEW
2.1. Prevalence of Dietary Practice during Pregnancy
Adequate nutrition is essential for a woman throughout her life cycle to ensure proper
development and prepare the reproductive life of the woman. Pregnant women require varied
diets and increased nutrient intake to cope with the extra needs during pregnancy. Poor
dietary practice during pregnancy often leads to long-term, irreversible and detrimental
consequences to the mother as well as the fetus(14) . Study conducted in Rawalpindi,
Pakistan revealed that Change in food intake practices by increasing frequency of meal, the
amount or both were reported by about 57.3% participants, 17.3% reported reduced intake,
while 25.5% pregnant women had no change in food consumption. About 22% avoid taking
some food during their pregnancy period, such as beef, chicken, egg, salt, fruits, fried food,
milk, oil, rice, tea, and butter (59). Study conducted in Ogun state of Nigeria revealed that
(46%) of pregnant women ate more than three times a day, 38% ate just three times while the
rest respondents ate once or twice daily. This indicates that majority of the study participants
(54%) they don’t have extra meal during pregnancy in the study area. Study conducted in
Aleta Chuko District of South Nations Nationalities People Representatives (SNNPR),
Ethiopia: The frequency of one additional food from any type of food within the last 24 hours
was 8%. However, the frequency of regular fed 3times per day was 92%,(3, 59). The study
conducted on pregnant women in Hadiya zone of southern Ethiopia indicates that over half
5
(65 %) avoided at least one type of food during pregnancy. According to this report milk and
cheese were regarded as taboo foods by nearly half of the women (44.4%) followed by
linseed and fatty meat (16%, 11.1%) respectively. Food restrictions to most foods were found
to be more prevalent during the last trimester, except for linseed which was said to be
prohibited throughout pregnancy(60).
Study conducted in Gondar, east Wollega zone of Guto Gida District and in Bahir Dar town,
Northwest Ethiopia showed that poor dietary practice of pregnant women were found to be
59.1%, 66.1% and 60.7% respectively, which indicates that majority of women’s had
experienced poor dietary practice during their pregnancy. Concerning meal frequency,
pregnant women in Gondar, about 89 (15.5%) of the respondents had meal frequency of 1-2
per day during their pregnancy. Majority of pregnant mothers, 445 (77.5%) had meal
frequency of 3 -4 times per day. Concerning the meal frequency per day, most of the
respondents of Guto Gida district pregnant women (66.1%) had meal frequency of 1-2 per
day during their pregnancy. The rest (20.3%) and (13.6%) had diet frequency of meals 3- 4
and >5 per day respectively during their pregnancy for the nutritional practice assessing
question.
The result from Bahir Dar town study indicated that 203(33%) study participants avoid
certain foods, about 61.7% skip their usual meal and the most commonly skipped meal was
breakfast
(33, 57, 58). Study conducted in Wondo Genet district of SNNPR revealed that, regarding
meal frequency majority about three fourth (75.2 %) of the respondents had no additional
meal during Pregnancy. Only 21.6 %of the subjects reported that they eat at least one
additional meal during pregnancy. About 43.8% commonly skipped lunch and 24.2 %
reported that they skip breakfast. Nearly all (98%) of the study participants used rock salt for
food preparation (61).
2.2. Factors associated with dietary practice
In Sudan, pregnant women often have restricted food intake mainly due to morning sickness
which is prevented and treated by eating little and limited items of food: and due also to the
belief that a large fetus causing obstructed labor will result from eating unrestricted amount
of food. In Sokoto state of Nigeria, the untrained traditional midwifes advice pregnant
women to avoid sugar and honey as they cause prolonged painful labor. They also advise
pregnant ladies not to take local soda which is supposed to make the fetus slim(8). Qualitative
study conducted in Arsi Negele, Ethiopia, stated that pregnant women did not change the
amount and type of foods consumed to take into account their increased nutritional need
6
during pregnancy. The consumption of meat, fish, fruits, and some vegetables during
pregnancy remained as low as the pre-pregnancy state, irrespective of the women’s income
and educational status. However, the frequency and extent of the practice varied by maternal
age, family composition, and literacy level(6, 8).
The study conducted in Hadia Zone revealed that the reason for avoiding food during
pregnancy was fear of difficulty during delivery (51%), disclosures of the fetus (20%) and
fear of abortion (9.75%) are the main reasons. Study conducted in Guto Gida district of east
wollega zone identified that family size and information about nutrition during pregnancy
have strong statistical association with nutrition practices of mothers during pregnancy.
Women who had no information about nutrition during pregnancy had 6.3 times more likely
poor nutritional practice than women who had nutrition information during pregnancy (58,
60).
Nutrition information on which foods to eat during pregnancy came from health care
providers, husbands, mothers-in-law, friends, and neighbors, as well as the Internet and
television, which mothers acknowledged as affecting choices of foods eaten during the
antenatal period.
Mothers most often reported valuing and trusting the advice from medical doctors, who
provide routine antenatal care, on the “best” foods to eat and which foods to avoid during
pregnancy(62).
Study conducted in Gondar showed that there was statistically significant association
between family income and dietary practices of mothers. This study also identified that
educational status had strong statistical association with dietary practices of mothers during
pregnancy. Beside these the study identified that information about nutrition during
pregnancy and nutritional knowledge had strong statistical association with dietary practices
of mothers during pregnancy(57). Similar study conducted in Behir Dar town revealed that
husband income, ownership of radio, history of illness and dietary knowledge had significant
association with dietary practices of pregnant women in the study area. Study conducted in
Gambela town 2014, revealed that statistically significant association between Pregnant
women who were from food insecure households and under nutrition(33, 63).
The extra energy needed during pregnancy and lactation represents a small percentage 5% of
total household food energy needs. However, when household food insecurity is persistent,
even these small amounts of extra food may be unavailable. Even when enough food is
available at the household level, the majority of women do not receive adequate nutrients
intake during pregnancy. Key contributing factors, including entrenched poverty, gross food
7
insecurity, gender discriminatory food allocation, food avoidances, and lack of access to
adequate health services, continue to challenge women’s health and nutritional practices(4).
Similar Study conducted in Wondo Gent District of SNNPR state that the frequency of meal
among the pregnant women in the study area was taking no additional meal was significantly
associated with family size, growing khat, not growing vegetables and fruits, and no
consumption of white vegetables and roots. Skipping meal was reported by the study
participants, and it was significantly associated with family size and number of
pregnancy(61).
Nutrition deserves special attention during pregnancy because of the high nutrient needs and
the critical role of appropriate nutrition for the mother and the foetus. Physiological
adaptations during pregnancy partly shield the foetus from inadequacies in the maternal diet,
but even so these inadequacies can have consequences for both the short and long-term health
and development of the foetus.
CHAPTER THREE; OBJECTIVES
3.1 General Objective
 To assess the dietary practice and associated factors among pregnant women in Jimma
town health centers, Jimma zone, Oromia region, south west Ethiopia, 2022.
3.2 Specific Objective
 To describe dietary practices of pregnant women in Jimma town health centers,
Jimma zone, Oromia region, south west Ethiopia, 2022.
 To identify associated factors with dietary practices of pregnant women at Jimma
town health centers, Jimma zone, Oromia region, south west Ethiopia, 2022.
8
CHAPTER FOUR: METHODS AND MATERIALS
4.1. Study Area and Period
The study was conducted from 15 April 2022 to 15 May 2022 in Jimma town the capital of
Jimma zone which is 352 Km far from Addis Ababa. The climatic zone is “Woinadega” and
has temperature that ranges from 20-30 oC and the average annual rainfall of 800-2500mm3
and altitude of 1750-2000m above sea level. There are two Public hospitals, four health
centers and more than 15 private clinics providing health services in Jimma town. According
to the 2022 report obtained from Jimma town health office, the total population of the town is
estimated to be 224,565, of which 112911 were males and 111654 were females. A total of
7,792 pregnant women found in the Jimma town.
4.2 Study period
The study was conducted from March 10-30, 2022.
4.3 Study design
Institution based cross-sectional study was conducted.
4.3. Population
4.3.1 Source Population
All pregnant women who visit MCH clinic for ANC follow up at Jimma town public health
facilities.
9
4.3.2. Study Population
Pregnant women who visit Jimma town public health facilities for ANC follow-up during the
study period.
4.4. Inclusion and Exclusion Criteria
4.4.1. Inclusion Criteria
Available pregnant women will come for ANC follow up during the study period.
4.4.2. Exclusion Criteria
Pregnant women who severely ill. Those who unable to communicate
4.6. Sample size and sampling techniques
The sample is determined using single population proportion formula as follows:
n = [(Z α/2)2∗p (1-p)]/d2
Where,
n= sample size Z α/2= Standard score for 95% confidence level (1.96)
P= 25.1% proportion dietary practice (23)
d= 5% the margin of error
n= (1.96)2∗0.251 (1−0.251)2/ (0.05)2 =216.38 ≈217
After adding 10% non-response rate= 22, the final sample size become= 239.
4.5 Sampling Techniques
First, the public health facilities are stratified into hospital and health centers. Then among
the four health centers two were selected by using simple random sampling technique. Of the
two public hospitals found in the town, Shanen Gibe hospital was purposively included for
representation. In this study the author excluded Jimma medical center as there are a number
of client with referral, which may not represent the jimma town population. Second, the total
sample was allocated proportionally to each selected health facilities based on number of
pregnant women who attend ANC follow up at the select health facilities. Then, a systematic
sampling technique was used and K-value was determined based on the total number
pregnant women in the health facilities. In case when more than one pregnant women
attending ANC follow up, a lottery method of simple random sampling technique was
employed to select the first mother. Then, data was collected every K- value until the final
sample size is achieved.
4.6. Data collection tool and procedures
Interviewer-administered structured questionnaire was adapted from different literatures. The
questionnaire consists of three main parts: socio demographic data, knowledge and dietary
10
practices. The questionnaire was first prepared in English and then translated to Afan Oromo
and Amharic languages. Local language versions was used for data collection. Data collectors
were those Midwives to their respective site who were assigned for their normal internship
under the supervision of principal investigator. Some data was also being reviewed from the
patient’s card.
4. 7. Study Variables
Dependent variable: Dietary practice of pregnant mothers
Independent variable
 Socio-demographic factors:- which are combination of social and demographic factors
like; Maternal age, country of birth, marital status, education level and occupation
 Socio-income factors: - are the factors arising from income level. This will show social
economic status
 Individual factors:- it is the individual life standard and property of individual
influencing pregnancy.
4.8. Operational Definition and Definition of Terms
4
Knowledge: -Accumulated awareness or information that one has gained on nutrition
during pregnancy through learning and practices.
 Good: if 75%or¾knowledge questions were correctly answered.
 Fair: if 50%-75%knowledg equestions were correctly answered.
 Poor: only 25% of knowledge questions were correctly answered.
 Maternal nutrition: - Refers to nutritional needs of women during the antenatal and
postnatal period.
 Pregnancy: - is a state of bearing developing fetus/embryo within the uterus from Period
of fertilization to delivery.
 Dietary practice: the observable actions of an individual that could affect his/her or
others’ nutrition, such as eating, feeding, cooking and selecting foods..
4. 9. Data Processing and Analysis
The data was collected first and then checked for completeness and internal consistency then
it was sorted, grouped and stored on the tally sheet by using computer. Processed data was
analyzed using descriptive statistics of frequency and percentage. Tables were prepared and
calculation were done by using computer. The association between explanatory variables and
dietary practices were determined by inferential statistics of chi square test using SPSS
software. And p-values of <0.05 were considered as statistically significant.
11
4.10. Ethical Consideration
Ethical clearance and permission from Jimma University CBE office was obtained and the
permission as well as the purpose and objective of the research was fully explained to each
study participants to obtain their verbal consent prior to the interview and collection of data.
Privacy and confidentiality of data was kept.
4.11. Dissemination Plan
The findings of the study will submitted to CBE office of Jimma University, and also will be
submitted to school of midwifery as part of bachelor of science in midwifery thesis and other
concerned bodies.
12
CHAPTER FOUR
RESULT
From all 239 pregnant women attending ANC clinics in health centers of Jimma town with
convenient non-probability sampling procedure was used to select the study participants and
with 100% response rate, all were responded.
Socio- demographic characteristics of the participants
Out of 239 study participant most of participant 96(40.2) age lies between age of 25-29. And
most of participants 191(79.9) live in urban. Majority of study participants 156(65.3%) are
oromo in ethnicity, 138(57.7%)of participants are muslim in religion, and 90(37.7%) of
participants can read and write,233(97.5%) of participants are married, 158(66.1%) of
participants are house wife. Majority of participants 182(76.2%) have 1-4 family size. Most
of participants 162(67.8%) have medium monthly income.
Table 1: Socio-demographic characteristics of the participants in Jimma town public health
centers, Jimma, south west Ethiopia (239)
No. Charac
Type
Frequency
%
15-19
7
-
20-24
51
21.3
25-29
96
40.2
30-34
69
28.9
35-39
16
6.7
Urban
191
79.9
Rural
48
20.1
Oromo
156
65.3
Amhara
41
17.2
teristic
s
2.
Residence
Age
1.
group
Ethnic
3.
13
Tigray
6
-
Gurage
22
9.2
Keffa
14
5.9
Muslim
138
57.7
Christian
100
41.8
Other
1
-
Illiterate
64
26.8
Read and write
90
37.7
Primary school completed
14
5.9
Secondary school completed
24
10.0
College/university graduate
46
19.2
Secondary degree and
1
-
Single
2
-
Married
233
97.5
Divorced
4
1.7
Widowed
0
-
Illiterate
42
17.6
Read and write
44
18.4
Primary school completed
27
11.3
Secondary school completed
25
10.5
College/university graduate
94
39.3
Secondary degree and above
7
-
Employed (gov’t/non gov’t)
41
17.2
Religion
4.
Level of education
5.
above
s
statu
onal
8.
upati
7.
Occ If married, partners educational status
Marital status
6.
14
Family size
9.
Monthly income
10.
Self employed
40
16.7
House wife
158
66.1
1 to 4
182
76.2
4 to 6
50
20.9
above six
7
-
Poor
27
11.3
Medium
162
67.8
Fair
48
20.1
Good
1
-
1. Obstetric characteristics of the participants
In this study, the total number of observed population was 239 peoples. The data of these
amount populations were evaluated for the obstetric characteristics of mothers under
investigation. The result obtained from the data gathered during the interview was calculated
and described by the following table.
Table 2: Obstetric characteristics of the participants in Jimma town public health centers,
Jimma, south west Ethiopia (239)
No.
1
2.
Characteristics
Number Of Pregnant
Gestational Above 28
Weeks
Frequency
%
1-3 Pregnancy
182
76.5
3-6 Pregnancy
55
23.1
>6 Pregnancy
2
-
Total
239
100%
1-3 Pregnancy
174
87.9
3-6 Pregnancy
23
11.6
15
>6 Pregnancy
Total
3
5.
History Of Abortion
Antenatal Visits For The
Current Pregnancy
Gestational Age In Weeks
on ANC visit
-
198
100%
No
210
87.8%
Yes
29
12.1%
Total
239
100%
Less Than 4 Visit
212
88.7
27
11.3
Total
239
100%
Less Than 28
209
87.4
30
12.6
239
100%
Greater Than 4 Visit
6.
1
Greater Than 28
Total
2. Knowledge of participant on dietary practice
Most of study participant 187(78.2%) eat only what they craves, majority of participants
132(55.2%) have knowledge on increasing amount of food during pregnancy and they take
more food. Most of study participant 146(61.1%) have no knowledge on iron source food.
Most of participants 176(73.6%) do not have knowledge on carbohydrate source of food but
most of participant 150(62.8%) have knowledge on protein source food. Majority of study
participants 209(87.4%) have knowledge on using iodized salt during pregnancy. Majority of
participants124 (51.9%) knows that maternal undernutrition can cause fetal low birth weight
and causes still birth. Majority of study participants 217(90.8%) have knowledge on balanced
diet during pregnancy.
Table 3 Knowledge of the participants on dietary practice in Jimma town public health
centers, Jimma, south west Ethiopia (239)
Variables
Knowledge on eating variety food
Category
variety of food
Only what she craves
Don't know
Total
More food
Less food
Knowledge on increasing amount of food
during pregnancy
16
Frequency
43
187
9
239
132
35
Percent
18
78.2
100%
55.2
14.6
The same as
Total
Red meat, liver and fish
Fruits and vegetables
Don't know
Total
1. No
2. Yes
3. Total
72
239
73
20
146
239
176
63
239
30.1
100%
30.5
8.4
61.1
100%
73.6
26.4
100%
Knowledge about protein source foods
1. No
2. Yes
Total
89
150
239
37.2
62.8
100%
Knowledge on using iodized salt during
pregnancy
1. No
2. Yes
Total
30
209
239
12.6
87.4
100
Knowledge on duration of Iron supplementation
1. Do not know
2. 3 months
3. 6 months
Total
9
3
227
239
95.0
100%
1. Do not know
110
46
2. No effect on
fetal weight
5
-
3. Low birth
weight and
stillbirth
124
51.9
239
98
141
239
33
206
239
22
217
239
100%
41
59
100
13.8
86.2
100
9.2
90.8
100
Knowledge on food source for iron
Knowledge about carbohydrate source foods
Knowledge on effect of maternal under
nutrition on fetal weight
Knowledge on fetal complication of maternal
under nutrition
Knowledge on maternal complications of under
nutrition
Knowledge on balanced diet
17
Total
1.
2.
Total
1.
2.
Total
1.
2.
Total
No
Yes
No
Yes
No
Yes
3. Dietary practice of pregnant mothers
Majority of study participant has medium level of dietary practice during pregnancy,while
very few has good practice.
Table 4 Dietary practice of the participants in Jimma town public health centers, Jimma,
south west Ethiopia (239)
Dietary Practice
Level of practice
Poor
Medium
Fair
Good
Total
Frequency
27
162
48
1
238
Percent
11.3
68.1
20.2
100%
4. Factor Associated to Dietary Practice of Pregnant Mothers
In this study, the total number of observed population was 239 peoples. According to the
finding Majority of factor studied has no association with dietary practice .Factor likes level
of education, occupation, monthly income, knowledges on eating variety of foods, foods
source of iron, carbohydrates source foods, effect of maternal undernutrition on fetal weight,
fetal complication of maternal underweight has association with dietary practice of pregnant
mothers
Table 4: Result of Cross tabulation and Chi-square of factor associated with Dietary practice
of the participants in Jimma town public health centers, Jimma, south west Ethiopia (239)
Variables
Categor
y
Count
Dietary practice
Number of
Pregnant
1-3
Pregnan
cy
Frequency
Percent From total
Fair
Goo
d
Tot
al
Medium
23
120
38
1
182
9.7
50.6
16
0.4
3-6
Pregnan
cy
Frequency
Percent
4
1.7
40
16.9
10
4.2
0
0.0
>6
Pregnan
cy
Frequency
0
1
0
0
76.
8
54
22.
8
1
Percent
0
0.4
0
0
0.4
1
0.4%
237
100.0
%
1
174
Frequency
Percent of total
Gestational
Poo
r
1-3
Frequency
27
11.4
%
24
18
161
67.9%
114
48
20.3%
35
Chi
squ
are
P
valu
e
2.2
93
0.7
02
8.1
0.2
Above 28
Weeks
Pregnan
cy
3-6
Pregnan
cy
>6
Pregnan
cy
Percent
Frequency
Percent
Frequency
Percent
Frequency
Percent of total
Antenatal
Visits For
The Current
Pregnancy
Family
size
17.8%
0.5%
88.3
%
1
19
2
0
22
0.5%
9.6%
1.0%
0.0%
11.2
%
0
0
1
0
1
0.0%
0.0%
0.5%
0.0%
0.5%
25
133
38
1
197
12.7
%
24
67.5%
19.3%
0.5%
145
41
1
100.0
%
211
60.9%
17.2%
0.4%
17
7
0
Frequency
Greater Than 4
Visit
Frequency
10.1
%
3
Percent
1.3%
7.1%
2.9%
0.0%
11.3
%
Frequency
27
162
48
1
238
Percent of
total
Frequency
Percent
11.3
%
68.1%
20.2%
0.4%
100.0
%
141
59.2%
42
17.6%
1
0.4%
Frequency
24
10.1
%
3
21
6
0
208
87.4
%
30
Percent
1.3%
8.8%
2.5%
0.0%
162
68.1%
48
20.2%
1
0.4%
Frequency
27
11.3
%
21
120
40
1
Percent
8.8%
50.4%
16.8%
0.4%
4
37
8
0
Percent
1.7%
15.5%
3.4%
0.0%
Frequency
Percent
Total
Total percent
5
2.1%
162
68.1%
0
0.0%
48
20.2%
0
0.0%
1
0.4%
125
52.5%
43
18.1%
1
0.4%
37
5
0
Greater Than
28
Percent
Frequency
Total
1-4 family size
4-6 family size
Frequency
1.Urban
Frequency
Percent
2
0.8%
27
11.3
%
22
9.2%
2 urban
Frequency
5
Above six
pregnancy
U
Residenc
y
57.9%
Less Than 4
Visit
Less Than 28
Antenatal
Visits For
The Current
Pregnancy
238
12.2
%
19
88.7
%
27
12.6
%
238
100.
0%
182
76.5
%
49
20.6
%
7
2.9%
238
100.
0%
191
80.3
%
47
36
01
0.7
47
0.7
82
0.2
18
1
5.1
80
0.5
21
3.8
86
0.2
72
4
Percent
2.1%
15.5%
2.1%
0.0%
162
68.1%
48
20.2%
1
0.4%
Frequency
27
11.3
%
14
98
25
0
Percent
5.9%
41.2%
10.5%
0.0%
Christian
Frequency
Percent
12
5.0%
64
26.9%
23
9.7%
1
0.4%
Other
Frequency
1
0
0
0
57.6
%
100
42.0
%
1
Percent
0.4%
0.0%
0.0%
0.0%
0.4%
Frequency
Percent
162
68.1%
48
20.2%
1
0.4%
Frequency
Percent
Frequency
27
11.3
%
9
27
8
48
162
73
7
48
8
0
1
0
238
100.0
%
64
238
89
Percent
3.4%
30.7%
3.4%
0.0%
3
6
5
0
Percent
Frequency
Percent
1.3%
0
0.0%
2.5%
20
8.4%
2.1%
4
1.7%
0.0%
0
0.0%
Frequency
Percent
6
2.5%
15
6.3%
24
10.1%
1
0.4%
1
0
0
0
0.0%
162
68.1%
0.0%
48
20.2%
0.0%
1
0.4%
Frequency
0.4%
27
11.3
%
6
16
18
1
Percent
2.5%
6.7%
7.6%
0.4%
Frequency
3
28
9
0
Percent
1.3%
11.8%
3.8%
0.0%
Frequency
Percent
18
7.6%
118
49.6%
21
8.8%
0
0.0%
17
7.1%
128
53.8%
17
7.1%
0
0.0%
Total
Percent
Religion
Muslim
Total
Percent
Level of
education
1Illiterate
2Read and
write
3Primary
school
Frequency
4 secondary
College
6 secondary
degree
Frequency
Percent
Total
Percent
Occupation
employed
self
employed
housewife
Income
Less than
3000
Frequency
Percent
20
19.7
%
238
100.0
%
137
10.
514
0.1
05
63.
962
0.0
0*
27.
133
0.0
0
46.
691
0.0
00*
37.4
%
14
5.9%
24
10.1
%
46
19.3
%
1
0.4%
238
100.
0%
41
17.2
%
40
16.8
%
157
66.0
%
162
68.1
%
5
18
7
0
30
Percent
2.1%
7.6%
2.9%
0.0%
Greater
than 6000
Fluency
Percent
5
2.1%
16
6.7%
24
10.1%
1
0.4%
Single
Frequency
1
1
0
0
12.6
%
46
19.3
%
2
Percent
Frequency
0.4%
24
0.4%
159
0.0%
48
0.0%
1
0.8%
232
Percent
10.1
%
2
0.8%
66.8%
20.2%
0.4%
2
0.8%
0
0.0%
0
0.0%
97.5
%
4
1.7%
162
68.1%
48
20.2%
1
0.4%
Frequency
Percent
Frequency
Percent
27
11.3
%
0
0.0%
5
2.1%
7
2.9%
37
15.5%
0
0.0%
8
3.4%
0
0.0%
0
0.0%
25-29
Frequency
Percent
15
6.3%
59
24.8%
21
8.8%
1
0.4%
30-34
Requency
Percent
7
2.9%
44
18.5%
18
7.6%
0
0.0%
35-39
Frequency
Percent
Frequency
0
0.0%
27
15
6.3%
162
1
0.4%
48
0
0.0%
1
Percent
68.1%
20.2%
0.4%
Frequency
Percent
11.3
%
5
2.1%
15
6.3%
22
9.2%
1
0.4%
Only what
she craves
Frequency
21
140
25
0
Percent
8.8%
58.8%
10.5%
0.0%
Don’t know
Frequency
Percent
1
0.4%
7
2.9%
1
0.4%
0
0.0%
Total
Frequency
Percent
27
11.3
%
14
5.9%
162
68.1%
48
20.2%
1
0.4%
81
34.0%
36
15.1%
1
0.4%
3001-5999
Marital status
Married
Divorced
Frequency
Frequency
Percent
Frequency
Total
Age
15-19
20-24
Total
Knowledge on
eating variety
food
Knowledge on
increasing
Variety of
food
More food
Frequency
Percent
21
238
100.
0%
7
2.9%
50
21.0
%
96
40.3
%
69
29.0
%
16
6.7%
238
100.
0%
43
18.1
%
186
9.6
70
0.1
39
14.
184
0.2
89
38.
059
0.0
0*
10.
647
0.1
00
78.2
%
9
3.8%
238
100.
0%
132
55.5
%
amount of food
during
pregnancy
4
28
3
0
35
Percent
1.7%
11.8%
1.3%
0.0%
Frequency
Percent
9
3.8%
53
22.3%
9
3.8%
0
0.0%
Frequency
27
162
48
1
14.7
%
71
29.8
%
238
68.1%
20.2%
0.4%
Frequency
11.3
%
20
133
22
0
Percent
8.4%
55.9%
9.2%
0.0%
Yes
Frequency
Percent
7
2.9%
29
12.2%
26
10.9%
1
0.4%
Total
Frequency
Percent
162
68.1%
48
20.2%
1
0.4%
No
Frequency
Percent
27
11.3
%
12
5.0%
62
26.1%
14
5.9%
0
0.0%
Yes
Frequency
Percent
15
6.3%
100
42.0%
34
14.3%
1
0.4%
Total
Frequency
27
162
48
1
11.3
%
1
0.4%
68.1%
20.2%
0.4%
24
10.1%
5
2.1%
0
0.0%
Less food
The same
as
Total
Frequency
Percent
Knowledge
about
carbohydrate
source foods
No
Knowledge
about protein
source
Percent
Knowledge
on using
iodized salt
during
pregnancy
Knowledge
food source of
Iron
No
Frequency
Percent
100.
0%
30
12.6
%
208
87.4
%
238
100.
0%
73
138
58.0%
43
18.1%
1
0.4%
162
68.1%
48
20.2%
1
0.4%
Frequency
39
26
0
Percent
3.4%
16.4%
10.9%
0.0%
30.7
%
Frequency
Percent
Frequency
Percent
1
0.4%
18
7.6%
10
4.2%
113
47.5%
8
3.4%
14
5.9%
1
0.4%
0
0.0%
Frequency
27
162
48
1
20
8.4%
145
60.9
%
238
Frequency
Percent
Total
Frequency
Percent
Red meat,
liver and
fish
Fruits and
vegetables
Total
73.5
%
63
26.5
%
238
100.
0%
88
37.0
%
150
63.0
%
238
26
10.9
%
27
11.3
%
8
Yes
Don’t know
100.
0%
175
22
27.
811
0.0
0*
2.6
06
0.4
56
3.013
37.
581
0.3
90
0.0
00*
Do not
know
Frequency
11.3
%
0
Percent
0.0%
3.4%
0.4%
0.0%
3.8%
3 months
Frequency
Percent
1
0.4%
2
0.8%
0
0.0%
0
0.0%
3
1.3%
6 months
Frequency
Percent
152
63.9%
47
19.7%
1
0.4%
Total
Frequency
Percent
162
68.1%
48
20.2%
1
0.4%
Frequency
Percent
26
10.9
%
27
11.3
%
16
6.7%
81
34%
12
5%
0
0
226
95.0
%
238
100.
0%
109
45.8
Frequency
Percent
0
0.0%
5
2.1%
0
0.0%
0
0.0%
5
2.1%
Frequency
Percent
11
4.6%
76
31.9%
36
15.1%
1
0.4%
124
52.1
%
Frequency
27
162
48
1
238
68.1%
20.2%
0.4%
72
30.3%
11
4.6%
0
0.0%
100.
0%
97
40.8
%
141
59.2
%
238
100.
0%
32
13.4
%
206
Percent
Duration of
Iron
supplementati
on
Knowledge on
effect of
maternal under
nutrition on
fetal weight
Do not
know
No effect
on fetal
weight
Low birth
weight and
still birth
Total
Knowledge on
maternal
complications
of under
nutrition
Knowledge on
balanced diet
20.2%
0.4%
8
1
0
100.
0%
9
No
Frequency
Percent
11.3
%
14
5.9%
Yes
Frequency
Percent
13
5.5%
90
37.8%
37
15.5%
1
0.4%
Total
Frequency
Percent
162
68.1%
48
20.2%
1
0.4%
No
Frequency
Percent
27
11.3
%
6
2.5%
19
8.0%
7
2.9%
0
0.0%
Yes
Frequency
21
143
41
1
Percent
8.8%
60.1%
17.2%
0.4%
Total
Frequency
Percent
162
68.1%
48
20.2%
1
0.4%
No
Frequency
Percent
Frequency
Percent
27
11.3
%
4
1.7%
23
9.7%
14
5.9%
148
62.2%
3
1.3%
45
18.9%
0
0.0%
1
0.4%
Percent
Knowledge
on fetal
complication
of maternal
under
nutrition
68.1%
Yes
23
86.6
%
238
100.
0%
21
8.8%
217
91.2
3.9
69
6.8
1
15.
807
0.0
15*
9.3
04
0.0
26*
2.4
06
0.4
92
1.7
03
6.3
6
Total
Frequency
162
48
1
68.1%
20.2%
0.4%
23
9.7%
18
7.6%
0
0.0%
yes
Frequency
Percent
11.3
%
9
3.8%
No
Frequency
Percent
18
7.6%
139
58.4%
30
12.6%
1
0.4%
Frequency
Percent
27
11.3
%
162
68.1%
48
20.2%
1
0.4%
Percent
History of
abortion
27
Those “*” at end of their P values are Significant at P value less than 0.05.
24
%
238
100.
0%
50
21.0
%
188
79.0
%
238
100.
0%
0.0
2*
15.
133
CHAPTER : FIVE
5.1. Discussion
Studies in Africa have indicated that at similar level of income, households in which women
have a greater control over their income are more likely to be food seller. Marital status of the
women is associated with house hold headship and other social and economic status of the
women that affect their nutritional status (15).In this Study 53.8% of participants has less
than 3000ETB and medium to poor dietary practice.
In this study 78.2 %( 186) eat only what they craves and only 18.1% has knowledge on eating
variety of foods. Research agrees with this findings; In Nigeria it shows They have limited
intake animal source food, fruit and vegetables. Studies show that nutritional knowledge
affects the quality of food intake and healthy choices of purchased food (18).In addition A
study in Tanzania, 19% of women in the age of 15-19 groups suffer from acute malnutrition,
due to inadequate intake of variety amount of dietary sources and 43% of household uses salt
that is inadequately iodized (17).In this study 87.4% has knowledge on using iodized salt.
This may be because of study area is on urban population majorly.
In our study about 73.5%of participant does not know food source of carbohydrates. It agrees
with DHS survey, conducted in Burkina Faso, Ghana, Malawi, Niger, Senegal and Zambia
show a greater proportion of mothers age 15-19 and 40-49 that exhibit chronic energy
deficiency (CED)(18).
In this study level of education, income, occupation, and knowledge on different dietary
sources has association with dietary habit. In line with this study . In Ghana, a study among
502 pregnant women. Socio demographics such as, educational, social class and geographical
location have also been found to correlate significantly with dietary habit and hence, nutrient
intake especially among pregnant women reported that pregnant women with higher family
income and high level of formal education tended to consume on notorious diet with greater
frequency than poor groups (22).
In This study employment has significant association with dietary habit (P=0.00). In line with
this study other study shows, Women’s employment increase household with consequent
benefit to house hold nutrition in general and the women’s nutritional status in particular
(19). In this study residency place has no association with dietary habit, but contrary
According to the Nigeria Demographic and Health Survey, conducted in 2008, the
micronutrient consumption pattern of mothers in urban areas was better than the intake of
rural women (15).This may because of country variation.
25
5.2. Conclusions
Majority of women have poor dietary practice. Education, income, knowledge about different
food is significant association with dietary practice. Majority of study participants did not
take additional meal during pregnancy. Skipped one of their regular meals. About 51.2%
have fair knowledge on variety food eating. Majority of them has no good nutritional
practice. About 67.8 of women have medium regarding dietary practice.
5.3. Recommendations
For Stakeholders: Since their dietary practice is medium to low JMC,Jimma Zone health
offices and other stakeholders have to give awareness creation for mass community about
nutrition of pregnant women
For health Professionals: Health professional working in the study area and similar setting
have take training regarding counseling pregnant women on preparing locally available food
appropriately to combat the problem of malpractice among community
Health extension workers: We recommend health extension workers in the area to teach
pregnant women appropriately about feeding during pregnancy
26
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31
ANNEX: QUESTIONNAIRE
JIMMA UNIVERSITY
INSTITUTE OF HEALTH
FACULTY OF HEALTH SCIENCES
School of midwifery
Annex one: Participant information sheet and consent form
I: Participant information sheet
Title: dietary practice and associated factors among pregnant women in jimma town public
health facilities, Jimma, south west Ethiopia, 2022 .
Principal investigator: Dureti Kebede (BSc midwife student)
Introduction: Good morning/good afternoon: Hello! My name is_______________ .I am
here today to collect data on dietary practice and associated factors among pregnant women
in Jimma town public health facilities, Jimma, south west Ethiopia, conducted by Dureti
Kebede who is BSc student in midwifery.
Purpose: The purpose of this study is to assess dietary practice and associated factors among
pregnant women in Jimma town public health facilities, Jimma, south west Ethiopia,
Procedure and participation: You are kindly asked to take part in this study and to respond
genuinely. Your cooperation and willingness is greatly helpful in identifying problems related
to the issue. The data collector will read the questionnaire for you to respond to those items
This questionnaire may take you a maximum of 15 to 20 minutes. Your Participation is
voluntary and you are not obligated to answer any question you do not wish to answer.
Confidentiality: Your personal identifiers that could be confidential to you like your name
will not be written in this form and will never be used in connection with any information
you provide. All information provided by you will be kept strictly confidential
Benefit: your benefit from the study will come with the possible advantages from the
recommendations that will be drawn based on the findings of the study.
Risk: There will not be possible risk associated with participating in this study.
32
Results Dissemination: the findings of the study will be disseminated to different concerned
bodies as well you can find it with soft and hard copy by contacting the principal investigator
by the address given below.
Freedom to withdraw: If you feel uncomfortable with the question, it is your right to drop it
any time you want. Again, you can withdraw from the study at any time you wish to
withdraw
Person to contact: if you have any concern, please feel free to contact the principal
investigator any time you wish to contact.
If you want more information and check about this project, you can contact with:
Principal investigator name and address: Dureti Kebede/ email: Tel. +251
II: Participant consent form
Title of the research: ‘‘dietary practice and associated factors among pregnant women in
jimma town public health facilities, Jimma, south west Ethiopia, 2022 ’’
I have been well aware of that this research is undertaken as a partial fulfilment of BSc
degree in midwifery which is fully supported and coordinated by the School of midwifery,
faculty of health sciences, and the designate principal investigator is Dureti Kebede. I have
been fully informed in the language i understand about the research project objectives
I have been informed that all the information I shall provide will be kept confidential. I
understood that the research has no any risk and no composition. I also knew that I have the
right to withhold information, skip questions to answer or to withdraw from the study any
time I have acquainted nobody will impose me to explain the reason of withdrawal.
I have assured the right to ask information that is not clear about the research before and or
during the research work and to contact: Principal Investigator’s Name: Dureti Kebede
Tel: +251
I have read this form, or it has been read to me in the language I comprehend and understood
the condition stated above, therefore, I am willing and confirm my participation by signing
the consent.
Agreed to participate in the study (tick “√”)
Yes
No
Questionnaire
33
Part I: Sociodemographic characteristics of the participants
Instruction: please indicate the choice of the participants by encircling from the given
options or writing on the space provided for each item
S.no Item
001 Age
002 Residence
003
Ethnicity
004
Religion
005
Level of education
006
Marital status
007
If married, partners educational
status
008
Occupational status
009
010
Family size
Monthly family income
Options
__________________
1. Urban
2. Rural
1. Oromo
2. Amhara
3. Tigray
4. Gurage
5. Keffa
6. Others. Specify___________
1. Muslim
2. Christian
3. Others. Specify ___________________
1. Illiterate
2. Read and write
3. Primary school completed
4. Secondary school completed
5. College/university graduate
6. Secondary degree and above
1. Single
2. Married
3. Divorced
4. Widowed
1. Illiterate
2. Read and write
3. Primary school completed
4. Secondary school completed
5. College/university graduate
6. Secondary degree and above
1. Employed (gov’t/non gov’t)
2. Self employed
3. Hose wife
_________________
________________
34
Part II: Obstetric characteristics of the participants
Instruction: please indicate the choice of the participants by encircling from the given
options or writing on the space provided for each item
S.no Item
011 How many pregnancies have you ever had?
012 How many births do you have? with gestational age of more than 28
weeks
013 Do you have history of abortion?
014
015
016
If yes to question number 013, how many times?
How many antenatal visits do you have for the current pregnancy?
Gestational age in weeks
Options
___________
____________
1. No
2. Yes
__________
___________
____________
Part III: Knowledge of the participants on dietary practice
Instruction: please indicate the choice of the participants by encircling from the given
options for each item
S.no Item
Options
017 Knowledge on eating variety food
1. Variety of food
2. Only what she craves
3. Don't know
018 Knowledge on increasing amount
1. More food
of food during pregnancy
2. Less food
3. The same as
019 Knowledge on food source for
1. Red meat, liver and fish
iron
2. Fruits and vegetables
3. Don't know
020 Knowledge about carbohydrate
4. No
source foods
5. Yes
021 Knowledge about protein source
3. No
foods
4. Yes
022 Knowledge on using iodized salt
3. No
during pregnancy
4. Yes
023 Knowledge on duration of Iron
4. Do not know
supplementation
5. 3 months
6. 6 months
024 Knowledge on effect of maternal
5. Do not know
under nutrition on fetal weight
6. No effect on fetal weight
7. Low birth weight and stillbirth
025
026
Knowledge on fetal complication
of maternal under nutrition
Knowledge on maternal
3. No
4. Yes
3. No
35
complications of under nutrition
Knowledge on balanced diet
4. Yes
027
4. No
5. Yes
Part IV: Dietary practice of pregnant mothers
Instruction: please indicate the choice of the participants by encircling from the given
options for each item
S.no Item
028 Addition of at least one additional meal from non- pregnant diet
029
Eating 2 to 3 servings of meat, fish, nuts or legumes per day
030
Eat 2 to 3 servings of dairy (milk, eggs, yogurt, and cheese) per day
031
Eat 2 servings of green vegetables; 1 serving of a yellow vegetable
per day
Eat 2 to 3 servings of fruit per day
032
033
034
Eat 3 servings of whole grain breads, cereals, or other high-complex
carbohydrates
Use Iodized salt
035
Taking Iron supplement tablets in the current pregnancy
036
Alcohol use and smoking in the current pregnancy
037
Decreasing coffee use in the current pregnancy
038
Avoiding one or more food type during pregnancy
039
Avoiding at least one meal from non-pregnant state
36
Options
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
1. No
2. Yes
37